In Slovakia, FHIR is at a very early stage of adoption. It is not yet widely used to exchange healthcare data, and only a small number of initiatives currently apply it in practice.

The respondent did not specify which FHIR versions are in active use in the country. This reflects the limited maturity of FHIR-based exchange so far.

Looking ahead, there is strong optimism. A significant increase in FHIR adoption is expected in the coming years, especially as European requirements take effect.

Rules and support

Slovakia has national rules for electronic health data exchange, but they do not yet point to FHIR.

  • A national law governs electronic health data exchange: Act 153/2013
  • The current mandatory standard at the national level is ISO 13606 (a European standard for electronic health record communication)
  • FHIR is not mentioned in the regulation
  • A compliance deadline exists, and fines apply if it is missed
  • No government funds are currently available to support FHIR adoption

The national standard is expected to change to align with the upcoming European Health Data Space (EHDS) requirements.

National setup

The national setup for FHIR standards in Slovakia is still limited:

  • There is no clear national organization responsible for FHIR-based health data standards
  • There is no national base or core FHIR implementation guide
  • No other FHIR specifications have been developed locally for specific use cases
  • European Implementation Guides serve as a reference point
  • There is no national FHIR terminology server, and none is planned

The country also has no known activity yet related to the FHIR Community Process (FCP), which is the formal process for publishing FHIR specifications.

Active use cases

Concrete FHIR activity in Slovakia is still rare. One notable example stands out:

  • Slovak biobanking node (BBMRI): uses FHIR to support biobank data exchange

This project has helped improve access to information through standardized data.

Who is using FHIR

FHIR adoption in Slovakia is currently driven by a small group:

  • App developers are the main stakeholders adopting FHIR
  • The main driver for adoption is regulation and grants

The National Health Information Centre (the Slovak eHealth Agency) has recently started looking into international standards, including FHIR and EHDS. However, most local vendors are still hesitant to invest, mainly because national regulators have not communicated clear expectations.

Successes and challenges

The biggest win so far is improved access to information through the biobanking node use case.

The main challenges include:

  • Frequent changes in political direction
  • Limited communication from national regulators to vendors
  • Lack of clear FHIR-related guidance at the national level

There is also a positive view on AI and FHIR. Increasing use of AI is seen as somewhat helping structured data efforts, and there is growing interest in FHIR as a foundation for AI. The respondent disagrees with the idea that AI removes the need to invest in structured data.

Future plans

Progress over the past year was less than expected, and overall satisfaction with FHIR adoption is very low.

Looking forward:

  • Pilot projects with selected healthcare stakeholders are expected in the coming year
  • EHDS requirements are likely to push national standards (including ISO 13606) toward FHIR
  • There is cautious optimism about reaping the benefits of FHIR within three years

Contributors

  • Eva Sabajova, Digital Health Slovakia / HL7 Slovakia affiliate

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