In Switzerland, FHIR (Fast Healthcare Interoperability Resources) is becoming a key standard for exchanging healthcare data. Currently, the R4 version of FHIR is the most actively used, with an emphasis on its adoption across various healthcare domains. Expectations are high for increased adoption rates in the coming years, driven by both regulatory mandates and the healthcare industry's recognition of FHIR's value in enhancing data interoperability.

Rules and Support

  • Health Data Exchange Rules:
    • Switzerland mandates the use of standards for electronic health data exchange.
    • FHIR is specifically mentioned and mandated in these regulations.
  • Deadlines and Fines:
    • There are no specified deadlines for compliance nor fines for non-compliance mentioned.
  • Funding:
    • Government funds are available to stimulate the adoption of FHIR.
  • Useful Links:

National Setup

  • Standards Organization:
    • Switzerland has a national organization responsible for health data standards.
    • Relevant organizations include HL7 Switzerland, IHE Suisse, and GS1 Switzerland.
    • ehealthstandards.ch serves as a central hub for information.
  • Implementation Guides:
    • A base/core FHIR implementation guide is widely used and can be found at fhir.ch.
  • Terminology Services:
    • A national FHIR terminology server is in development, indicating ongoing efforts to standardize healthcare terminology.

Active Use Cases

  • Local Implementations:
    • Prescriptions/Pharmacy, Clinical Decision Support, and Document Exchange are key areas where FHIR is actively used.
  • International Standards Use:
    • Switzerland participates in developing and using international patient summaries and European implementation guides.
  • Key Projects:
    • eVaccination and ePrescription are notable projects demonstrating FHIR's success in improving healthcare data exchange and interoperability.

Who's Using FHIR

  • Active Organizations:
    • EHR system vendors and diagnostic system vendors (like Imaging/Lab) are actively using FHIR.
  • Main Reasons for Adoption:
    • Regulation and grants, along with the potential for innovation, drive FHIR adoption.
  • Usage:
    • FHIR is used for a variety of purposes, including messaging, documents exchange, and REST APIs to facilitate better healthcare data interoperability.

Success Stories and Challenges

  • Benefits:
    • Improved access to information has been a clear benefit of FHIR implementation.
  • Examples:
    • The CH ELM project, enabling electronic reporting of communicable diseases, showcases FHIR's effectiveness.
  • Difficulties:
    • High investment costs, unclear benefits, and changes in political direction are noted challenges.
  • Future Plans:
    • Anticipation for patient access to structured data showcases the direction of future FHIR implementations.

Future Plans

  • Progress So Far:
    • Switzerland has made significant progress in adopting FHIR, more than initially expected.
  • Next Steps:
    • Development of new FHIR standards for specific use cases and launch of pilot projects are immediate next steps.
  • Expected Changes:
    • Increased adoption of FHIR is expected to lead to cost savings, enhanced care coordination, and a robust digital health ecosystem.

Contributors

  • Permission to Use Names: Not provided explicitly for the purposes of this summary document.

The above summary is based on the answers to the State of FHIR Survey 2025, organized by Firely and HL7 International.