In Ukraine, the adoption of FHIR (Fast Healthcare Interoperability Resources) for exchanging healthcare data is in its early stages but shows promise for expansion. Current usage involves a few versions of FHIR, with version R4 being rated the highest at '5' for its implementation level. The country anticipates increased adoption of FHIR in the coming years, with an expectation rating of '3' on a scale where '5' would indicate very rapid adoption.

Rules and Support

  • Health Data Exchange Rules: Ukraine has regulations mandating the use of standards in electronic health data exchange.
  • FHIR Requirements: While these regulations are in place, they do not specifically mention FHIR.
  • Deadlines and Fines: Compliance deadlines are included in the regulation, but no fines are imposed for failure to meet these deadlines.
  • Funding: No government funds are currently available to stimulate the adoption of FHIR in Ukraine.

National Setup

  • Standards Organization: Ukraine has a national organization responsible for health data standards, found at IITs.
  • Implementation Guides: No base/core FHIR implementation guide exists for the country yet.
  • Terminology Services: A national FHIR terminology server is up and running in production.

Active Use Cases

  • Local Implementations: FHIR is being used in several specific areas:
    • Prescriptions / Pharmacy
    • Referrals / Continuity of care
    • Diagnostic Orders/Reports
    • Document Exchange
    • Immunizations
    • Ukrainian national requirements for medical records
  • Key Projects: The National E-Health system is a notable project, ensuring the availability of high-quality medical data through REST API, benefiting over 36.5 million patients.

Who's Using FHIR

  • Active Organizations: Care providers and EHR system vendors are among the primary users.
  • Main Reasons for Adoption:
    • Improving care workflows
    • Innovation
  • How FHIR is Used: Primarily through the FHIR Rest API, rated '4' for its usage level.

Success Stories and Challenges

  • Benefits: The National E-Health system is highlighted as a success story, improving access to information and care workflows.
  • Challenges:
    • High investment cost
    • Unclear regulations
    • Lack of FHIR knowledge
    • Changes in political direction

Future Plans

  • Progress So Far: Ukraine has made less progress than expected in the last year regarding FHIR adoption.
  • Next Steps:
    • Development of a national FHIR data model
    • Development of new FHIR standards for more specific use cases
    • Launch of pilot projects with selected healthcare stakeholders
    • Expanded adoption of FHIR across the healthcare ecosystem
  • Expected Changes: Significant cost savings, enhanced care coordination, and a more robust digital health ecosystem are anticipated benefits within the next three years.

Contributors

  • Andrew Krylov, Executive Director at HL7 Ukraine Affiliate, provided valuable insights for this overview.

This document offers a concise snapshot of FHIR's current state, utilization, and future in Ukraine, presenting a hopeful outlook for its role in enhancing healthcare interoperability and outcomes.

The above summary is based on the answers to the State of FHIR Survey 2025, organized by Firely and HL7 International.