What Are HL7 Fast Healthcare Interoperability (FHIR) Accelerators?

Argonaut

The Argonaut Project is an implementation community launched in 2014 to advance industry adoption of open interoperability standards. The private-sector initiative includes health IT vendors and other healthcare stakeholders such as athenahealth, Allscripts, eClinicalWorks, Epic, Humana, and MEDITECH.

The Argonaut Project developed a first-generation FHIR-based application programming interface (API) and Core Data Services specification to enable expanded data sharing for EHRs and other health IT systems based on Internet standards and architectural patterns and styles.

In 2016, the Argonaut Project published the FHIR DSTU2 Data Query Implementation Guide and promoted support for SMART on FHIR, which laid the foundation for FHIR-based APIs across the healthcare industry.

The accelerator has continued to advance health data exchange through artifacts such as CDS hooks, bulk data, clinical notes, and US Core, which provides FHIR guidance for ONC's US Core Data for Interoperability (USCDI).

Da Vinci

The HL7 Da Vinci Project is a multi-stakeholder effort comprised of health plans, hospital systems, accountable care organizations (ACOs), and health IT vendors working to accelerate interoperability standards to support value-based care.

The project aims to minimize the development and implementation of one-off solutions between partners to help medical groups and health plans improve care quality, reduce hospital costs, and boost health outcomes.

Da Vinci use cases are interrelated, currently with five categories: quality improvement, coverage/burden reduction, member access, process improvement, and clinical data exchange.

The CARIN Alliance

The CARIN Alliance is a multi-sector alliance working with government stakeholders to overcome barriers in consumer-directed exchange.

Consumer-directed exchange occurs when a consumer or an authorized caregiver invokes their HIPAA Individual Right of Access and requests their digital health data from a HIPAA-covered entity via an application or other third-party data steward.

Members of the CARIN Alliance include risk-bearing providers, payers, consumers, pharmaceutical companies, consumer platform companies, health IT vendors, and consumer advocates.

The CARIN Alliance aims to advance the ability of consumers and authorized caregivers to easily access, use, and exchange their digital health information through non-proprietary application programming interfaces (APIs). 

For instance, the CARIN for Blue Button Framework aims to help health plans meet the CMS Blue Button 2.0 capabilities. The CMS Blue Button 2.0 project provides over 53 million Medicare fee-for-service beneficiaries access to electronic claims information.

CodeX

CodeX is a member-driven FHIR Accelerator working to enable interoperability to improve patient health.

CodeX use case projects are in the planning or discovery stages. Current use cases include collecting patient data for real-world-data clinical trials, matching patients with trials, registry reporting, radiation therapy treatment, hypertension management, and genomics data exchange.

In the oncology space, CodeX members are integrating and testing the minimal Common Oncology Data Elements (mCODE) FHIR Implementation Guide, an open standard language for cancer data.

GenomeX is a foundational domain dedicated to advancing genomic data interoperability within CodeX.

The GenomeX community, launched in August 2022, will design scalable pilots that use FHIR Genomics for multiple use cases, including FHIR Genomics Data Exchange, which designs and builds scalable FHIR Genomics interfaces to support interoperability of genomic data from laboratories to EHRs and genomic repositories, and FHIR Genomics Operations, which Supports access to complex genomic data through APIs so that developers can more easily populate data for genomic applications.

FAST

ONC founded the HL7 FHIR at Scale Taskforce (FAST) initiative in 2017 to accelerate the scalability of FHIR across the industry by defining a standard set of infrastructure solutions for prior authorization and authentication workflows, patient matching, and identity management.

The public-private partnership transitioned FAST to an official HL7 FHIR Accelerator in May 2022 to continue its FHIR scalability efforts.

While groups such as the Da Vinci Project develop health IT data standards to support specific use cases, FAST focuses on scalability approaches that healthcare organizations can leverage across use cases to simplify the deployment of FHIR in disparate environments.

Gravity

The Gravity Project seeks to identify coded data elements and value sets to represent social determinants of health (SDOH) data in EHRs. The project includes three specific social risk domains: food insecurity, housing instability and quality, and transportation access.

The Gravity Project worked with healthcare stakeholders such as health IT vendors, payers, providers, philanthropies, and federal and state government officials to develop a foundational elements framework for SDOH information exchange.

During an ONC webinar in March 2022, Greg Bloom, strategic advisor on community resources and engagement for the Gravity Project, noted that the framework is not a one-size-fits-all approach. Instead, it's a set of conceptual guidelines that can help shape initiatives' planning, design, implementation, and evaluation to facilitate social information exchange.

"These foundational elements include community readiness and stewardship, mission and purpose, values and principles, policy, legal, finance, measurement and evaluation, implementation services, technical infrastructure, and data standards, user support and learning networks, and governance," Bloom said.

Helios

Helios is an alliance of government, private sector, and philanthropic stakeholders focused on supporting the widespread implementation of FHIR APIs and applications to advance public health.

The accelerator intends to streamline data sharing across all levels of public health using the FHIR standard. Areas of focus include scalable data exchange for high-priority, cross-cutting use cases such as prenatal, birth, and postpartum outcomes.

"FHIR accelerators have had great success in engaging implementers as early as possible to help identify and overcome longstanding barriers to interoperability," Micky Tripathi, PhD, MPP, ONC's national coordinator for health IT, said in a press release when HL7 first launched Helios.

"The Helios alliance is a market-based implementation collaboration that will help to ensure FHIR development is coordinated and focused on real-world public health needs," Tripathi said.

Vulcan

The Vulcan FHIR accelerator, launched in August 2020, aims to support interoperability for clinical research. The group comprises representatives from government agencies, academia, health IT vendors, standards development organizations, patients, and industry consortiums.

Project Vulcan aims to bridge the gap between clinical care and clinical research to improve patient lives, decrease costs, and boost efficiency

The organization intends Vulcan to cultivate better collaboration between leaders in translational and clinical research fields and to define an international set of standards.

"Improving data sharing can bring significant benefits to medical research, which is often a time-intensive and costly process that unnecessarily delays progress in discovering treatments for medical conditions because researchers are unable to share critical information," Charles Jaffe, CEO of HL7 International, said in a statement at the time of Vulcan's launch.

As interoperability use cases continue to emerge, the HL7 FHIR accelerator program is set to support the standardized adoption of FHIR across the care continuum.