In Ukraine, FHIR is widely used to exchange healthcare data. It plays a major role in the national eHealth system, though it is not yet the single main standard for every use case.

The active version of FHIR in Ukraine is R4. This is the most established and stable version used by implementers today.

Looking ahead, the rate of FHIR adoption is expected to grow slightly in the coming years. Progress, however, has been slower than many had hoped.

Rules and Support

Ukraine has rules in place for electronic health data exchange, but FHIR is not specifically named in them.

  • Standards are required for electronic health data exchange.
  • FHIR is not mentioned in the regulations.
  • There are no fines for missing compliance.
  • There is no government funding available to support FHIR adoption or standardization work.

In short: electronic standards are required, but FHIR support and funding for a national standards body are missing.

National Setup

Ukraine has a national organization responsible for health data standards. However, the national FHIR foundation is still limited.

  • A national standards organization exists.
  • There is no national base or core FHIR implementation guide.
  • There are no other national FHIR standards developed for specific use cases.
  • There is no national FHIR terminology server, and none is planned.

Regarding the FHIR Community Process (FCP), one or more organizations in Ukraine are exploring becoming participants. Looking 2–3 years ahead, the expectation is that there will be little known FCP activity in the country.

Active Use Cases

The main FHIR work in Ukraine centers on the national eHealth system. This is a large-scale, real-world deployment.

  • The Ukrainian national eHealth system uses FHIR.
  • It serves 30+ million patients.
  • It connects 10,000 healthcare providers.
  • It supports 100,000 healthcare professionals.

In terms of exchange mechanisms, the FHIR REST API is heavily used. Other tools like SMART on FHIR, Subscriptions, CDS Hooks, SQL on FHIR, FHIRcast, and FHIR Questionnaires see little to no use today.

Who's Using FHIR

The main adopters of FHIR in Ukraine are government agencies. The primary driver for adoption is regulation and grants.

The software landscape leans strongly toward proprietary solutions rather than open source.

Success Stories and Challenges

The biggest success is the national eHealth system itself. It has delivered real benefits at scale:

  • Improved access to information
  • Improved care workflows

But there are also clear challenges holding back wider FHIR adoption:

  • Unclear benefits for stakeholders
  • Lack of FHIR knowledge
  • Changes in political direction

There is also a strong view in Ukraine that AI advances may reduce the need to invest heavily in FHIR and structured data, since AI can interpret unstructured data directly.

Future Plans

Progress over the last year has been much less than expected, and overall satisfaction with FHIR adoption is low.

Looking forward, the expected next steps in Ukraine include:

  • Developing a national FHIR data model
  • New regulation that prescribes the use of standards in electronic health data exchange
  • Developing new FHIR standards for more specific use cases
  • Expanding FHIR adoption across the healthcare ecosystem

The outlook for the next three years is cautiously neutral. There is potential for cost savings and better care coordination, but real benefits will depend on overcoming the current challenges.

Contributors

  • Andrii Krylov, Co-chair / Executive Director, HL7 Ukraine

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