In Bosnia and Herzegovina, FHIR is used in a limited way. It supports a few specific use cases rather than serving as the main standard for health data exchange. FHIR stands for Fast Healthcare Interoperability Resources, a standard for exchanging healthcare information electronically.

The version in active use is R5, the most recent stable release of FHIR.

Looking ahead, we expect a strong increase in FHIR adoption over the coming years.

Rules and Support

The regulatory landscape for health data exchange is still developing:

  • There are no regulations that require the use of standards for electronic health data exchange.
  • FHIR is not mentioned in any current regulation.
  • There are no compliance deadlines in place.
  • It is unclear whether government funds are available to support FHIR adoption.

National Setup

The national infrastructure for health data standards is limited:

  • There is no national organization responsible for health data standards.
  • There is no national base or core FHIR implementation guide.
  • There is no national FHIR terminology server, and there are no plans to develop one.
  • One or more organizations are exploring becoming participants in the FHIR Community Process (FCP), a framework for developing and approving FHIR specifications. This situation is expected to remain similar over the next 2–3 years.

Despite this, a few FHIR standards are being developed for specific use cases.

Active Use Cases

FHIR specifications are being developed in Bosnia and Herzegovina for:

  • Diagnostic orders and reports
  • Imaging

For international alignment, the country builds on:

  • European Implementation Guides

Who's Using FHIR

The main groups adopting FHIR locally are:

  • Diagnostic system vendors, such as imaging and laboratory providers
  • App developers

The main driver behind adoption is interoperability — the ability of different systems to share and use health data smoothly.

How FHIR is used:

  • FHIR Documents and the FHIR REST API are applied at a meaningful level. The REST API lets systems request and exchange health data over the web.
  • FHIRcast (which synchronizes apps in real time) and FHIR Bulk Data (for sharing large data sets) see some limited use.
  • Tools like SMART on FHIR, CDS Hooks, CQL on FHIR, SQL on FHIR, FHIR Questionnaires, and FHIR Shorthand are not yet in use.

The mix of software leans slightly toward open source over proprietary solutions.

Success Stories and Challenges

Successes

FHIR has already delivered real benefits, including:

  • Improved healthcare outcomes
  • Improved access to information

Concrete examples include:

  • A Clinical Data Repository (a central store of patient health data)
  • A patient portal
  • Interoperability between radiology and laboratory systems

Challenges

The main difficulties slowing FHIR adoption are:

  • Unclear benefits
  • Unclear regulations
  • A lack of FHIR knowledge

AI and FHIR

The rise of AI and machine learning is somewhat helping FHIR efforts in the country. It is especially useful for speeding up the mapping and transformation of existing data into the FHIR format. There is disagreement with the idea that AI reduces the need to invest in structured FHIR data.

Future Plans

Progress So Far

Over the past year, we made less progress than expected. The main achievement was the launch of pilot projects with selected healthcare stakeholders. Overall, satisfaction with the current pace of adoption is neutral.

Next Steps

Looking ahead to the coming year, we expect:

  • Development of new FHIR standards for more specific use cases
  • More pilot projects with healthcare stakeholders
  • A Clinical Data Repository at the county or entity level

Looking Further Ahead

We agree that within the next three years, FHIR adoption will bring meaningful benefits — including cost savings, better care coordination, and a stronger digital health ecosystem.

Contributors

  • Tarik Demirovic, EHS Group (CTO)

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