In Germany, FHIR (Fast Healthcare Interoperability Resources) is increasingly being used to exchange healthcare data. This standard helps healthcare providers to share clinical and administrative data more efficiently. Currently, the most active FHIR version in use is R4, indicating that Germany is keeping pace with international standards. Respondents anticipate a continued rise in the adoption of FHIR in the coming years, driven by both national regulations and the healthcare sector's push for better interoperability.
Rules and Support
- Health data exchange rules:
- A regulation mandates the use of standards in electronic health data exchange.
- FHIR is specifically mentioned and mandated by this regulation.
- Deadlines and penalties:
- Compliance deadlines are set.
- Fines are imposed for not meeting these deadlines.
- Funding:
- Government funds to stimulate FHIR adoption are not universally available, but some initiatives are supported.
- Regulations and Funds Information:
- Detailed regulations can be found in Sozialgesetzbuch V (SGB V) and the operations of the Competence Center for Interoperability in Healthcare (no direct link provided).
National Setup
- Standards Organization:
- Implementation Guides:
- A widely used base/core FHIR implementation guide is available at Basisprofil DE R4.
- Terminology Services:
- A national FHIR terminology server is in production, facilitating standardized vocabularies for healthcare terms.
Active Use Cases
- Local Implementations:
- Prescriptions/Pharmacy
- Provider Directory
- Public Health Reporting
- Patient Access
- International Standards Use:
- International Patient Summary
- European Implementation Guides
- Key Projects:
- ePrescription (eRezept)
- Medical Informatics Initiative
Who's Using FHIR
- Active organizations include care providers, payers/insurers, EHR system vendors, and app developers.
- Main reasons for adoption:
- Regulation and grants
- Innovation
- FHIR is used for messaging, document exchange, REST APIs, and more, reflecting its versatility in healthcare interoperability.
Success Stories and Challenges
- Benefits:
- Improved healthcare outcomes and access to information.
- Better care workflows, as seen in the German ePrescription initiative.
- Challenges:
- High investment costs and lack of FHIR knowledge.
- Difficulty in navigating regulations for some stakeholders.
- Future Plans:
- Anticipation of significant cost savings, enhanced care coordination, and a more robust digital health ecosystem through FHIR adoption.
Future Plans
- So far, there's been considerable progress in FHIR adoption, matching or exceeding expectations in some areas.
- Next steps include the development of more specific use cases and continued expansion of FHIR across the healthcare ecosystem.
- Expected changes include further improvements in interoperability and healthcare outcomes, driven by FHIR.
Contributors
- Maximilian Reith, KBV
- Dennis Kipping, mio42 GmbH
- Dr. Kai Heitmann, HL7 Germany
- Sylvia Thun, Charité - Universitätsmedizin Berlin
The above summary is based on the answers to the State of FHIR Survey 2025, organized by Firely and HL7 International.
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HL7 Deutschland ist eine von ca. 40 Landesvertretungen und arbeitet an der Förderung und Verbreitung des Standards
in Deutschland. Dabei stehen die Weiterentwicklung des Standards bezogen auf die deutschen Anforderungen durch die
Technischen Komitees im Vordergrund und schließt Ausarbeitung von
Implementierungsleitfäden und anderen Spezifikationen sowie Schulung von Anwendern und Systemherstellern ein.
http://hl7.de/
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Uniklinik Köln
This is the project page for the University Clinic Cologne.
The University Clinic Cologne seeks to improve interoperability within clinical care and research projects.
The projects are united by a shared desire for accurate process and data representation in order to improve patient outcomes through digital health.
Nevertheless, the participants of the published projects are commited to uphold patient and healthcare provider privacy.
The initial focus lies on standarized cancer care through various interconnected projects, yet the scope is not limited to this topic.
All content pusblished by the University Clinic Cologne is subject to the following licence:
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License .
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Die Medizininformatik-Initiative ist ein mehrphasiges Förderprogramm des BMBF, in dem an den deutschen Universitätskliniken und Partnereinrichtungen Datenintegrationszentren aufgebaut und vernetzt werden, um Forschungs- und Versorgungsdaten standortübergreifend verknüpfen zu können. Für konkrete medizinische Anwendungen werden auf dieser Basis innovative IT-Lösungen entwickelt, die die Möglichkeiten moderner digitaler Dienstleistungen und Infrastrukturen im Gesundheitsbereich zeigen sollen.
Weiterführende Links:
- [Website der Medizininformatik-Initiative](https://www.medizininformatik-initiative.de/)
- [Website des BMBF zur Medizininformatik](https://www.bmbf.de/de/medizininformatik-3342.html)
- [Interaktive Karte: Medizininformatik in Deutschland](https://www.medizininformatik-karte.de)
- [Medizininformatik-Initiative im HL7-Wiki](http://wiki.hl7.de/index.php?title=Medizininformatik-Initiative)
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Die Kassenärztliche Bundesvereinigung (KBV) ist der Dachverband der Kassenärztlichen Vereinigungen in Deutschland und damit beauftragt für alle gesetzlich Krankenversicherten die gleiche hochwertige medizinische Betreuung zu garantieren. In diesem Zusammenhang setzt sich die KBV entsprechend der Vorgaben des Bundesministeriums für Gesundheit (BMG) auch für die Digitalisierung des Gesundheitswesens ein. Dazu gehören folgende Projekte:
* Medizinische Informationsobjekte (MIOs)
* KBV-Basis-Profile
* eAU
* eRezept
* Verordnungsschnittstelle
* Archiv-und Wechselschnittstelle
* Schlüsseltabellen
* eTerminservice
**Weiterführende Links:**
* [KBV-Basis-Profile auf simplifier.net](https://simplifier.net/Base1x0)
* [FHIR®-Plattform der KBV](https://fhir.kbv.de/)
* [Kommentierungsplattform mio.kbv.de](https://mio.kbv.de/)
* [Themenseite MIO auf kbv.de](https://www.kbv.de/html/mio.php)
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As a national centre of expertise for digital health, gematik supports the efforts of providers and users to make positive network effects possible.
gematik’s core area of expertise is relevant in five areas of action:
1. **A platform for a national telematics infrastructure:**\
gematik establishes the basic functionalities and security measures for a common nationally usable platform so that it can be shared by as many participants as possible.
1. **A centre of expertise and a coordination centre for standardization:**\
gematik coordinates the close communication with the community of standardization experts, the medical profession and industry. It hosts the round table for targeted and internationally implementable standardization on the basis of internationally recognized standards.
1. **A partner for providers and users:**\
gematik advocates user-focused dialogue and provides advice regarding specific technical matters. It focuses on partnerships and these partnerships’ support for solutions. Only in exceptional cases does gematik develop applications of its own.
1. **A forum for future concepts of digital health:**\
gematik has a wide network of contractual partners and supporters, including the central organizations of the healthcare system as shareholders. To promote the mutual dialogue about the future, gematik will develop the forum for sharing ideas and presenting innovative solutions.
1. **A European partner and moderator for national cooperation:**\
In European projects, gematik specifically supports the promotion of uniform data formats for the cross-border sharing of patient data in the EU. It also closely cooperates with other national centres of expertise for digital healthcare and with European authorities.
[www.gematik.de](https://www.gematik.de/)
[github.com/gematik](https://github.com/gematik)
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