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FAST Proposed Solutions
The proposed solutions depicted in the diagram have been developed by each of the respective Tiger Teams.
These proposed solutions were already presented to the FAST Technical Learning Community for feedback which has been incorporated as appropriate in the current version the our proposed solutions.
The next step is where you come in. We are convening SME Panel Sessions to further refine, validate and determine best way to operationalize each of these proposed solutions.
Below is a full list of the proposed solutions and the form the Tiger Team believes may be the best format for use by the industry.
What's the end goal?
Directory: focused on easing ability to identifying endpoints, which currently are located in multiple locations
A National Solution for FHIR Endpoint Discovery
Output format(s) under consideration:
- FHIR Implementation Guide detailing maintenance, validation and retrieval of information from a validated directory
- Recommendation for a central, federally managed, validated provider directory
- Recommendation for federal rules requiring participation in the central directory
Security: solutions focused on determining how to manage permissions and security of millions of patients, payers and providers
UDAP Trusted Dynamic Client Registration | UDAP Tiered OAuth | UDAP JWT-Based Client Authentication| UDAP JWT-Based Authorization Assertions
Output format(s) under consideration:
- Implementer guidance that applies current rules and techniques to FHIR use. Potentially a FHIR IG or other form of guidance
Identity: focused on enabling unique identification of patients/members for requesters Mediated Patient Matching | Collaborative Identifier for Patient | Distributed Identity Management | Networked Identity Management Output format(s) under consideration: - Best practices for Identity Matching Services
- Recommended KPIs for Identity Matching Services
- Best practices for Identity Assurance
- FHIR Implementation Guide for use of Collaborative Identifiers in FHIR queries and pre-query matching
| Scale: focused on enabling a high-volume of FHIR transactions to be consistently and predictably exchanged in a hybrid exchange model Requirements for FHIR RESTful Exchange Intermediaries Output format(s) under consideration: - HL7 FHIR standard for intermediary-to-intermediary exchange
- FAST guidelines for intermediary performance (SLA)
| Exchange: Focused on enabling consistent and reliable transaction exchange
Reliable Routing with Metadata Across Intermediaries
Reliable Routing Across Intermediaries Using Destination SpecificOutput format(s) under consideration:
- Standard routing metadata definitions to support exchange involving intermediaries, which can be used for any exchange method
- Recommendation for capturing provenance information related to intermediary exchange
Testing & Certification: focused on ensuring standard conformance ONC FHIR Testing and Certification Output format(s) under consideration: - Requirements for the development of a FHIR testing platform, captured in an RFI to industry participants
- Recommendation to establish an ONC certification program for FHIR implementers
| Versioning: focused on solving issues caused by the use of multiple versions of FHIR across the healthcare ecosystem Supporting Multiple Production Versions of FHIR Output format(s) under consideration: - Content in the Directory FHIR IG (above)
- Request to HL7 for a FHIR version translation capability (to be part of the core FHIR spec)
- Support in the FAST Testing & Certification solution (testing platform) for:
- version-related testing
- capabilityStatement-related testing
- confirmation that FHIR versions are stated in exchanged artifacts
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