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

The active versions of FHIR are not clearly known at this time. Adoption is still in its early stages, with limited visibility into which versions are being deployed.

There is cautious optimism about the future. Progress over the past year has been slightly better than expected, and there is interest in building a stronger FHIR foundation.

Rules and Support

  • Health data exchange rules: There is no regulation that mandates the use of standards for electronic health data exchange.
  • FHIR requirements: FHIR is not currently required by law.
  • Deadlines: No compliance deadlines are in place.
  • Funding: Government funds are available to support FHIR adoption.

National Setup

  • Standards organization: There is no national organization responsible for health data standards.
  • Implementation guides: Tunisia does not yet have a base or core FHIR implementation guide.
  • Terminology services: There is no national FHIR terminology server, and no plans to create one at this time.
  • FHIR Community Process (FCP): There is no known FCP activity in Tunisia. The future direction for FCP participation is uncertain.

Active Use Cases

  • There are some successful FHIR use cases in the country, though specific projects were not detailed.
  • No national FHIR standards have been developed yet for specific use cases.
  • International specifications (such as the International Patient Summary or IHE profiles) are not currently used as a basis for local work.

Who's Using FHIR

The main groups adopting FHIR in Tunisia include:

  • EHR (Electronic Health Record) system vendors
  • App developers
  • Government agencies
  • Researchers

The main driver for FHIR adoption is:

  • Improving patient access to their own health data

Open source FHIR software is strongly favored over proprietary tools.

Success Stories and Challenges

Reported benefits from FHIR use:

  • Lower costs
  • Better healthcare outcomes
  • Improved access to information
  • Better care workflows

Main challenges:

  • Lack of FHIR knowledge among professionals
  • Changes in political direction that affect priorities

On AI and FHIR: There is a view that advances in AI (Artificial Intelligence) may reduce the perceived need to invest in structured FHIR data, since AI can interpret unstructured data directly. This perception may slow structured data efforts.

Future Plans

  • Progress so far: Over the past year, Tunisia launched pilot projects with selected healthcare stakeholders. Progress has been somewhat better than expected.
  • Next steps: The focus for the coming year is on developing a national FHIR data model.
  • Looking ahead: There is agreement that within the next three years, FHIR adoption will deliver real benefits, including cost savings, better care coordination, and a stronger digital health ecosystem.

Contributors

The contributor for Tunisia 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.