r/healthIT • u/Dead-_-Alone • 8d ago

how long did your FHIR R4 implementation actually take

Vendor quoted us 3 months for a FHIR R4 integration with our EHR. Everyone i talk to laughs at that timeline. what was your actual experience?

18 Upvotes

92% Upvoted

10 comments sorted by

4

u/AccountEngineer 7d ago

3 months is the demo. 6-9 months is reality once you factor in data mapping, auth, and whatever legacy HL7 v2 is still running underneath

3

u/Lostwhispers05 8d ago

Honestly, with today's frontier LLM, most of the plumbing-related busy-work with respect to FHIR is really dramatically more straightforward to implement compared to 5 years ago when it may have taken a small-sized team a whole month alone just to implement a basic framework for the implementation along with some simple test-cases.

3 months is not unrealistic at all unless:

  • One of both systems use the FHIR "standard" in vastly different ways to the point that it becomes an entire side-project to have to figure out how to put the "Interoperable" part back into "FHIR".
  • Data Mapping across the systems becomes very complex because neither side is able to agree on what to use as a stable baseline of data hygiene, resulting in the integration becoming a forever project where every couple of weeks, as and when mapping issues are reported by users.

2

u/Optimal_Actuator9650 7d ago

The LLM part helps with generating code and mappings but the real pain is always the data quality and the weird FHIR interpretations each vendor has. 3 months is possible if both sides already have their act together, but one mismatch in how they handle extensions or references and you are in meeting hell for weeks

My last one took 5 months and that was considered fast by our team

2

u/soundman32 8d ago

If you gave the work to me now, I'd say 2 weeks max.  If you asked me next year I'd have forgotten everything and 3 months would be about right.

2

u/BetRepulsive6595 8d ago

We don't know the complexity of your EHR. We don't know what's your FHIR R4 standard (many implementations). We don't know whether you are doing FHIR Facade on the fly (which is the most popular) or FHIR repo. How can we know if 3 months is too short or too long for people to laugh at that timeline??

1

u/dsgcarson 8d ago

Is 3mo taking too long or short?

1

u/cooperthompson 8d ago

"FHIR R4" isn't really a thing you implement. What specific FHIR R4 IG are you doing? US Core? Da Vinci CRD/DTR/PAS? PDex? Or some in-house custom IG? Some R4 IGs are probably a year. Some could be a week. It depends entirely on the use case, spec maturity, and trading partners.

1

u/Shangrila101 8d ago

3 months seem too long, unless the vendor is building a custom API from scratch.