FHIR Maturity Model

This page describes the 5 level FHIR maturity model for resources. It's based on the CMM (Capability Maturity Model) framework, and the intention is to give implementers a sense of how mature a resource is based on the level and types of review it has been subject to. These criteria may evolve over time.

• FMM0 = the resource or profile (artifact) has been published on the current build. This level is synonymous with Draft.
• FMM1 = FMM0 + the artifact produces no warnings during the build process and the responsible WG has indicated that they consider the artifact substantially complete and ready for implementation
• FMM2 = FMM1 + the artifact has been tested and successfully exchanged between at least three independently developed systems leveraging at least 80% of the core data elements using semi-realistic data and scenarios based on at least one of the declared scopes of the resource (e.g. at a connectathon). These interoperability results must have been reported to and accepted by the FMG
• FMM3 = FMM2 + the artifact has been verified by the work group as meeting the STU Quality Guidelines; has been subject to a round of formal balloting; has at least 10 distinct implementer comments recorded in the tracker drawn from at least 3 organizations resulting in at least one substantive change
• FMM4 = FMM3 + the artifact has been tested across its scope (see below), published in a formal publication (e.g. STU), and implemented in multiple prototype projects. As well, the responsible work group agrees the resource is sufficiently stable to require implementer consultation for subsequent non-backward compatible changes.
• FMM5 = FMM4 + the artifact has been published in two formal publication release cycles at FMM1+ (i.e. STU level) and has been implemented in at least 5 independent production systems in more than one country
• (Normative. could be called FMM6, but not formally defined)

Any of the criteria can be waived provided the sponsoring WG can convince the FMG that that criteria should not apply in the case of a specific artifact.

Tested across scope means:

- The FMG has signed off on the list of "example contexts" defined for the artifact

- For each example context, the artifact has either been: reviewed and approved by a domain expert for that scope area, mapped to an existing implemented scope-area-specific standard or tested in an implementation

FMM1 and higher will be published as STU level rather than draft. FMM 5 is a pre-requisite (but not sufficient) to be published as Normative. i.e. Normative is a step beyond

In some cases, a resource may have components or dependencies that are a lower level than the resource overall. For example, a resource may have been well tested, with the exception of one or two data elements which are "new" or that have limited production use due to the distribution of early adopters. In these cases, a "maturity note" will be provided that highlights areas of the resource that are considered "less mature" than the resource as a whole.