FHIR Versions

• Incremented when HL7 publishes FHIR as an updated specification, e.g. a Trial Use or Normative version of FHIR
• The first Trial Use was version 0
• FHIR Release 2, Draft Standard for Trial Use (DSTU), ) was version 1
• FHIR Release 3, Standard Trial Use (STU) is version 3 (skipped '2' to align the major numbers at implementer request)

• Increments every time a breaking change is implemented in a version
• Each time a new publication is released, it resets to 0 in the publication, and 1 in the development branch
• Since HL7 has not implemented any substantial changes as technical corrections to a published specification, these versions of FHIR always have a version number X.0.n.r
• Because the development version is the subject of ongoing analysis, debate, ballot and repeated alterations, breaking changes are to be expected in STU content

• Increments every time an official snapshot release contains one or more substantive changes
• Resets to 0 any time the major version changes
• Snapshot releases are produced approximately 6 weeks in advance of the 3 annual HL7 working group meetings (and their associated connectathons), though they can also be produced for other major connectathons or to meet implementer requirements.

Original Proposal, labelled as RfH

Resources for Healthcare (RFH) defines a set of "resources" that represent granular clinical concepts. The resources can be managed in isolation, or aggregated into complex documents. This flexibility offers coherent solutions for a range of interoperability problems.

RFH is based on three major parts:

• Exchange Specification – Specifies the technical resource formats and exchange protocols.
• Data Dictionary – Provides requirements tracking, formal computable definitions, and mappings for the data elements.
• Workflow Management – Maps the resources to real world business events.

Technically, RFH is designed for the web; the resources are based on simple XML, with an http-based RESTful protocol where each resource has predictable URL. Where possible, open internet standards are used for data representation.

Reference: http://hl7.org/fhir/2011Aug/

First version labelled as `FHIR`

Fast Health Interoperability Resources (FHIR) is a standard to support interoperability and availability in the healthcare industry. It defines how healthcare information can be exchanged between different computer systems regardless of how it is stored in those systems. It allows healthcare information, including clinical and administrative data, to be available securely to those who have a need to access it, and to those who have the right to do so for the benefit of a patient receiving care. The standards development organization HL7® (Health Level Seven®) uses a collaborative approach to develop and upgrade FHIR.

The basic building block in FHIR is a Resource. All exchangeable content is defined as a resource. Resources all share the following set of characteristics:

• A common way to define and represent them, building them from data types that define common reusable patterns of elements
• A common set of metadata
• A human-readable part

Reference: http://hl7.org/fhir/2012May/

FHIR is a framework of next generation standards developed by High Level 7 (HL7). It carries the best features of HL7’s Version 2, Version 3, and CDA® product lines. It leverages the latest web standards and helps in applying a tight focus on implementability.

Reference: http://hl7.org/fhir/DSTU1/

A substantial amount of changes are made in this version to address various modules in the healthcare industry and renamed terminologies, such as:

• General: Maturity framework was introduced.
• New data types: markdown, Annotation,
• New resources: Account, ImplementationGuide, TestScript
• Renamed: Contraindication -> DetectedIssue, MedicationPrescription -> MedicationRequest, QuestionnaireAnswers -> QuestionnaireResponse
• Changed: Almost all resources - add, remove elements, change types, references, definitions & value sets, re-order elements, provide much more documentation and new examples
• Implementation Guide: Moved Argonaut content out

Reference: http://hl7.org/fhir/DSTU2/

http://build.fhir.org/history.html

R3 is a complete overhaul of the specification from R2.

Major changes:

• Reorder many resources and improve their definitions and bindings (Quality Assurance work)
• Add draft resources AdverseEvent and GraphDefinition
• Change to the way discriminators work in profiles (for profile/tooling authors)
• Consolidation of Version management issues into a single Version Policy page, and update to current policy
• Add rules about how missing data in search
• Rename the "Conformance" resource to "CapabilityStatement"

Reference: http://build.fhir.org/history.html

This version includes huge changes from the previous version and offers the first normative content for the data standard.

Normative content enables health IT developers to implement FHIR efficiently. It has been finalized in terms of development after it has passed through all six stages of the FHIR maturity model. This maturity model is set up by HL7 to ensure that the content has gone through extensive levels of review states and tested to resolve real-world problems in the healthcare industry.

Reference: https://healthitanalytics.com/news/hl7-releases-fhir-version-4.0-for-healthcare-interoperability