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The FAST Initiative has made great strides, evolving the FAST solutions from proposed to recommended status.  Harnessing the knowledge and expertise of a wide range of stakeholders and subject matter experts across the industry, the team is working to ensure the FAST solutions align with regulatory drivers and the needs of the industry at large.  The following FAST solutions have been vetted through the FAST Technical Learning Community, as well as a series of 5 Subject Matter Expert Panel Sessions and a full day interactive ONC FAST Workshop.  Now the FAST Initiative is ready to shift its focus and progress its work into actionable and implementable industry-wide solutions, through standards development and recommended best practices and processes. 

This dashboard provides a brief overview of FAST recommended solutions and a snapshot of current solution status.  Choose from the following menu to view supporting materials and links to resources for each solution:

  • Solution documentation and presentations
  • HL7 Connectathon track information
  • HL7 project artifacts
  • In the future, technical doumentation and resources to support implementers

Solution Summary



Targeted Path Forward

A FHIR based approach for building a national endpoint directory capability, focused on easing the ability to identify endpoints currently located in multiple locations by proposing a federated model that uses a single authoritative source of truth. Aims to ensure accuracy of the endpoint information and reduce burden to keep the information up to date.

HL7 Implementation Guide: Update Validated Healthcare Directory (VHDir) for US Realm

Targeting HL7 September 2022 STU Ballot

HL7 Implementation Guide: Endpoint Query

Targeting HL7 September 2022 STU Ballot

HL7 Implementation Guide: Attestation and Validation

Targeting HL7 September 2022 STU Ballot

Build Asset: Endpoint Directory

Development of a scalable, easy to adopt, core security solution, using Unified Data Access Profiles (UDAP), focused on how to manage the security of millions of patient records, payers, providers and public health agencies information sharing needs at scale. Aims to provide the industry with scalable security solutions, that ensure the requestor of information using FHIR based information is appropriately authenticated and has the authorization to see the requested data. 

HL7 Implementation Guide: Scalable Registration, Authentication, and Authorization for FHIR Ecosystem Participants

HL7 Sept 2021 STU Ballot

Leverage most up to date industry considerations to build on best practices and recommendations for identity matching services and KPIs, and identity assurance for an appropriate, national, standards based approach for individual identity matching. 

HL7 Implementation Guide: Improving identity assurance and patient match quality through interoperable Digital Identity and Patient Matching capabilities

HL7 May 2022 STU Ballot

A scalable solution leveraging existing internet name server and routing mechanisms to enable reliable exchange regardless of whether the transaction is dynamic point-to-point or via intermediaries.

HL7 Implementation Guide: Exchange with or without Intermediaries

HL7 Jan 2022 STU Ballot

A Testing & Certification approach focused on ensuring standard conformance for scalable FHIR based solutions, including requirements for the development of an automated FHIR testing platform.

Finalizing Proposed Solutions Path Forward

Focused on enabling a high-volume of FHIR transactions to be consistently and predictably exchanged in a hybrid exchange model. Considering FHIR standards for intermediary-to-intermediary exchange and intermediary performance guidelines/service level agreements (SLAs).

Finalizing Proposed Solutions Path Forward

Focused on solving issues caused by the use of multiple versions of FHIR across the healthcare ecosystem. Considering content to be included in the recommended National Healthcare Directory solution (above), a request to HL7 for a FHIR version translation capability to be part of the core FHIR spec, and support in the recommended Testing & Certification Platform solution (above) for version-related testing, capability statement-related testing, and confirmation that FHIR versions are stated in exchanged artifacts.

Finalizing Proposed Solutions Path Forward

Development of an incremental approach to test and pilot FAST solutions 

Development of an incremental
approach to test and pilot FAST
solutions including:

  • Connectathon testing
  • Development of a “FAST Pilot
    Toolkit/Sandbox” to be leveraged by FHIR
    Accelerators and other FHIR initiatives
  • Demonstration projects and multistakeholder pilots as needed


FAST Organization & Structure

With ONC serving as the convener, the FAST collaborative adopted a taskforce model to leverage the knowledge and expertise of various SMEs across the healthcare continuum. The seven Tiger Teams aim to develop proposed approaches to address the barriers to FHIR-based solutions scalability, through additional standards work, processes, or proposed regulatory measures.

Two FAST Chief Architects ensure the taskforce is focused on the industry’s most relevant infrastructural challenges and solutions.

The FAST Coordinating Committee and the Executive Steering Committee are comprised of a public-private mix of significant, top industry leaders that review and further guide the taskforce work.

A large technical learning community (TLC) provided feedback and validation as part of the solution development process.

FAST Work & Process

  • 15 ecosystem use cases, developed by the FAST Ecosystem Use Cases Tiger Team, reflect the the infrastructural needs for the industry functional use cases to scale and ensure an efficient and scalable model to support data exchange and accelerated FHIR adoption.
  • A gap analysis identified 35 technical and regulatory barriers that need to be overcome, and 15 core capabilities required to develop scalable FHIR solutions.
  •  11 proposed solutions were developed across five Tiger Teams: Directory, Versions and Scale; Identity; Security; Exchange Process; Testing & Certification 
  •  Over 1900+ people attended six interactive TLC webinars and various industry meetings and provided relevant feedback which helped refine the proposed solutions to their current status.