In Croatia, FHIR (Fast Healthcare Interoperability Resources) is starting to be used for exchanging healthcare data. Currently, the most active FHIR version in use is R4, indicating some level of modern implementation. Respondents to the survey anticipate significant growth in the adoption of FHIR in the coming years, signaling a positive outlook towards leveraging this standard for healthcare data interoperability.

Rules and Support

  • Health Data Exchange Rules
    • A central eHealth system, CEZIH, mandates the use of healthcare IT standards, including FHIR, for data exchange among healthcare institutions.
  • FHIR Requirements
    • Regulations advise the use of FHIR but do not specifically mandate it.
  • Deadlines and Fines
    • There are no specified deadlines or fines for non-compliance.
  • Funding
    • Currently, there are no government funds available to stimulate FHIR adoption.
  • Regulation Links
    • More about health data regulations and CEZIH can be found here.

National Setup

  • Standards Organization
    • Croatia has a national organization responsible for health data standards, linked here.
  • Implementation Guides
    • A base/core FHIR Implementation Guide for Croatia, used in a limited set of cases, is available here.
  • Terminology Services
    • Croatia has a national FHIR terminology server in production.

Active Use Cases

  • Local Implementations
    • The Croatian Oncology Database is a noted successful FHIR use case.
  • International Standards Use
    • No specific mentions.
  • Key Projects
    • The integration of emergency services is a future use case being looked forward to.

Who's Using FHIR

  • Active Organizations
    • EHR system vendors and app developers are actively involved.
  • Reasons for Adoption
    • Improved healthcare outcomes and access to information are the main benefits noted.
  • Usage
    • FHIR is being used for messaging, documents, and REST API functionalities.

Success Stories and Challenges

  • Benefits
    • The Croatian Oncology Database project is highlighted as a clear success, improving healthcare outcomes and access to information.
  • Challenges
    • The main difficulties include lack of FHIR knowledge and unclear benefits.
  • Future Plans
    • Expanding the Oncology Database project to other medical specialties for national data exchange is anticipated.

Future Plans

  • Progress So Far
    • There has been "quite the progress" expected in FHIR adoption over the last year, with respondents being satisfied.
  • Next Steps
    • Development of a national FHIR data model and new standards for specific use cases are underway.
  • Expected Changes
    • Strong agreement exists that FHIR adoption will lead to significant cost savings, enhanced care coordination, and a robust digital health ecosystem in the next three years.

Contributors

  • Kresimir Kers, Product Manager at Ericsson Nikola Tesla d.d.
  • Siniša Košćina, Business Development Director, Healthcare at IN2

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