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VA Technical Reference Model v 24.11

Fast Healthcare Interoperability Resources Specification (FHIR)

General Information

Technologies must be operated and maintained in accordance with Federal and Department security and privacy policies and guidelines. More information on the proper use of the TRM can be found on the TRM Proper Use Tab/Section.

Website:	Go to site
Description:	FHIR® – Fast Healthcare Interoperability Resources (hl7.org/fhir) – is a next generation standards framework created by HL7. FHIR combines the best features of HL7`s v2 , HL7 v3 and CDA product lines while leveraging the latest web standards and applying a tight focus on implementability. FHIR solutions are built from a set of modular components called `Resources`. These resources can easily be assembled into working systems that solve real world clinical and administrative problems at a fraction of the price of existing alternatives. FHIR is suitable for use in a wide variety of contexts – mobile phone apps, cloud communications, EHR-based data sharing, server communication in large institutional healthcare providers, and much more. The version recommended for implementation is 4.0.1.
Technology/Standard Usage Requirements:	Users must ensure their use of this technology/standard is consistent with VA policies and standards, including, but not limited to, VA Handbooks 6102 and 6500; VA Directives 6004, 6513, and 6517; and National Institute of Standards and Technology (NIST) standards, including Federal Information Processing Standards (FIPS). Users must ensure sensitive data is properly protected in compliance with all VA regulations. Prior to use of this technology, users should check with their supervisor, Information Security Officer (ISO), Facility Chief Information Officer (CIO), or local Office of Information and Technology (OI&T) representative to ensure that all actions are consistent with current VA policies and procedures prior to implementation.
Section 508 Information:
Decision:	View Decisions

Decision Source:	TRM Mgmt Group
Decision Process:	One-VA TRM v24.9
Decision Date:	09/16/2024 at 14:32:15 UTC
Aliases:	FHIR
Introduced By:	Enterprise Program Management Office (EPMO) TRM Team
Standards Body:	HL7

Vendor Release Information

The Vendor Release table provides the known releases for the TRM Industry Standard, obtained from the vendor (or from the release source).

You must be logged into the RSAA website prior to clicking the Attestation URLs or the URLs won't open.

Version	Release Date	Vendor End of Life Date
0.0.82	09/30/2014
1	10/24/2015	02/01/2016
3	10/24/2019
4.0.0	10/30/2019
5.0.0	03/26/2023

Current Decision Matrix (09/11/2024)

Users must ensure their use of this technology/standard is consistent with VA policies and standards, including, but not limited to, VA Handbooks 6102 and 6500; VA Directives 6004, 6513, and 6517; and National Institute of Standards and Technology (NIST) standards, including Federal Information Processing Standards (FIPS). Users must ensure sensitive data is properly protected in compliance with all VA regulations. Prior to use of this technology, users should check with their supervisor, Information Security Officer (ISO), Facility Chief Information Officer (CIO), or local Office of Information and Technology (OI&T) representative to ensure that all actions are consistent with current VA policies and procedures prior to implementation.

The VA Decision Matrix displays the current and future VAIT position regarding different releases of a TRM entry. These decisions are based upon the best information available as of the most current date. The consumer of this information has the responsibility to consult the organizations responsible for the desktop, testing, and/or production environments to ensure that the target version of the technology will be supported.

Legend:

White	Authorized: The technology/standard has been authorized for use.
Yellow	Authorized w/ Constraints: The technology/standard can be used within the specified constraints located below the decision matrix in the footnote[1] and on the General tab.
Gray	Authorized w/ Constraints (POA&M): This technology or standard can be used only if a POA&M review is conducted and signed by the Authorizing Official Designated Representative (AODR) as designated by the Authorizing Official (AO) or designee and based upon a recommendation from the POA&M Compliance Enforcement, has been granted to the project team or organization that wishes to use the technology.
Orange	Authorized w/ Constraints (DIVEST): VA has decided to divest itself on the use of the technology/standard. As a result, all projects currently utilizing the technology/standard must plan to eliminate their use of the technology/standard. Additional information on when the entry is projected to become unauthorized may be found on the Decision tab for the specific entry.
Black	Unauthorized: The technology/standard is not (currently) permitted to be used under any circumstances.
Blue	Authorized w/ Constraints (PLANNING/EVALUATION): The period of time this technology is currently being evaluated, reviewed, and tested in controlled environments. Use of this technology is strictly controlled and not available for use within the general population. If a customer would like to use this technology, please work with your local or Regional OI&T office and contact the appropriate evaluation office displayed in the notes below the decision matrix. The Local or Regional OI&T office should submit an inquiry to the TRM if they require further assistance or if the evaluating office is not listed in the notes below.

Release/Version Information:

VA decisions for specific versions may include a ‘.x’ wildcard, which denotes a decision that pertains to a range of multiple versions.

For example, a technology authorized with a decision for 7.x would cover any version of 7.(Anything) - 7.(Anything). However, a 7.4.x decision would cover any version of 7.4.(Anything), but would not cover any version of 7.5.x or 7.6.x on the TRM.

VA decisions for specific versions may include ‘+’ symbols; which denotes that the decision for the version specified also includes versions greater than what is specified but is not to exceed or affect previous decimal places.

For example, a technology authorized with a decision for 12.6.4+ would cover any version that is greater than 12.6.4, but would not exceed the .6 decimal ie: 12.6.401 is ok, 12.6.5 is ok, 12.6.9 is ok, however 12.7.0 or 13.0 is not.

Any major.minor version that is not listed in the VA Decision Matrix is considered Authorized w/ Constraints (POA&M).

<Past

CY2025

CY2026

CY2027

Future>

Release

0.0.82

Authorized w/ Constraints (DIVEST)

Authorized w/ Constraints (POA&M)

Authorized w/ Constraints (DIVEST)

Authorized w/ Constraints (POA&M)

Authorized w/ Constraints (DIVEST)

Authorized w/ Constraints (POA&M)

4.0.0

Authorized

5.0.0

Authorized w/ Constraints (POA&M)

Decision Constraints


[1]	This Industry Standard is currently being evaluated, reviewed, and tested in controlled environments. Use of this technology is strictly controlled and not available for use within the general population.

[2]	Please contact the VHA Office of Standards & Interoperability (Mailgroup: VHA S&I Response Team) prior to implementation to obtain guidance and the VHA-endorsed version of this standard.

[3]	Users must contact the VHA Office of Standards & Interoperability (Mailgroup: VHA S&I Response Team) prior to implementation to obtain guidance and the VHA-endorsed version of this standard.

Note:

Current authorized version for implementation is FHIR Version R4. US Core has been based on FHIR Version R4. FHIR Version R4 was released on Dec 27, 2018, and was the first version with Normative content. In January 2024, the HL7 US Realm Steering Committee decided that the next version of FHIR that US Core will be based on will be the upcoming FHIR Version R6 and skipping FHIR R5. As of the publication date, there is no timeline for R6 release. FHIR R6 is under planning/evaluation and future FHIR upgrades will be to FHIR R6. FHIR R6 is currently in draft and not an authorized FHIR standard for implementation at this time. Please contact the VHA Office of Standards & Interoperability (VHA S&I Response Team: VHAS&IResponseTeam@va.gov) prior to implementation to obtain guidance and the VHA-endorsed version of this standard.

Note: This list may not be complete. No component, listed or unlisted, may be used outside of the technology in which it is released. The usage decision for a component is found in the Decision and Decision Constraints.
Source	Name	Description
No components have been identified for this entry.


Health Care Standard	Health Care Standards

- The information contained on this page is accurate as of the Decision Date (09/16/2024 at 14:32:15 UTC).

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VA Technical Reference Model v 24.11

General Information

Vendor Release Information

Current Decision Matrix (09/11/2024)

Decision Constraints

References

Standard Components

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Technologies/Standards Relationships

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VA Technical Reference Model v 24.11

General Information

Vendor Release Information

Current Decision Matrix (09/11/2024)

Decision Constraints

References

Standard Components

VA Categories View the VA Categorization Framework

Technologies/Standards Relationships

Implemented By/Verified With:

Comparable Standards:

Associated Standards:

General Analysis

Adoption Benefits

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VA Categories

View the VA Categorization Framework