In Greece, FHIR (Fast Healthcare Interoperability Resources) is beginning to shape the way healthcare data is exchanged. Currently, its adoption is at a nascent stage, with a score of 2 out of 5 indicating early phases of use. The versions R4 and R5 of FHIR are notably recognized, with R4 having a modest adoption (scored 3) and R5 being more anticipated (scored 4). The expectation for FHIR adoption in the coming years is positive, with a score of 4 suggesting growing optimism.

Rules and Support

  • Health Data Exchange Rules:
    • FHIR is advised in regulations for electronic health data exchange.
    • Specific regulations are in place mandating the use of standards like FHIR.
  • FHIR Requirements:
    • The regulation explicitly mentions FHIR.
  • Deadlines and Compliance:
    • No strict deadlines for compliance.
    • Uncertainty around fines for non-compliance.
  • Funding:
    • Currently, no government funds are available to support FHIR adoption.
    • Upcoming regulations and digital reform tenders may change this scenario.

National Setup

  • Standards Organization:
    • Greece currently has no national organization responsible for health data standards.
  • Implementation Guides:
    • A base/core FHIR implementation guide is under development.
  • Terminology Services:
    • A national FHIR terminology server is planned but not yet available.

Active Use Cases

  • Local Implementations:
    • Specific use cases developed include Prescriptions/Pharmacy, Referrals/Continuity of care, Terminology, Diagnostic Orders/Reports, Document Exchange, Imaging, and Immunizations.
  • International Standards Use:
    • European Implementation Guides are being adopted.

Who's Using FHIR

  • Active Organizations:
    • Care providers, payers/insurers, EHR system vendors, diagnostic system vendors (like Imaging/Lab), and app developers are actively involved.
  • Main Reasons for Adoption:
    • Regulation and grants, innovation, and development of new FHIR standards for specific use cases.
  • Usage of FHIR:
    • While specifics on how each sector is using FHIR are not detailed, the engagement across a broad spectrum suggests a foundational effort to integrate FHIR into multiple facets of healthcare information technology.

Success Stories and Challenges

  • Benefits:
    • The survey does not detail specific success stories or direct benefits realized from FHIR adoption in Greece.
  • Main Difficulties:
    • Key challenges include unclear regulations, a lack of FHIR knowledge, and changes in political direction.
  • Future Plans:
    • Expectations are set on the expanded adoption of FHIR, the development of a national FHIR data model, and new regulations that prescribe the use of standards in health data exchange.

Future Plans

  • Progress So Far:
    • Greece has made "quite the progress expected" in the last year regarding FHIR adoption.
  • Next Steps:
    • Development of a national FHIR data model and new FHIR standards for specific use cases.
    • Launch of pilot projects with selected healthcare stakeholders.
  • Expected Changes:
    • In the next three years, significant benefits from FHIR adoption are anticipated, including cost savings, enhanced care coordination, and a robust digital health ecosystem.

Contributors to the survey have chosen to remain anonymous; thus, individual names are not listed.

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