In Italy, the use of FHIR (Fast Healthcare Interoperability Resources) for exchanging healthcare data is growing. Currently, it holds a moderate level of usage with a score of 3 out of 5, indicating that it's in active development and adoption phases. The most used version of FHIR is R4, rated at 5 out of 5, followed by R4B at a score of 4, showing a clear preference and progression towards newer standards. The expectation for FHIR adoption in Italy is positive, with a forecast of increased usage in the coming years.

Rules and Support

• Health Data Exchange Rules
  • There is regulation in place mandating the use of standards for electronic health data exchange.
  • FHIR is specifically mentioned and mandated in these regulations.
  • No deadlines are imposed for compliance, nor are there fines for non-compliance.
• Support and Funding
  • Government funds are available to stimulate the adoption of FHIR.
  • Key regulations and funding sources include the Ecosistema Dati Sanitari (Italian EHDS) and the Italian PNRR (National Recovery and Resilience Plan). Further information can be found on their respective platforms.

National Setup

• Standards Organization
  • Italy has a national organization responsible for health data standards, HL7 Italy. HL7 Italy
• Implementation Guides
  • A base/core FHIR implementation guide specific to Italy is under development. Italian FHIR Implementation Guide
• Terminology Services
  • While a national FHIR terminology server is not yet available, it is currently in planning.

Active Use Cases

Italy is developing FHIR standards for various healthcare data exchanges, including:

• Prescriptions / Pharmacy
• Referrals / Continuity of care
• Terminology
• Diagnostic Orders/Reports
• Document Exchange
• European Implementation Guides

These reflect the local implementations and adherence to international standards, showcasing the flexibility and scalability of FHIR within Italy's healthcare ecosystem.

Who's Using FHIR

Several entities are actively engaged with FHIR in Italy:

• Care Providers and EHR System Vendors are the primary users.
• The main reasons for adopting FHIR include regulation and grants, innovation, and the development of a national FHIR data model.

Success Stories and Challenges

• Benefits and Examples
  • Improved access to information and care workflows have been highlighted as clear benefits.
  • Successful use cases: FHIR project for the Lombardy Region and FHIR project "OMr - Digital Management of the Laboratory Network" for the Lombardy region.
• Main Difficulties
  • Challenges include unclear benefits, unclear regulations, and a lack of FHIR knowledge.

Future Plans

• Progress So Far
  • Italy has made significant strides in FHIR adoption, aligning with expectations.
• Next Steps
  • Development of a national FHIR data model and new standards for more specific use cases are in progress.
• Expected Changes
  • In the next three years, Italy anticipates significant benefits from FHIR adoption, including cost savings and enhanced care coordination.

Contributors

Per the survey permission, names of the contributors can be included. However, the survey response provided does not list specific contributors by name.

This summary provides a snapshot of FHIR's current state, its implementation, and future direction in Italy, making complex information accessible and understandable.

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