The work begins
in 1987 — not with me.

The storm that started a standard

At the Hospital of the University of Pennsylvania, during what Ed Hammond later called the worst electrical storm he’d ever seen, a group of hospital CIOs, vendors, and engineers gathered with one goal: build a standard simple enough to implement immediately.

The catalyst was real pain. Sam Schultz, HUP’s chief information officer, had learned the hard way that connecting clinical systems got more expensive and more brittle by the day. Every interface was bespoke. Nothing was repeatable.

Don Simborg gave the protocol away

The seed was the StatLAN protocol, born at UC San Francisco and commercialized by Simborg Systems. It would have been easy to keep it proprietary — a competitive moat.

Instead, Donald W. Simborg put StatLAN into the public domain and pushed to create a neutral standards body to carry it forward. That act of generosity — choosing the commons over the moat — is the reason the rest of this story is possible.

In 1989, when critics worried HL7 was too close to his own company, Simborg stepped down as chair. He let the standard outgrow him.

The standard hardens into infrastructure

HL7 v2 arrived in 1988 — pipe-delimited, fast, immediately useful. ADT, orders, results. For the first time, an interface could be repeatable instead of reinvented.

Ed Hammond took the chair and professionalized the community: formal balloting, governance, and finally ANSI accreditation in 1994. A volunteer idea became national infrastructure.

Grahame Grieve writes FHIR after hours

Two decades on, the web had moved and healthcare hadn’t. Grahame Grieve — an HL7 veteran later called “the father of FHIR” — began writing “Resources for Health” outside the hours of his day job, after a family health emergency showed him how fragmented care really was.

His insight: stop sending rigid messages, start exposing small modular resources — Patient, Observation, Encounter — over plain REST and JSON, the same web every developer already knew. Open-licensed, by design.

FHIR R4 — the foundation goes normative

With R4, the core resources stabilized into a normative standard you could build a business on without fear of the ground shifting. Patient. Condition. Observation. The vocabulary of modern interoperability was set.

This is the platform. Theirs, not mine. What follows is the engineer who bound his whole career to it — the old standard and the new alike.