This overview is based on the insights gathered from the DevDays 2024 State of FHIR survey, with a comparison to the 2023 survey to highlight the progress and changes.

Regulation

In Australia, there is currently no specific regulation mandating the use of standards in electronic health data exchange. However, the landscape is evolving, and the absence of regulation does not hinder the proactive steps being taken towards FHIR adoption.

Adoption

FHIR is gradually being adopted in Australia, with its use currently limited to a few specific use cases. The most widely used version is FHIR R4, while earlier versions like DSTU2 see minimal use. The future looks promising, with a strong increase in the rate of adoption expected in the coming years—an expectation that has grown from a 4 in 2023 to a 5 in 2024. This optimistic outlook is driven by various factors, including improved care, innovation, and national initiatives.

Authoritative Bodies

The key authoritative bodies driving FHIR adoption in Australia include the Australian Digital Health Agency, HL7 Australia, CSIRO, and the Department of Health and Aged Care. These organizations are central to the development and coordination of FHIR standards and initiatives in the country.

Relevant Institutes

Several institutes play a crucial role in the FHIR ecosystem in Australia. Notably, CSIRO acts as the National Community Coordinator for the National FHIR Accelerator, Sparked, launched in August 2023. This accelerator is a collaborative effort involving the Australian Digital Health Agency, CSIRO, HL7 Australia, and the Department of Health and Aged Care.

National Standards Development

Australia is actively developing a national FHIR data model, which can be accessed here. This model is part of a broader effort to create specific FHIR standards for various use cases. The initiative includes the development of AU Core, SNOMED CT Value Sets, and use case-specific Implementation Guides (IGs). Additionally, HL7 Australia has established a FHIR Management Framework and an Australian FHIR Coordination Committee to streamline these efforts. The commitment towards a national accelerator program for National IDs mentioned in 2023 has evolved into the launch of Sparked in 2024.

Terminology Usage

Terminology services are a significant driver for FHIR adoption in Australia. The National Clinical Terminology Service (NCTS) and SNOMED CT Value Sets are integral to the country's FHIR infrastructure, ensuring standardized and interoperable healthcare data exchange.

Infrastructure

Australia boasts a robust national infrastructure for FHIR implementation, including the National Terminology Services, Provider Directories, and Health Information Exchange. Software companies looking to integrate with this infrastructure must align with the national standards and guidelines set forth by the authoritative bodies. The infrastructure supports various FHIR features, with the FHIR Rest API and FHIR Shorthand being widely used.

FHIR Implementation

The main parties adopting FHIR in Australia include care providers, EHR vendors, app developers, and national infrastructure services. The main drivers for FHIR adoption are regulation and grants, improved care, innovation, and the support from terminology services and the National FHIR Accelerator. Successful FHIR use cases, such as the National Clinical Terminology Service and Mobile Gateway MyHR, have demonstrated benefits like lowered costs and improved access to information.

The challenges to FHIR adoption have become more detailed in 2024, highlighting high investment costs, unclear benefits, unclear regulations, lack of FHIR knowledge, workforce issues, the need for clear adoption roadmaps, migration from legacy systems, and national infrastructure. Future FHIR implementation use cases are varied and promising, including AU Core as a platform for other IGs, eRequesting, patient summaries, clinical decision support, questionnaires, and bulk FHIR.

In conclusion, while FHIR adoption in Australia is still in its early stages, the groundwork laid by national bodies and the optimistic outlook for future growth paint a positive picture. The collaborative efforts of key stakeholders and the development of national standards and infrastructure are set to propel Australia towards becoming a leader in FHIR implementation.

This summary presents the current state of Fast Healthcare Interoperability Resources (FHIR) in Australia based on the HL7 FHIR DevDays 2024 State of FHIR survey results provided by Kate Ebrill and Reuben Daniels of HL7 Australia.

Additional background was added based on the answers to the HL7 FHIR DevDays State of FHIR survey 2023 by by Kate Ebrill of HL7 Australia.