Software connecting to the MHR using FHIR will be required to adopt the new standards while legacy tech will be retired in a staged transition. Vendors ‘would be foolish’ not to make the move now, said the ADHA.
The Australian Digital Health Agency will mandate the use of national interoperability standards for software connecting to My Health Record using FHIR and begin retiring legacy technologies in what it says is the next major step towards a more connected digital health system.
The reforms, announced today, will require relevant software systems connecting to My Health Record via Fast Healthcare Interoperability Resources (FHIR) to comply with AU Core and AU CDI (Australian Clinical Data for Interoperability).
Together, AU Core and AU CDI define the core clinical information that should be exchanged and how it should be represented consistently across different healthcare software systems.
The Agency will also retire a range of outdated Healthcare Identifiers and My Health Record conformance profiles, and introduce staged end-of-access dates for older versions of the Healthcare Information Provider Service (HIPS), the Agency’s software used by health services and clinicians to view and interact with My Health Record.
ADHA chief digital officer Peter O’Halloran told HSD exclusively that the timing of the announcement reflected the sector’s readiness to move from designing interoperability standards to implementing them at scale.
“The work through Sparked is sufficiently compressed to the point that we’re now starting to talk about mass implementation across the sector,” Mr O’Halloran told HSD.
“We’ve seen a number of individual chunks being implemented, which is great.
“We’re now at the point where later next year we’ll be launching My Health Record on FHIR. It will no longer be this sort of strange vapourware thing. It’ll actually be real, live in production with real data.”
Mr O’Halloran said recent legislative changes to healthcare identifiers, together with growing concerns about clinical safety, privacy and cyber security, had also made the reforms timely.
“We need to upgrade the clinical safety of these products,” he said.
“We need to ensure that privacy and cyber security is addressed. We’ve seen too many breaches. We’ve seen too many risks being raised, and we’ve seen too much pushback from some vendors to say it’s not a priority.
“Consumers and clinicians are saying it is a priority, and we need to listen to them.”
Mr O’Halloran said AU Core and AU CDI would become Australia’s national interoperability baseline for any FHIR-based connections to My Health Record.
“The goal is simple, to make health information easier to share safely, securely and consistently across the system,” he said.
“These changes give the sector a clear pathway to modern interoperability and help lay the groundwork for more connected care for Australians.”
FHIR is the modern international standard increasingly being adopted to exchange healthcare information between clinical software systems.
Mr O’Halloran said the changes were about much more than replacing outdated technology.
“We’re saying these are the standards you need to be conformant with,” he said.
“What we’re also doing is, as people go through the new conformance process, we’re being quite strict in assessing it.”
He warned that software vendors ignoring the transition risked leaving their customers unable to comply with the government’s expanding information-sharing requirements.
“With Share by Default coming in … health services and individual clinicians will not be able to be paid if they can’t share data with My Health Record in a manner that is conformant,” he said.
“My take is the software vendors would be foolish if they didn’t look at what is happening in the standards and conformance space today as a key part of how they’re formulating their future roadmap.”
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Mr O’Halloran acknowledged the transition would require substantial work across the software industry but said the Agency was publishing roadmaps and indicative timelines early so vendors could plan their development programs.
“We also recognise this is a substantial impost on all software vendors. This is not something we take lightly, when we put these timelines out there,” he said.
“We are circulating them now to try and provide as much transparency.”
Mr O’Halloran said the scale of the work ahead for software vendors had often been underestimated.
“At this point in time today, there is not a single system that is conformant with the latest version of the Healthcare Identifiers Conformance Profile,” he said.
“It means every single software vendor and every single system will need to be uplifted.”
He said the Agency had deliberately adopted a staged transition rather than requiring vendors to move directly to FHIR.
“What we’re trying to do is rather than make it an almost impossible step to go from a very low base now to modern FHIR in one massive hit, let’s get everyone two-thirds of the way there by making these changes now,” Mr O’Halloran said.
“Then the lift to FHIR is much easier because they already have the data structures. They can cope with the new identifiers … then it’s looking more at a transport protocol rather than, ‘Oh my goodness, we have to rearchitect everything.'”
The Agency’s indicative transition timetable would see final My Health Record FHIR conformance profiles published by mid-2027, no new conformance assessments against existing Clinical Document Architecture (CDA) standards from mid-2028 and no new CDA-based connections from the end of that year.
By mid-2029, existing CDA connections would be retired entirely, leaving FHIR profiles as the only option.
The timetable will be subject to consultation, and some streams, including pathology, may move earlier. New capabilities will be made available only through FHIR.
Alongside the new interoperability baseline, the Agency will begin retiring legacy conformance profiles that are either no longer in active use or have been superseded.
Healthcare Identifiers conformance profile versions 1.0, 1.1, 1.2 and 1.3 will be retired immediately because they have no actively conformant systems.
Versions 1.4 to 4.0 will retire on 30 June 2027, and versions 4.1 to 5.0 will retire on 1 December 2027.
For My Health Record, the Agency will also immediately sunset 11 of the 80 conformance profile versions currently active across the ecosystem.
The reforms also include a staged transition to HIPS version 9.1, the current release of the Agency’s software for accessing My Health Record.
According to the Agency, HIPS supports around half of all clinician views of My Health Record data, more than 40% of information uploaded to My Health Record and more than 90% of pathology uploads.
Older HIPS versions will reach end-of-access on a staged basis, with version 6.x retiring on 31 March 2027, versions 7.x and 8.2.1 on 31 August 2027, and versions 8.3.0 and 8.3.1 on 30 November 2027.
Mr O’Halloran said clinicians and consumers would begin seeing the benefits much sooner than many expected.
“This is not some time of the never-never,” he said.
“Every few months now, clinicians and consumers should see constant marked improvements.”
He said the sector had reached a turning point.
“We’ve moved from talking about it, let’s design it, to the fact of we’re now doing it,” Mr O’Halloran said.
“We can’t be sitting here in another three years talking about doing it. In three years’ time I want to be sitting here talking about what went well, what are the three edge cases we haven’t fixed, and what are we going to do with the data and the new potential we have, rather than talking about doing it.”