The following is based on the answers to the State of FHIR survey 2023.
Regulation
In France, the use of FHIR is advocated through CI-SIS, the Interoperability framework set by the French e-Health agency (ANS). While the exact compliance deadlines are not specified, FHIR is advised for electronic health data exchange. There is no information on fines for non-compliance. However, funds are available to stimulate FHIR adoption, with reference to the Segur Numerique en Sante program, which is part of a broader digital health initiative.
National Standards Development
InteropSanté & ANS are the primary national standards organizations. A national FHIR data model is already widely used and published on Simplifier.net. France has developed many FHIR standards for specific use cases, almost all deriving from this national data model. There is a strong drive towards improved care and innovation in health data standards.
FHIR Implementation
The anticipated growth in FHIR adoption in France is significant, with the expectation of improved access to information. Noteworthy FHIR use cases include the Annuaire santé (a healthcare professional directory) and Service d'Accès aux Soins (SAS for healthcare access). Future implementations to look forward to include services for bed availability (Répertoire Opérationnel des Ressources or ROR), Mon Espace Santé, and a FHIR terminology service.
Challenges in FHIR implementation include high investment costs, unclear benefits, and a lack of FHIR knowledge. Despite these challenges, the outlook for FHIR implementation in France is positive, with a strong push towards leveraging FHIR for better healthcare outcomes.
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The mission of the non-profit association [Interop'Santé](http://www.interopsante.org) is to build and promote standardized semantic interoperability in the field of healthcare in France.
This association embeds HL7 France, the French affiliate of HL7 International, as well as IHE France, the French affiliate of IHE International.
Interop'Santé in its HL7 France component has signed a development license agreement with _SNOMED International_, so as to be able to include SNOMED CT content in its products (specifications, implementation guides, value sets).
Implementation, deployment and usage of any SNOMED CT content is subject to the signature of a [SNOMED CT Affiliate License Agreement](https://www.snomed.org/snomed-ct/get-snomed-ct).
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