In Nauru, FHIR (Fast Healthcare Interoperability Resources, a standard for exchanging health data electronically) is being used for a few specific healthcare use cases. It is not yet the main standard for health data exchange in the country.

The FHIR versions currently active in Nauru are:

  • R4
  • R5

Looking ahead, we expect a strong increase in FHIR adoption in the coming years.

Rules and Support

The state of health data regulation in Nauru is not fully clear. Key points include:

  • It is not currently known whether national regulation mandates the use of standards for electronic health data exchange.
  • More information would need to come from the government ICT ministry.
  • There is a recognized need for standard operating procedures (SOPs) to support implementation.

National Setup

Here is what we know about the national setup for FHIR in Nauru:

  • Standards organization: Yes, there is a national organization responsible for health data standards.
  • Base FHIR implementation guide: No national base or core FHIR implementation guide exists yet.
  • National FHIR terminology server: None is available, and there are no plans to develop one.
  • FHIR Community Process (FCP): The status of FCP activity in Nauru is not known.

There is a clear call for strong and effective coordination to support national standards development.

Active Use Cases

FHIR use in Nauru is still at an early stage. Based on current information:

  • No specific successful FHIR use cases have been identified yet.
  • No international specifications (such as the International Patient Summary) are confirmed to be in use.
  • No specific national FHIR use cases (such as prescriptions, referrals, or immunizations) are currently reported.

Who Is Using FHIR

In Nauru, FHIR adoption is driven by:

  • Main stakeholders: Care providers
  • Main driver: Improving care workflows

The country uses a balanced mix of open source and proprietary FHIR software.

How FHIR Is Being Used

The following FHIR exchange mechanisms are applied at a moderate level:

  • FHIR Messaging
  • FHIR Documents
  • FHIR REST API (a way for systems to share data over the web)

More advanced FHIR tools, such as SMART on FHIR, CDS Hooks, CQL on FHIR, SQL on FHIR, FHIR Bulk Data, and Subscriptions, are not yet in use in Nauru.

Success Stories and Challenges

At this stage, there are no specific success stories or challenges that have been highlighted for FHIR adoption in Nauru. No specific upcoming FHIR use cases have been identified yet.

Artificial Intelligence and FHIR

AI and machine learning (ML) are seen as strongly helping FHIR and structured data efforts in Nauru. At the same time, there is some view that AI's ability to interpret unstructured data may reduce the need for heavy investment in structured FHIR data.

Future Plans

Progress and next steps for FHIR in Nauru include:

  • Last year's progress: Quite the progress we expected, including the development of new FHIR standards for more specific use cases.
  • Next step expected: Launch of pilot projects with selected healthcare stakeholders.
  • Long-term outlook: There is strong agreement that, within the next three years, Nauru will see the benefits of FHIR adoption, including cost savings, better care coordination, and a stronger digital health ecosystem.

Contributors

The contributor to this survey for Nauru chose to remain anonymous.

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