How Adapcare turned a compliance deadline into a connected care platform

When leading Dutch healthcare IT provider Adapcare began exploring HL7 FHIR, the motivation was compliance. Driven by new national mandates, they needed a secure, standardized way to exchange patient data. But what started as a legal requirement evolved into a strategic opportunity. 

Partnering with Firely, Adapcare didn’t just check the regulatory boxes—they laid the technical foundation that supports CACAO, a FHIR-enabled cross-organizational collaboration platform powering real-time, secure data sharing for 25+ care institutions across the Netherlands.

The Challenge

Navigating Regulatory Complexity 

• Compliance with Dutch standards and programs (MedMij and VIPP) required integration of Health and Care Information Models (HCIM).
• Implementing e-Overdracht—a Dutch national standard for the exchange of information between nursing and long-term care healthcare professionals—was challenging due to unclear regulations and the fact that many software vendors weren’t yet ready to support it.
• Adapcare lacked the infrastructure to support future data exchange use cases and evolving interoperability requirements in Dutch healthcare. 

Lack of Internal FHIR Expertise 

• Adapcare lacked the time, resources, and knowledge to build its own FHIR solution from scratch. 

Interoperability and Scalability Needs 

• Their existing low-code platform was limiting scalability and cross-organizational collaboration.
• They needed to prepare for future requirements like the European Health Data Space (EHDS) and WEGIZ (the Dutch law on electronic data exchange in healthcare). 

The Solution

Firely Server 

• Served as the FHIR backend to ensure compliance with data standards (MedMij) and enable integration with external systems. 

Consulting & Support 

• Firely provided education, hands-on guidance, and support during integration not offered by larger vendors. 

Paul van Zagten, Product Manager at Adapcare noted:

“If we didn’t use Firely, we would’ve had to develop it ourselves and that’s not feasible for us. We’d rather focus on our core business: making software for Dutch healthcare.” 

Technical Validation 

• Firely’s demo environment and extensive documentation allowed Adapcare to independently explore, test, and validate the solution before committing—ensuring confidence in both functionality and fit.

Why Firely? 

FHIR Expertise and Support

Adapcare was seeking more than a vendor—they needed a partner to navigate the complexities of FHIR implementation. Adapcare’s internal team brought vast domain knowledge of Dutch healthcare, they were relatively new to HL7 FHIR. Firely’s deep experience as core contributors to the standard, paired with their responsiveness, made them a natural fit.

“We were not so familiar with FHIR and we needed help, especially in the beginning,” Paul noted, adding that Firely’s ability to provide highly responsive, hands-on support made a big difference. The “short lines of communication” made it easy to get help quickly, contributing significantly to their success. He continued:

“When we need help, we just pick up the phone—and that was important for us.” 

Compliance and Speed

Faced with a deadline for regulatory compliance, Adapcare implemented Firely’s FHIR Server and related tools in a matter of months. Paul described the overall process as smooth and efficient, helped by Firely’s responsiveness and transparency. 

Accessible Tools and Transparent Process

Before committing, Adapcare was able to validate Firely Server in their environment thanks to Firely’s openly available demo and rich documentation. This hands-on approach helped build internal confidence without needing heavy upfront investment.

Future-Focused and Flexible

While the initial reason for choosing Firely was compliance, Adapcare’s needs evolved toward real-time collaboration and system-wide interoperability. Firely’s architecture allowed for that growth. 

This stood out to Paul van Zagten:

“With Firely, we were able to move from regulatory pressure to building something scalable, flexible, and future-ready.”

Beyond Compliance: CACAO and Firely 

Over time, Firely’s role extended beyond compliance. Today, it plays an important role for CACAO—Adapcare’s cross-organizational platform hat now connects over 25 healthcare institutions across the Netherlands. CACAO uses FHIR APIs to enable real-time data sharing and collaborative care—moving beyond individual systems to a unified, patient-centered experience. 

How CACAO uses FHIR: 

• Aggregates patient data from various EHR systems via FHIR APIs using Open Health Hub’s Structure Data Capture Forms
• Offers real-time access to a 360° patient view with role-based filtering using the Open Health Hub FHIR Viewer—for an interactive demo of Firely Server and the FHIR Viewer, request access via this form
• Enables cross-institutional workflows (messaging, task management, scheduling, etc.)
• Integrates with the Dutch MITZ system for consent management
• Supports plug-in extensions by third-party developers (e.g., Open Health Hub’s ZIB Viewer) 

With this architecture, care providers see only the information relevant to their role and the patient’s consent—streamlining coordination and reducing manual handovers. Paul van Zagten said:

“When we have a wound, there’s multiple teams involved—the practitioner, home nursing, and maybe a hospital pain team… and they can now work together in CACAO on the same file.”

Looking Ahead

Adapcare is continuing its transition to a microservices-based architecture, with Firely Server playing a crucial role as the foundation alongside Open Health Hub’s modular viewer and patient view tools. As Dutch and EHDS regulations evolve, the CACAO platform is well-positioned to meet emerging requirements while supporting future innovation through its extensible, FHIR-driven plug-in model.

From Compliance to Connected Care

Adapcare’s journey illustrates the transformation of FHIR from a compliance requirement to a foundational enabler of integrated care.

With Firely, they built a flexible, collaborative, and future-proof platform that supports a growing network of care providers working across organizational boundaries. CACAO is not just compliant—it’s a blueprint for connected care.

Looking to future-proof your organization and unlock smarter data exchange like Adapcare? Talk to one of our experts today to explore Firely’s solutions can help your organization navigate complex standards, scale faster, and improve patient outcomes.