What is the FHIM?

FHIM is the "Federated Health Information Model."  It is a complex but elegantly designed framework (including information and terminology models) to help enable widespread health information exchange.  It can be used locally, regionally, and globally.

The FHIM was developed within the U.S. Government by the former Federal Health Architecture (FHA) Program, which was located at the Office of the National Coordinator for Health IT (ONC) in the Department of Health and Human Services.  Over $5 million and more than 200,000 person hours were spent building and using the FHIM when the FHA was sunset in September 2019.  Early in 2019 the US Government selected The Open Group as the new FHIM Steward.  

The FHIM is a single integrated model composed of health- and healthcare-related content explicitly aligned with other industry information models and standards.  The FHIM address two persistent gaps:

  • The “too many standards” problem in healthcare, and

  • Data inconsistencies within and between standards

The FHIM supports the exchange of meaningful, interoperable information, quickly and accurately and consistently, for the betterment of patient care.


A Common Information Model to Enable Interoperability

In healthcare, the primary barrier to standards agreement is more social and economic than technical.  Of course standards-making is not easy and requires on-going maintenance and governance.  However, it is obvious today that it is easier to create standards than to gain broad consensus on how to use them in a consistent and meaningful way.

The good news is that standards compatibility does not mean that everyone needs to use the same standard.  As long as standards are mapped to a common, logical, evidence-based information model, they can work together, regardless of the source.

The purpose of the FHIM is to map types of, and relations among, key health information and to bind terminologies to it, regardless of the source of terminology standards.

In so doing, the FHIM can be used to “harmonize” different health standards developed by different organizations.  The FHIM is extensible and thus agile to the certainty of change in this field.  In essence, the purpose and promise of the FHIM is to improve interoperability.  By using the FHIM Profile Builder (FPBTM) user interface (or Editor) and the Generator, one can easily build FHIR© profiles (and other standards’ profiles) that conform to US Core (for example) and that are widely reusable and meaningful.  In this way, the FPB provides a key solution to the “one exchange only” limitation for FHIR profiles.  


Person Centric Value Based Care Depends on Interoperability

Healthcare systems the world over are organizing to provide value-based care.  Many believe that value-based payment is the single most important lever to influence high quality and efficient person-centric health and healthcare.  Of at least equal importance, we know, is that patient-oriented, evidence-based measures need to have the property of “flow” or interoperability.  If value-based outcomes measures and, critically, the data and information that underlie them, cannot move with the patient, they are of limited use.