| Type |
Standard / Implementation Specification |
Standards Process Maturity |
Implementation Maturity |
Adoption Level |
Federally required |
Cost |
Test Tool Availability |
|
Standard
|
|
Final
|
Production
|
 |
Yes
|
Free
|
No
|
|
Implementation Specification
|
|
Final
|
Production
|
 |
Yes
|
Free
|
No
|
|
Implementation Specification
|
|
Final
|
Production
|
 |
Yes
|
Free
|
No
|
|
Implementation Specification
|
|
Balloted Draft
|
Pilot
|
 |
No
|
Free
|
No
|
|
Standard
|
|
Balloted Draft
|
Production
|
 |
No
|
Free
|
Yes
|
= Federal FHIR Action Plan: Marks standards for coordinated federal adoption. See Appendix V: Federal FHIR Action Plan for more details.
| Federal FHIR Action Plan Alignment |
HL7® FHIR® Release 4.0.1 (R4) - The baseline FHIR standard version provides foundational FHIR Resources that are stable, mature, and backwards compatible, referred to as “Normative”. These resources form the base standard and are constrained into FHIR Profiles by implementation specifications, ensuring consistent implementation necessary for interoperability.
- While a newer version, FHIR Release 5 (FHIR R5), has been balloted, all current implementation specifications adopted by federal regulations are based on FHIR R4.
- The standards community is actively working towards releasing FHIR Release 6 (FHIR R6) in 2026. FHIR R6 is expected to include more FHIR Resources designated as Normative.
- Unless there is a compelling need for a use case that requires functionality exclusive to FHIR R5, it is recommended that any new standards development activities and implementations continue to be based on FHIR Release 4.0.1 to ensure alignment with current federal regulations.
- Referenced in Federal Rulemaking: ASTP Cures Act Final Rule; CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F)
HL7® FHIR® CDS Hooks Implementation Guide (CDS Hooks IG) - This implementation specification describes a “hook”-based pattern for invoking or triggering an external decision support from within a health IT solution, including Certified Health IT. This pattern enables clinicians to integrate results from a clinical decision support (CDS) tool directly into their workflow or to launch an interactive application for clinical decision support.
- The CDS Hooks IG provides a more advanced interaction than simply invoking a third-party application, making it an advanced use of FHIR APIs. Implementing CDS Hooks requires clients, typically Certified Health IT systems, to support "hooks" at specific points within the electronic health record (EHR) workflow to facilitate seamless integration.
- Organizations interested in implementing CDS Hooks should evaluate the CDS Hooks IG to enable native or third-party applications, provided their Certified Health IT system supports CDS Hooks as a client and includes the necessary "hooks" within the workflow.
|
| Limitations, Dependencies, and Preconditions for Consideration |
Applicable Security Patterns for Consideration
|
|
|
|
Submitted by kwboone on
I know of relatively few…
I know of relatively few implementations of SOAP based messages, but rather a large number of the HTTP based requests.