FHIR Licensing Update

Apr 2, 2012

I’ve had a number of queries about the status of FHIR licensing. Here’s an update. Background

HL7 standards are not free for use. In order to use the standards in derived standards research or or production systems, implementers must pay a licensing fee. This can be done by joining HL7, or by purchasing the standards on a commercial basis. Neither option is particularly cheap; it costs a lot of money to produce, publish, and maintain the standards. Note that HL7 is a not-for-profit organization, and no one is drawing profits from selling the standards.

The fact that a licensing cost is required bothers many implementers, especially in countries where governments mandate use of HL7 standards, and the users don’t get to opt-in. HL7 is continually criticized for this, and compared to radically different standards organizations such as W3C, or OMG, which produce specifications that are not “encumbered” by having to pay for their use.

Not surprisingly, HL7 has looked repeatedly at how it converts it’s IP into a revenue stream, but each time, it elects not to change. Fundamentally the problem is that while these other models have been proven to work, no one knows whether they’ll work for HL7, and no one knows how to go about transitioning from where we are.

Hence, HL7 mostly is locked into a encumbrance model, though some newer products are being made available for free.

FHIR

Though FHIR is built entirely on the strengths of the existing standards HL7 has,in form and implementation it is entirely new. I’ve developed it personally, and while I’ve consulted widely, and there’s been a small team who’ve contributed, the entire content of FHIR is mine (© Health Intersections P/L). I’ve developed it with the express purpose of gifting it to the public domain.

Beyond the general principles of encumbered IP, and the question of why a bunch of volunteers would develop product in order to give it to some other organivation to sell, there’s a practical reason for that: existing HL7 members have spent many millions of dollars on existing HL7 standards. For all their flaws, they’re naturally going to be reluctant to implement new specifications, at least until their utility is well proven in practice. That’s a reasonable position to take. So how is a new specification going to become well proven in practice?

The answer is that the implementation experience is going to have to come from a new set of implementers, outside the HL7 community. And who is going to be doing interoperability in healthcare, who’s not an HL7 member? The answer is mobile apps, a tsunami of healthcare integration already winding up into high gear. These communities need a practical lightweight exchange standard, which is exactly what FHIR is. And if FHIR is going to appeal to them, it at least has to be free for use (it has to be other things too. for instance, I’d like to provide FHIR with an out of the box ObjectiveC reference implementation - I’m looking for volunteers to work on that).

So I’ve made an offer to HL7: I’ll gift FHIR to HL7 if HL7 will make it available to the public for free.

Specifically, we’re talking around something like this:

  • The FHIR IP would remain the property of HL7, along with the right to continue to maintain it
  • The base FHIR standard would be published (perhaps at http://www.hl7.org/fhir though http://www.fhir.org is also reserved for this purpose)
  • HL7 would grant implementers the right to use the FHIR standard for free, for production/research systems or derived products such as implementation guides
  • HL7 and affiliates (and members?) may develop derived specifications and make these available on a commercial basis. Other parties may not

This agreement would hold until the first full normative publication of FHIR, after which the impact of this would be reassessed and other models considered.

I’ve been in discussions with the HL7 Board, and we seem to be in agreement to this. I’m just waiting to get the agreement formalized, and then I’ll turn FHIR over to HL7.