Interoperability out-of-the-box / Assessing FHIR

First released by HL7 in 2014, FHIR (Fast Healthcare Interoperability Resources) has over the years become very attractive for healthcare delivery organisations, companies and governing bodies to address their communication needs of health data.


FHIR provides interoperability out-of-the-box, has computer processable specifications, good tooling support, free to use implementation libraries, and the standard itself is licensed to be free without restrictions. Several initiatives within the United States as well as in Europe have led to a wider uptake.


FHIR resources are however only the basic building blocks to build an application. Additional steps are necessary in order to fit a particular context of use, but that level of customisation also has some drawbacks.

On top of that there are other challenges: issues of fragmentation and maturity affect compatibility; the proliferation of initiatives result in inconsistencies undermining the reusability and sustainability; and the creation of different “dialects” leads to inefficient use of resources within the developer community and risks confusing the users in understanding the best specifications and requirements for their environment.

Nevertheless, the introduction of FHIR has led to a new and strong drive in standardising healthcare data. Awareness on the topic of interoperability, both on the demand and the supply side, is on the rise. With healthcare increasingly moving beyond the walls of traditional healthcare facilities, such as through the use of sensors, wearables and consumer equipment, new possibilities and use cases for health data exchange emerge as well.

The use and exchange of health data is fundamental for providing equitable high-quality care. The digital transformation of health and care will bring many benefits to patients, healthcare professionals and society. The use of FHIR can make a tangible contribution, but only if all involved stakeholders are properly informed and educated on how to safeguard interoperability when developing and deploying FHIR-based solutions.