Welcome to FHIR IQ, where I write about healthcare data, interoperability, and building better products using FHIR. In this issue, I want to address a crucial yet often overlooked factor in the success of FHIR-based products: everyone on the team needs to understand FHIR—not just the engineers.
Too often, organizations rely on data SMEs (Subject Matter Experts) to “own” the data, engineers to “own” the build, and product teams to “own” the strategy. While each group plays a vital role, FHIR is not just another database schema or API spec—it’s a framework that dictates what is possible, how to implement solutions, and how systems connect. For teams to truly innovate and create seamless, high-quality FHIR-based solutions, everyone—data SMEs, engineers, and product/client teams—must develop a working knowledge of FHIR.
The Three Key Roles and Why They Need FHIR
Data SMEs: The Keepers of Data Context
Data SMEs understand healthcare data better than anyone else. They know the nuances of coding systems (SNOMED, LOINC, ICD-10), payer-specific formats, and clinical workflows. Their insights are crucial in:
Validating use cases
Identifying potential data gaps
Translating real-world scenarios into structured FHIR resources
Why They Need to Know FHIR: Without understanding FHIR, SMEs struggle to effectively map their domain expertise into a usable implementation. They risk handing off ambiguous requirements, leading to misalignment between intent and execution.
Engineers: The Builders of the Solution
FHIR is fundamentally an implementation framework. Engineers bring it to life by designing the right architecture, developing APIs, and ensuring compliance with interoperability standards. They need to:
Build systems that conform to FHIR’s resource-based structure
Implement APIs that are secure, scalable, and compliant
Handle FHIR versioning, profiles, and extensions properly
Why They Need to Know FHIR: Engineering decisions must align with how FHIR models healthcare data. Without this knowledge, they might reinvent the wheel or create inefficient solutions that don’t integrate well with existing FHIR ecosystems.
Product Managers & Client Teams: The Bridge Between Vision and Execution
PMs and client teams focus on defining the right product-market fit, ensuring usability, and working with stakeholders to deliver value. They need to:
Understand what is and isn’t possible within FHIR
Shape product roadmaps aligned with FHIR’s capabilities and limitations
Communicate effectively with engineers and SMEs
Create a feedback loop between Clients, Data Domain Expertise, Product value and Engineering
Why They Need to Know FHIR: Without FHIR knowledge, product teams may design features that are technically infeasible, misinterpret regulatory requirements, or struggle to scope work effectively.
FHIR: More Than Just a Specification
FHIR is more than just a schema—it’s a guide for what can be built, how it can be built, and how it connects. Here’s why:
FHIR Shows You What Is Possible
Does the specification support it and what are the considerations?
What data is available and how is it structured in the real world?
Thinking end use cases, is there value to deliver the solution?
FHIR Guides Implementation
How should data be structured?
What’s the right API interaction?
How do we ensure compliance?
FHIR Helps You Connect to External Data
Whether you’re pulling EHR data from Epic or payer data from a claims system, understanding FHIR is critical for smooth integrations.
FHIR Enables Scalable Solutions
Instead of custom point-to-point integrations, teams can design reusable, interoperable solutions that work across organizations using Implementations that are repeatable across various use cases and help solve a real need
Creating a FHIR-Literate Team
So how do you make sure your whole team is fluent in FHIR? Here are some steps:
Invest in Training: Encourage all team members to take FHIR courses or hands-on training.
Collaborate Cross-Functionally: Hold joint FHIR workshops where data SMEs, engineers, and product teams review real-world use cases together.
Encourage Hands-On Learning: Set up sandbox environments where non-engineers can test FHIR queries and see how data is structured.
Make FHIR Part of the Culture: Ensure that FHIR literacy is an expectation, not an afterthought, when onboarding new team members.
Define what personas need to know: How can folks learn what they need to know to do their job, ask questions, understand the end goal and vision
Final Thoughts
FHIR is not just for architects or engineers. It’s a framework that impacts how data is structured, how solutions are built, and how products are designed. If your team is working with FHIR, everyone needs to understand it at some level—from the data SMEs defining the requirements to the product managers shaping the vision.
By fostering a shared understanding of FHIR across all roles, your team can build more innovative, scalable, and effective healthcare products. It’s not about becoming a FHIR expert overnight—but embracing it as a common language that connects data, technology, and business goals.
If you enjoyed this post, consider subscribing to FHIR IQ for more insights on building better healthcare data solutions!
Need training FHIR IQ has very reasonable training options for your team built to go at your own pace.