In Ireland, FHIR is being used for a few healthcare data exchange use cases. It is not yet the main standard, but adoption is growing. FHIR stands for Fast Healthcare Interoperability Resources, a modern standard for exchanging health information between systems.
The version currently in use is R4. Looking ahead, we expect a strong increase in FHIR adoption over the coming years.
Ireland is actively building the foundations for wider FHIR use, with strong support from the Department of Health.
Rules and Support
Ireland has regulations that mandate standards for electronic health data exchange:
- FHIR is advised (not strictly mandated) in current regulations
- There is a deadline for compliance
- No fines are imposed for missing the deadline
- No specific government funds are available to stimulate FHIR adoption
- Key regulations include the European Health Data Space (EHDS) Regulations with a 2029 implementation target, and the Irish Health Information Bill
The Department of Health is very supportive of developing FHIR governance and standards.
National Setup
Ireland has a clear structure for health data standards:
- The national organisation responsible for health data standards is the Health Information and Quality Authority (HIQA)
- There is no national base FHIR implementation guide yet
- A few FHIR standards have been developed for specific use cases
- A national FHIR terminology server is in production (this server provides shared lists of medical codes and terms)
- Ireland is in the process of establishing a FHIR Affiliate to provide governance, education, and support
Regarding the FHIR Community Process (a global way to develop and share FHIR specifications), one or more Irish organisations are exploring becoming participants. Within 2-3 years, Ireland expects to have one or more approved participants.
Active Use Cases
Ireland is developing FHIR specifications for use cases including a Health App.
The country builds on several international specifications:
- International Patient Summary
- European Implementation Guides
- IHE profiles (Integrating the Healthcare Enterprise)
Who's Using FHIR
The main organisations adopting FHIR in Ireland are:
- Care providers
- EHR (electronic health record) system vendors
- App developers
- Government agencies
The main drivers for adoption are:
- Improving health outcomes
- Improving care workflows
- Patient data access
Exchange mechanisms in use include FHIR Messaging and FHIR REST APIs (moderate use), with FHIR Documents seeing some uptake. Tools like SQL on FHIR, Subscriptions, and FHIR Shorthand are in early stages. The market leans more towards open source than proprietary FHIR software.
Successes and Challenges
A successful use case in Ireland is the Health App, which has improved access to information.
Looking forward, there is excitement about extracting data from the National Shared Care Record using FHIR.
The main challenges include:
- Lack of FHIR knowledge across the ecosystem
- Changes in political direction
- Getting senior-level sponsorship
As one respondent put it: "FHIR will be a key enabler to deliver interoperability and exchange health data."
Future Plans
Ireland has made more progress than expected over the past year, and people are satisfied with the current adoption rate.
Key achievements over the past year include:
- New regulation prescribing the use of standards
- Development of new FHIR standards for specific use cases
- Launch of pilot projects with selected healthcare stakeholders
- Expanded adoption of FHIR across the healthcare ecosystem
The main next step expected in the coming year is:
- Establishment of a national standards organisation
There is general agreement that within three years, Ireland will benefit from FHIR adoption through cost savings, better care coordination, and a stronger digital health ecosystem.
Contributors
- Patrick Marren, HSE (MyHealth@EU Team Leader)
The above summary is based on the answers to the State of FHIR Survey 2026, organized by Firely and HL7 International.