📖 FHIR's 80% rule

The 80% rule is a decisive strategic approach to handle the huge amount of diversity of healthcare data. Because of the sheer volume of different use cases and perspectives in the healthcare sector, it is hard to agree on data structures. FHIR resources that satisfy all participants for a nephrologist specialize on kidney transplantations, the exact time of birth of a patient will seem to be of no importance, while for the neonatologist it will be very relevant.

To capture the ethnicity of a patient is not important or even adequate in Germany, but of clinical relevance for the interpretation of certain lab parameters or risk factors in the US.

To include all possible properties for all resources would lead to very big constructs that would be hard to navigate. Therefore, the 80% rule states that only the 80% most important commonly agreed upon properties are included in the resource. Or put differently, a resource should be usable for 80% of. All use cases in all sub sectors of the healthcare industry. The remaining 20% of special use cases are not represented by the predefined resources.

Note:

The opposite approach would be to include all possible elements that any use case would ever need. This approach is followed the openEHR, an open standard for managing and sharing electronic health records (EHRs).