In Cyprus, the adoption of FHIR (Fast Healthcare Interoperability Resources) for exchanging healthcare data is still in its early stages, with a primary focus on version R4. Despite this, there is a clear expectation for increased adoption in the coming years. The use of FHIR is seen as a pivotal step towards improving healthcare data interoperability within the country.

Rules and Support for FHIR

  • Health Data Exchange Rules: Cyprus has regulations mandating the use of standards for electronic health data exchange. However, FHIR is not explicitly mentioned in these regulations.
  • FHIR Requirements: Despite the lack of specific mention, FHIR is expected to become a key standard for national EHR (Electronic Health Records) systems by law.
  • Deadlines and Fines: Regulations include deadlines for compliance, with fines imposed if these are not met.
  • Funding: Government funds are available to stimulate FHIR adoption, supported by the European Union's Recovery and Resilience Facility (RRF), the NCP eHealth, and direct EU funding. More information can be found here.

National Setup

  • Standards Organization: Currently, there is no national organization responsible for health data standards in Cyprus.
  • Implementation Guides: A base/core FHIR Implementation Guide (IG) for Cyprus is under development. A prototype for the Single EHR Bank of Cyprus can be found here.
  • Terminology Services: A national FHIR terminology server is in planning but not yet available.

Active Use Cases

  • Local Implementations: The eHealth4U platform serves as a prototype for the Single EHR Bank of Cyprus.
  • International Standards Use: Cyprus is involved in the Xt-EHR project to develop implementation guides and technical specifications for adopting the European Electronic Health Record Exchange Format (EEHRxF) across various domains.
  • Key Projects: Projects focusing on ePrescription, eDispensation, patient summaries, discharge notes, laboratory reports, and medical imaging results are underway.

Who's Using FHIR

  • Active Organizations: The National eHealth Authority of Cyprus (NeHA) is leading the adoption of FHIR.
  • Main Reasons for Adoption: The main aim is to improve interoperability, access to information, and care workflows within the healthcare system.
  • How They're Using FHIR: FHIR is being used through the Rest API and SMART on FHIR, focusing on exchanging health data efficiently.

Success Stories and Challenges

  • Clear Benefits: Improved access to information and improved care workflows are cited as benefits from FHIR use cases.
  • Real Examples: The eHealth4U platform is highlighted as a successful implementation.
  • Main Difficulties: Challenges include a lack of FHIR knowledge and resistance to change.
  • Future Plans: Cyprus looks forward to EU cross-border healthcare services (EU patient summary and ePrescription) and further development of the Single EHR Data Bank.

Future Plans

  • Progress So Far: Adoption has made less progress than expected, with current satisfaction levels being low.
  • Next Steps: Development of a national FHIR data model and new regulations prescribing the use of standards in electronic health data exchange are in progress.
  • Expected Changes: Significant benefits from FHIR adoption are anticipated within the next three years, including cost savings and enhanced care coordination.

Contributors

  • Maria Papaioannou, External Contributor, National eHealth Authority of Cyprus
  • Constantinos Pattichis, President of the National eHealth Authority (NeHA)

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