5.2.1 FHIR Resources

There is no specific FHIR Resource applicable for Synoptic Cancer Reporting, and the diversity of information required in different types of cancer makes it very difficult to use a single FHIR resource; this leads to the need for a specific FHIR resource for every kind of cancer.

Creating a new FHIR resource is a collaborative and iterative process. It requires significant engagement with the healthcare community to ensure that the resource is both technically sound and clinically relevant. The ultimate aim is to facilitate interoperability and improve patient care by representing health data in a standardized and meaningful way.

These are the typical steps involved in the creation of a new FHIR Resource:

1. Identification of Need:
   1. Consult with oncologists, pathologists, and IT professionals. Review current FHIR resources to ensure there's no overlap with existing structures concerning synoptic cancer reporting.
2. Initial Research:
   1. Gather templates and standards currently used in synoptic reporting. Identify unique data elements necessary for the report.
3. Drafting the Proposal:
   1. Define the data elements, structure, and relationships of the new resource. Document the purpose and use cases of the proposed resource.
4. Community Engagement:
   1. Share the draft proposal with relevant FHIR workgroups to gather feedback. Refine the proposal based on the insights and suggestions from the community.
5. Development & Prototyping:
   1. Utilize FHIR development tools to model and prototype the new resource. Ensure that it aligns with existing FHIR guidelines and conventions.
6. Documentation:
   1. Provide detailed information about the resource, including its purpose, structure, and examples, to assist future implementers.
7. Formal Review:
   1. Submit the resource for review by official FHIR governance bodies. Address any suggestions or concerns raised by HL7 committees.
8. Trial & Feedback:
   1. Implement the new resource in real-world healthcare settings. Gather feedback from these implementations and refine the resource accordingly.
9. Standardization Process:
   1. Push for the inclusion of the resource in future FHIR standards. Engage with the FHIR community and stakeholders to promote its adoption.
10. Maintenance:
    1. Regularly review and update the resource, considering new clinical insights or technological advancements.
11. Promotion & Training:
    1. Develop training materials or sessions for the new resource. Engage with health IT and clinical communities to increase awareness and understanding.

The decision to use FHIR resources for this Use Case will provide great specificity and level of detail in the captured data and great uniformity between implementations. However, the process of creating resource specifications from scratch is slow, taking many months to develop each resource. The stability of the resources, only updating in new FHIR versions and not independently, also complicates the need for continuous improvement or adaptations to new requirements.