In Saudi Arabia, FHIR is being used for a few specific use cases. It is not yet the main standard for exchanging healthcare data, but adoption is growing.

The active FHIR version in the country is R4. This is the version powering current national implementations.

Looking ahead, we expect a strong increase in FHIR adoption in the coming years. Clinical data exchange using FHIR is starting to emerge alongside existing implementations.

Rules and Support

Saudi Arabia has regulation in place for electronic health data exchange. Here's what you need to know:

  • Standards required: Yes, regulation mandates the use of standards.
  • FHIR specifically: Yes, FHIR is mandated.
  • Deadline: Yes, there is a compliance deadline.
  • Fines for non-compliance: No fines are imposed.
  • Government funding: No specific funds are available to stimulate FHIR adoption.

The national eClaims system is built on FHIR R4. Clinical data exchange using FHIR is now emerging as the next area of focus.

National Setup

The national standards landscape in Saudi Arabia is still developing:

  • National standards organization: There is no single national organization responsible for health data standards.
  • Base/core FHIR implementation guide: No national base or core implementation guide exists yet.
  • Terminology server: A national FHIR terminology server is planned but not yet in development.
  • FHIR Community Process (FCP): Saudi Arabia already has one or more approved FCP specifications. Balloting is managed through the HL7 affiliate process, which mirrors HL7 International processes rather than the FCP process itself.

A few FHIR standards have been developed for specific use cases, mainly focused on invoice and claim.

Active Use Cases

The main FHIR-based work in Saudi Arabia centers on financial and administrative exchange:

  • National eClaims system: Fully implemented in FHIR R4.
  • Invoice and Claim specifications: Locally developed FHIR profiles support this use case.

Other internationally-driven specifications (like the International Patient Summary or IHE profiles) are not currently used as a basis for national work.

Who's Using FHIR

The main stakeholders adopting FHIR in Saudi Arabia include:

  • Care providers
  • Payers and insurers
  • App developers
  • Clinical registries

The main drivers for adoption are:

  • Regulation and grants – meeting national mandates
  • Improving care workflows – making day-to-day processes smoother
  • Innovation – enabling new digital health solutions

In terms of how FHIR is used, FHIR Messaging is the most widely applied exchange mechanism. FHIR Shorthand (a tool for authoring FHIR profiles) is also used. The FHIR REST API sees limited use. Most software in use is proprietary rather than open source.

Success Stories and Challenges

Wins

  • The Saudi national eClaims system is a major success, fully implemented in FHIR.
  • Key benefits include lowered cost and improved care workflows.

Challenges

  • Lack of FHIR knowledge across the ecosystem
  • Changes in political direction affecting consistent progress

Looking forward

The most anticipated upcoming project is FHIR-based clinical data exchange to the national repository.

Future Plans

Progress so far

Over the past year, Saudi Arabia has seen:

  • Establishment of a national standards organization
  • Development of new FHIR standards for specific use cases
  • Expanded adoption of FHIR across the healthcare ecosystem

Overall, progress has been less than expected, and satisfaction with the current adoption rate is neutral.

Next steps

In the coming year, we expect:

  • Further development of FHIR standards for more specific use cases
  • Launch of pilot projects with selected healthcare stakeholders
  • Expanded adoption of FHIR across the healthcare ecosystem

Outlook

There is general agreement that within the next three years, Saudi Arabia will see meaningful benefits from FHIR adoption, including cost savings, better care coordination, and a stronger digital health ecosystem.

Contributors

  • Paul Knapp, President and Standards Lead, Knapp Consulting Inc.

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