FHIR as a foundation for real-world impact: a CEO’s perspective 

FHIR adoption has never been higher, and regulations continue to accelerate. The vision of interoperable healthcare data is no longer up for debate.

As we enter 2026, FHIR is no longer just an emerging standard. More and more, the conversation is about how we use it to create real value in practice. 

In this blog, I share my perspective on the evolution of FHIR and my excitement about our collective journey. It is not always easy, but please remember, no pain, no gain. So hold on. We can make it happen.

Looking back: the foundations that got us here

Before looking ahead, it is worth pausing to reflect on what we’ve achieved together over the years. 

The first ideas that would become FHIR started taking shape in 2011 and 2012, when a small group of people began rethinking what a modern healthcare data standard could look like. What began as an experiment quickly grew into an open standard shaped by implementers, built for real-world use, and supported by a passionate and steadily growing global community. 

That community has remained one of FHIR’s greatest strengths. From working groups and online collaboration to events like FHIR DevDays, people from all around the world have contributed to the standard’s evolution. Today, as FHIR moves toward its next normative milestone with R6, it is clear how much the standard has matured, and how much collective effort has gone into getting it here.

(For those interested in the early days, I previously shared a conversation with Grahame Grieve, Lloyd McKenzie, and Firely’s own Ewout Kramer about how it all started.) 

These successes didn’t happen overnight. They are the result of years of belief, persistence, and craftsmanship. At Firely, that journey started with our founder, Rien Wertheim, who believed in FHIR’s potential since the beginning and helped build the company around it. I am grateful for his guidance and mentorship over the past years. 

Stepping into the CEO role

As of January 1, I stepped into the role of CEO of Firely. I do so with a great sense of excitement and responsibility. Not because the road ahead will be easy, but because it truly matters.  

I believe we are entering an era in which interoperability will enable real breakthroughs and innovations that genuinely improve healthcare delivery, operations, and outcomes. The opportunity to lead a company that helped develop the standard from the very beginning and has spent years implementing it in real-world environments makes this moment especially exciting. 

Today, we see FHIR data becoming available in more and more places. The 2025 State of FHIR Survey confirms this. FHIR is becoming the default language for healthcare data exchange worldwide.  

Often this is driven by regulation, but it also creates something more important: the opportunity to start using that data. Whether it’s better insights, quality reporting, clinical decision-making, or more efficient workflows, structured data opens the door to many meaningful use cases. 

In many places, I see the priority is to simply meet regulatory deadlines. And that’s fine too. Because once that hurdle is behind you, you’ll be all set to tap into this new world of possibilities.

Why infrastructure makes the difference

One of the recurring themes I hear in conversations is this: everyone wants value, but not everyone wants to invest in the foundation. 

While there is broad agreement on the importance of available, exchangeable, standardized healthcare data, building a solid FHIR foundation is not always the most obvious or “sexy” investment. 

It’s a lot more tempting to focus on AI, analytics, or nice-looking user interfaces. But without that foundation based on high-quality data, consistent profiles, and scalable infrastructure, innovation will struggle to move beyond early experiments. 

This is why infrastructure is where long-term success is decided. FHIR servers, terminology services, validation, and governance are not optional extras. They are the enablers that make every downstream innovation possible. AI included. 

At Firely, this is where we focus our energy: helping organizations move from “FHIR because we must” to “FHIR because it enables something better.” I truly believe that the organizations who get this right now will be the ones who can scale innovation sustainably in the years ahead.

From compliance to use cases that truly matter 

Regulation plays an important role in driving adoption, but compliance should never be the end goal. 

The real value of FHIR lies in the use cases it enables. In the United States, Prior Authorization and Quality Measures are emerging as some of the most impactful FHIR-driven applications in 2026. These use cases go beyond technical implementation and directly affect efficiency, cost control, and the experience of clinicians and patients. 

In Europe, the European Health Data Space is moving closer to implementation. We are starting to see this translate into concrete, cross-border use cases, such as the European Patient Summary, which builds on the International Patient Summary. Delivering these use cases will require solid, interoperable infrastructures that can support data exchange at scale, across organizations and borders. 

Across regions, the question is the same: how can we use standardized data to solve real problems? 

The people behind the progress 

What makes me most optimistic about the years ahead is the Firely team. 

I get to work with incredibly intelligent, passionate people who deeply understand FHIR and the global healthcare ecosystem. People who care about building great software, helping others succeed, and doing things the right way, even when that is the harder path. 

I am also inspired by the broader FHIR community: implementers, partners, customers, contributors, and organizations who keep pushing the standard forward in practical ways.

Looking ahead (and meeting in person) 

As we move into 2026, I’m looking forward to helping many more organizations build their FHIR foundations and enable use cases that truly matter. 

I’ll be attending several events this year, including  ICT & Health World Conference, HIMSS, Zorg & ICT, DMEA, and of course, our very own FHIR DevDays run in collaboration with HL7 International. If you’re navigating the transition from compliance to value, or interested in exchanging perspectives on where FHIR is going, I’d love to connect in person. 

The year ahead will bring challenges, but also a lot of opportunity. I am excited to lead Firely through this next chapter and to continue building alongside our community.