Health Interoperability
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FHIR is transforming interoperability in healthcare – but what is it?

Michelle Beck - avatar

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Fast Healthcare Interoperability Resources (FHIR®) is the modern global standard for exchanging healthcare data. 

FHIR solves one of the toughest problems in health IT: enabling different systems to talk to each other. By using the same web technologies that power the internet, FHIR enables healthcare apps, electronic health records (EHRs), and data platforms to share information quickly and securely. Today, FHIR is at the core of digital health innovation worldwide.

When clinicians and patients have access to the right information at the right time, care improves. Yet too often, data is trapped in silos across disconnected systems. Legacy workflows still rely on emails, PDFs, or even faxes to move critical information around. 

The result? 

  • Clinicians make decisions without a full medical history.
  • Patients repeat the same forms again and again.
  • Researchers struggle to access the data they need to improve care. 

FHIR changes this by creating a shared “language” for healthcare data. Governments, providers, payers, vendors, and developers around the world now support it. 

Imagine a patient arriving in an emergency room unable to speak. With FHIR, their allergies, medications, and medical history can be securely retrieved from another system in seconds. 

FHIR works because: 

  • It uses internet standards like REST, JSON, XML, and OAuth.
  • It breaks down information into reusable building blocks called resources (e.g., Patient, Medication, Observation).
  • These resources can be combined to tell the patient’s complete clinical story. 

In short: FHIR makes healthcare data more usable, portable, and secure.

Governments across the globe are embedding FHIR into law and policy: 

  • United States: The 21st Century Cures Act and CMS’s CMS-0057-F rule require providers and payers to enable FHIR-based APIs for patient access, prior authorization, and digital quality measures.
  • Europe: The European Health Data Space (EHDS) and national initiatives (e.g., ISiK in Germany, NHS UK Core in the UK) mandate FHIR for cross-border and national data exchange.
  • Asia-Pacific: Countries like India, Australia, and Singapore have also endorsed FHIR in their national health strategies. 

These policies ensure that FHIR isn’t just a trend—it’s the backbone of healthcare interoperability worldwide.

Traditional health information exchange meant sharing entire documents. FHIR makes data available in smaller, structured pieces that are easier to use. 

Why FHIR stands out: 

  • Built on familiar web standards
  • Free to use and open source
  • Supported by major EHR and health IT vendors
  • Flexible enough for apps, devices, research, and national infrastructure
  • Backed by a vibrant global community

Every healthcare system has unique requirements. FHIR allows customization through profiles—local definitions of standard data elements such as Patient, Medication, or Observation—so that countries and organizations can tailor FHIR to their workflows while remaining compatible worldwide. 

For example: 

  • The NHS UK Core Patient Profile adapts the Patient resource for use in England.
  • National programs worldwide publish their profiles on Simplifier.net, Firely’s global FHIR collaboration platform.

Firely has been part of FHIR since the very beginning. Grahame Grieve (FHIR’s founder) worked alongside Firely CTO Ewout Kramer to create the standard. Today, Firely continues to: 

With Firely, organizations don’t just use FHIR, they gain a partner deeply invested in the standard’s success.

When we first published this article in 2022, FHIR adoption was accelerating but still emerging. A few things have changed since then: 

  • Global momentum: National mandates such as the U.S. CMS-0057-F final rule and Europe’s EHDS proposal have solidified FHIR as the regulatory foundation for interoperability.
  • From pilots to production: What were once experimental FHIR apps are now powering real-world workflows in hospitals, payer organizations, and government programs.
  • Community growth: HL7 reports that FHIR is now the most implemented interoperability standard in healthcare worldwide, with thousands of implementers participating in connectathons and communities like chat.fhir.org.
  • What we’ve learned: Through customer projects, open-source contributions, and surveys of the global FHIR community, we’ve seen that implementers value:
    • – Profiles and Implementation Guides as the key to scaling adoption. 
    • – Cloud deployment patterns for performance and compliance. 
    • – Education and training to bridge the skills gap between traditional IT and modern FHIR development.
  • Survey insights: In Firely’s State of FHIR surveys (and from conversations across the community), implementers consistently highlight patient access, prior authorization, and digital quality measures as the top drivers for adoption in 2025. Read the key takeaways from the 2025 State of FHIR Survey. 

This updated article reflects that shift—from asking “what is FHIR?” to showing how it is now embedded in healthcare systems worldwide.

FHIR is evolving with healthcare’s biggest challenges: 

  • Digital quality measures (dQMs): Automating quality reporting with FHIR + CQL.
  • Patient-generated health data (PGHD): Integrating wearables and remote monitoring into clinical workflows.
  • AI and analytics: Using standardized data for decision support and population health.
  • Cross-border exchange: Enabling patients to access their health data anywhere in the world.
  • FHIR is no longer “emerging”—it’s the standard shaping the next generation of digital health.

Want to get hands-on with FHIR? 

FHIR is here to stay, and Firely is here to help you make the most of it.

Looking to get started? Get in touch for a chat with one of our FHIR experts.

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