In Iceland, FHIR is just starting to be used for healthcare data exchange. Adoption is currently very limited, with only a few use cases in production.

The FHIR versions in active use are R4 and R5. FHIR stands for Fast Healthcare Interoperability Resources, a standard for exchanging health data electronically.

Looking ahead, we expect moderate growth in FHIR adoption over the coming years, though the pace remains uncertain.

Rules and Support

Iceland currently has limited regulatory support for FHIR adoption:

  • No regulation mandates the use of standards in electronic health data exchange
  • No government funds are available to stimulate FHIR adoption
  • No deadlines or fines apply, since no mandate exists

The main concern raised is the lack of driving regulations to push standards adoption forward.

National Setup

Iceland has some national infrastructure in place to support health data standards:

  • National standards organization: Stafræn heilsa (Digital Health) — Visit website
  • National base FHIR implementation guide: Not yet available
  • National FHIR terminology server: Currently in development

A few FHIR standards are being developed for specific use cases. There is no known activity yet around the FHIR Community Process (FCP), and this is not expected to change in the next 2–3 years.

Active Use Cases

FHIR specifications in Iceland are being developed for:

  • Prescriptions and pharmacy
  • Allergy intolerance

Iceland's national specifications draw on European Implementation Guides as a foundation.

Who's Using FHIR

The main organizations adopting FHIR in Iceland are:

  • EHR (Electronic Health Record) system vendors
  • Government agencies

The primary driver for adoption is innovation, rather than regulation or funding.

In terms of how FHIR is applied:

  • FHIR Messaging, Documents, and REST API: Very limited use
  • Advanced FHIR tools (such as SMART on FHIR, CDS Hooks, Bulk Data, Subscriptions, Questionnaires): Not yet in use

The software landscape leans slightly toward open source, but a mix of open source and proprietary tools is used.

Success Stories and Challenges

A success story

  • Centralized Allergy registry: This project improved access to allergy information across the healthcare system.

AI and FHIR

AI and machine learning are seen as strongly helping FHIR and structured data efforts in Iceland. AI is particularly useful for accelerating the mapping and transformation of data into FHIR. There is strong disagreement with the idea that AI reduces the need for structured data.

Main challenges

  • High investment cost
  • Unclear benefits of FHIR adoption
  • Lack of funding to drive national standards work forward

Future Plans

Progress over the past year has been slower than expected, and there is dissatisfaction with the current adoption rate. Looking forward, key next steps include:

  • Establishing a national standards organization with a clearer mandate
  • Developing a national FHIR data model
  • Implementing the EU Patient Summary, which is the most anticipated upcoming use case

There is some skepticism about whether Iceland will fully reap the benefits of FHIR adoption within the next three years, given the current pace.

Contributors

  • Gunnar Friðriksson, CTO, Helix Health

The above summary is based on the answers to the State of FHIR Survey 2026, organized by Firely and HL7 International.