Doctors looking at laptop

MITRE Researchers Blaze a Shortcut to Health Data Sharing and Analysis

By Beverly Wood

Interoperability is a big word but a simple concept. If health providers all had computer systems and software that could quickly exchange patient health records, patients could be treated faster and more efficiently. MITRE’s developed tools for that.

Behind the exchange of health data—which is critical to improving patient care—are the standards, tools, and developers that make data sharing possible.

MITRE has a deep well of experience in health IT, collaborating with other healthcare stakeholders to advance data sharing and analysis and system interoperability.

Interoperability is a critical goal of the government and the entire community—because it provides the connections among software and systems that allow data to be shared in useful ways. For example, through interoperable systems, your doctor may access your patient records from other providers around the country, quickly and easily. This approach will also help researchers to analyze data from millions of patients to find which treatments work best for various demographics.

Those kinds of outcomes are why MITRE has worked for many years on the standards and technology that are helping the community share data more efficiently.

One of our most recent contributions is “FHIR Shorthand 2.0,” which was just approved as a standard by both Health Level 7 International (HL7) and the American National Standards Institute.  

How will this new tool support interoperability?

“The adoption of Fast Healthcare Interoperability Resources (FHIR®)—pronounced “fire”—as a framework for interoperability has helped developers more easily create new health-data tools and applications,” explains Andre Quina, principal investigator of MITRE’s Oncology Standard Health Record research program. “But FHIR is only a framework.

“To solve a specific use case requires added information provided by an implementation guide. Each guide provides in-depth technical details, such as profiles, extensions, value sets, and examples, as well as narrative text, graphics, and workflows that specify how FHIR should be applied.”

Creating each guide can be a difficult, slow process—that’s where FHIR Shorthand™ (also called FSH) comes in.

“We developed FSH to make the development much easier and faster,” adds Mark Kramer, an expert in digital health, who co-developed FSH with MITRE’s Chris Moesel. “It’s an agile, scalable method for the creation and maintenance of implementation guides. This tool will support broader adoption of FHIR and lead to more data sharing applications.” 

Our approach aligns with such government initiatives as the 21st Century Cures Act. This legislation directs health organizations to use FHIR to advance interoperability and support the access, exchange, and use of electronic health information.

100,000 Downloads for Better Healthcare

“We created this tool out of necessity because we needed a better way to quickly and collaboratively develop the implementation guide for the minimal Common Oncology Data Elements (mCODE) research project,” Quina says. 

mCODE is a core set of non-proprietary, open-source structured data elements for oncology that establishes minimum recommended standards for the structure and content of health record information across use cases and users.

The goal of mCODE is to improve the overall quality and consistency of cancer data available to clinicians, patients, researchers, and other stakeholders in the fight against cancer. It was created and continues to evolve with the help of a large community, funded primarily by MITRE’s independent research and development program.

“mCODE is a large project with many moving parts, and we’re working with dozens of stakeholders providing requirements and input,” Quina says. “We needed an agile way to create mCODE and adapt to changes. Now we’ve made mCODE and FHIR Shorthand available to the whole community through open source.

“Chris Moesel’s team developed productivity tools, including learning resources, an online code playground, and a plug-in to a Virtual Studio Code [a popular development environment], which greatly shortens the development time and makes it easier to apply FHIR to use cases.”

The result?

“From the moment we introduced FSH to the health IT community, developers began testing it and giving us feedback. Today, hundreds of FHIR interoperability projects are using it. We just passed 100,000 downloads,” Kramer adds. “FSH was originally developed for mCODE and cancer, but now it's used to help model vaccinations, patient identity, death records, vital signs, and many other health domain areas.”

And with every download comes the promise of better outcomes in cancer care and healthcare.

Read more information about FHIR ShorthandmCODECodeX (the member organization that advances mCODE use cases), and other tools.