How might public health access and exchange patient-level data more efficiently and effectively using FHIR to deliver the greatest net benefit overall? This Priority Area will help to lay the groundwork to help provide more complete and up to date data to public health that would not be available easily under existing data channels. It will:

  • Identify common requirements and assess various FHIR-based paradigms for accessing and exchanging patient-level data in EHRs.
  • Identify building blocks and opportunities for collaboration and accelerated development with industry.
  • Demonstrate ways through which FHIR can help support public health action and improve the quality and consistency of public health data shared nationwide while saving time, money, and effort
  • Inform a strategic roadmap to help align and advance public health adoption of FHIR moving forward.

Project Champions

Gillian Haney (Council of State and Territorial Epidemiologists), Michelle Barber (Oregon Health Authority), and Steven Hill (Cerner)

Current Status

The Project Champions are working to refine the goals and approaches for the Priority Area. The initial meeting of the Project Team is expected to be scheduled for early June.


  • Use the existing Health Record Exchange (HRex) to explore options for sharing data with public health and returning actionable information to care providers
  • Describe a process for assessing the interoperability needs of a use case and identifying optimal FHIR-based approaches for achieving data sharing

Building Blocks

  • Da Vinci Health Record Exchange (HRex) FHIR IG (particularly the Approaches to Exchanging FHIR Data page)
  • Existing public health FHIR IGs such as MedMorph, Vital Records, Case Reporting, Immunization Forecasting, VCI Smart Health Cards, Healthcare Associated Infections, Electronic Referrals and Maternal & Infant Health


  • Review the existing public health uses cases and the approaches taken to utilize FHIR
  • Using a small number of example use cases, assess the potential FHIR paradigms to describe an optimal approach (e.g., RESTful query, subscription, messaging)
  • Where possible, implement small scale pilots to test one or more optimal approaches to fulfill a use case
  • Test use cases may include:
    • Patient race and ethnicity
    • Antibiotic usage and microbial resistance
    • Negative follow ups (e.g., return to school)
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