Health Interoperability
3 Min Read

Reflections on Vitalis 2024: Advancing FHIR and Interoperability

Rien Wertheim

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I’ve just wrapped up three inspiring days at Vitalis in sunny Gothenburg, connecting with friends and colleagues from the FHIR community across the Nordics. It was an honor to present on the global and local adoption of FHIR. One of my key points was the correlation between a country’s FHIR maturity and the extent of government involvement in accelerating interoperability through legislation and funding. Notably, Sweden has lagged behind in FHIR adoption. 

One of the highlights was attending Petter Wolff’s presentation on the “Report of the Inquiry of Health Data as a National Interest – Legislation for Interoperability.” The report, commissioned by the national government, contains recommendations to accelerate interoperability and is expected to be included in legislation by July 1, 2025. 

In Peter’s recommendations, the Swedish eHealth Agency (E-hälsomyndigheten) will play a central role in defining the specifics of these mandated specifications. While FHIR wasn’t explicitly mentioned in the report, the focus on APIs strongly suggests its inclusion. The presence and support from HL7 Sweden members highlighted the importance of these recommendations, especially given the autonomy of Sweden’s 21 regions and 290 municipalities—a well-recognized hurdle to achieving interoperability. 

There was also a lot of talk about European initiatives like the EHDS and other projects in which representatives from the Nordics take an active role. Conversations with EU interoperability leaders highlighted how EHDS is creating a framework for cross-country and intra-country interoperability regulation, leaving the actual technical specs (FHIR or something else) to so called Implementation Acts. Here too, all signs (think MyHealth@EU) point in one direction: more FHIR.

With Mikael Rinnitmaki, who did 5 sessions at Vitalis!

I also had the chance to walk around the exhibition floor and speak with several vendors, app developers, and other tech companies. It’s heartening to see the progress individual companies are making in advancing interoperability despite the lack of national coordination. Conversations with innovators and vendors (e.g. Cambio, Platform24, Blaappen, and Visiba) revealed a robust ecosystem developing specialized apps and platforms in a range of areas such as home monitoring and patient-driven triage.

Sweden, like many other countries, faces rising healthcare costs. Unique to Sweden (and Norway) are the remote areas where emergency care often relies on helicopter transport. It’s no wonder you see more vendors focusing on home monitoring and telemedicine here than at your average health IT exhibition. 

Many tech companies I met have international ambitions and see FHIR as key to global scalability. However, the reality is that integrating various technical interfaces and incompatible semantics remains a challenge. The widespread implementation of FHIR APIs is still years away, both in Sweden and globally. Meanwhile, we stay ardent, hopeful, and realistic about the journey ahead. 

Looking forward to continuing these important conversations and seeing the progress we can achieve together!

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