Author Archives: Mark Kramer

About Mark Kramer

Mark Kramer, Ph.D., is Group Leader for Healthcare Standards and Interoperability at MITRE Corporation. Mark led the standardization of hData, the first lightweight REST methodology for healthcare data exchange, now a normative standard of HL7. With HL7, ONC, and CMS, Mark focused on developing FHIR profiles unifying standards for clinical quality measures and decision support. Mark has also worked the US Department of Veterans Affairs on interoperable healthcare information exchange, and helped the DOD transfer radiological images of wounded warriors from Afghanistan and Iraq to regional hospitals. Prior to joining MITRE, Mark was Chief Technology Officer at Gensym Corporation, a leading provider of AI software, VP of Engineering at InterOPS, a network management company, CTO of Light Pharma, provider of capability improvement software and services to the pharmaceutical industry, and Associate Professor of Chemical Engineering at Massachusetts Institute of Technology.

From Class-Attribute Models to Data Element Models (and Back)

Last time, I explained why the Standard Health Record (SHR) is based on data elements. Primarily, clinicians think in terms of data elements, and there are many preexisting libraries of data elements that we can use. Data elements are reusable … Continue reading

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Maximizing Reuse in Healthcare Standards

“Imagine you are trying to build a house, but you have bricks of varying sizes and materials to build the foundation– this is analogous to the situation that occurs when we don’t have common data elements.”  —  Julia Skapik of … Continue reading

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FHIR Profiling Made Easy

Over the past year, MITRE has been working on a domain specific language (DSL) for defining logical healthcare data models and producing FHIR profiles. By design, it is a very simple and compact method of describing a logical data model … Continue reading

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The Standard Health Record: What We’ve Accomplished in Year 1

Some of you must be wondering – is MITRE’s Standard Health Record more than just a fanciful idea? I want to quickly summarize the top 10 things we’ve accomplished since the project launched a little more than a year ago: … Continue reading

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The Need for Faster Standards Development

The Standard Health Record (SHR) is an ambitious standards development project. It seeks to standardize information in every area of a person’s health, with the goal of establishing a high quality, complete, computable, integrated health record. “One human, one health … Continue reading

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The Standard Health Record (SHR)

The trouble with diets and blogs is that they often have a short half-life. I admire folks like David Hay, who publish interesting and useful material with great regularity. After a year of slacking off, I have accumulated a large … Continue reading

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Profile Validation in FHIR Exchanges

When and how should resource validation happen in a FHIR-based information exchange? Those familiar with the FHIR specification will know that FHIR provides several ways to validate whether a resource conforms to a FHIR Structure Definition, whether that StructureDefinition is a profile or a … Continue reading

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Postel’s Law and FHIR Profiles

Last time, I mentioned the possibility of having different sets of profiles for producing and consuming resources. Since then, I have gotten questions about why a FHIR server might want to have two sets of profiles, and how these profiles relate to FHIR’s … Continue reading

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Interoperability of FHIR Profiles

One of the most significant claims made by FHIR is out-of-the-box interoperability (see the one page glossy summary on FHIR). This is only true for a weak definition of interoperability. Any well-formed FHIR resource can be parsed by any compliant FHIR application, but this doesn’t mean the … Continue reading

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Syntaxes for #FHIR Extensions (Part 2)

In the last post, I took up Grahame’s request for feedback on possible alternative syntax for extensions. To review, the goal would be to eliminate the use of the tag and use readable names, similar to the way core elements are represented. It may or may not be possible to improve on the current representation, but it is worth investigating. In the last post, I listed the following requirements… Continue reading

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