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

The United Kingdom has established a robust regulatory framework to guide the use of standards in electronic health data exchange. The cornerstone of this framework is the Health and Social Care Act (HSCA) 2012, as amended by the Health and Care Act (HCA) 2022. This marks a significant development from 2023, where no specific regulation was mentioned. While FHIR is not explicitly mentioned in these regulations, there is a clear deadline for compliance, underscoring the government's commitment to standardization. However, there are no significant funding programs currently available to stimulate FHIR adoption. The recent release of UK Core 2.0 marks a significant milestone in the nation's regulatory landscape.

Adoption

The adoption of FHIR in the United Kingdom is steadily gaining momentum. In 2023, FHIR was used for a few use cases, rated at 2, but by 2024, this has increased to a rating of 4, indicating more widespread use. The most widely used versions of FHIR in the UK are STU3 and R4, with a noticeable increase in R4 usage from 2 to 4. While DSTU2 usage has seen a slight increase, R5 and the pre-release R6 remain unused. This indicates a cautious but progressive embrace of newer FHIR versions. The expected change in the rate of adoption remains optimistic, though slightly tempered from a strong increase rating of 5 in 2023 to 4 in 2024.

Authoritative Bodies

NHS England, formerly known as NHS Digital, is the principal authoritative body overseeing the development and implementation of FHIR standards in the UK. This is a shift from 2023, where HL7 UK was noted as the primary standards organization. NHS England's leadership and guidance are pivotal in steering the national strategy for electronic health data exchange.

Relevant Institutes

In addition to NHS England, other key stakeholders include DHCW (Wales), NHS Scotland, HSC Northern Ireland, and HL7 UK. These organizations play crucial roles in the regional and national implementation of FHIR, contributing to a cohesive approach across the United Kingdom.

National Standards Development

The UK has made significant strides in developing national standards for FHIR. The UK Core, accessible here, serves as the national FHIR data model and is currently used in a limited set of use cases. This continuity from 2023 shows ongoing development and implementation. Additionally, there are now numerous specific FHIR standards derived from the national model, highlighting the country's commitment to tailored and comprehensive data exchange solutions.

Terminology Usage

While the survey did not provide specific details on terminology usage, the adoption of FHIR inherently supports standardized terminologies, which are crucial for interoperability and accurate data exchange.

Infrastructure

The UK's infrastructure for FHIR implementation is decentralized, making it somewhat challenging to track progress comprehensively. This was also noted in 2023, with the additional insight in 2024 that issues are more about the lack of well-funded integration projects rather than a lack of desire to use FHIR. Software companies looking to plug into this infrastructure must navigate a landscape marked by high investment costs and a need for clearer regulations and national strategy.

Conclusion

The United Kingdom is on a promising path toward widespread FHIR adoption. With strong regulatory frameworks, active authoritative bodies, and ongoing national standards development, the future of FHIR in the UK looks bright. The progress from 2023 to 2024 is evident in the increased adoption and more detailed regulatory landscape. Continued efforts to address challenges such as high investment costs and lack of FHIR knowledge will be crucial in realizing the full potential of FHIR and improving healthcare outcomes across the nation.

This summary presents the current state of Fast Healthcare Interoperability Resources (FHIR) in the United Kingdom based on the HL7 FHIR DevDays 2024 State of FHIR survey results provided by Rik Smithies of HL7 UK and others.

Additional background was added based on the answers to the HL7 FHIR DevDays State of FHIR survey 2023 by Rik Smithies of HL7 UK.