In Japan, the adoption of FHIR (Fast Healthcare Interoperability Resources) is currently in its early stages, with a growing interest in its potential to improve healthcare data exchange. FHIR allows healthcare information to be available, discoverable, and understandable globally, and supports a wide range of applications, including electronic health records (EHRs), mobile apps, and data analysis tools. The versions of FHIR currently in use include DSTU2, STU3, with a notable interest in R4, indicating a progression towards more recent standards. Expectations are set for an increased rate of adoption in the coming years, reflecting an optimistic outlook on FHIR's role in Japan's healthcare IT landscape.

Rules and Support

  • Health Data Exchange Rules: Regulations mandate the use of standards in electronic health data exchange.
  • FHIR Requirements: The regulations specifically advise the use of FHIR.
  • Deadlines: There are no specified deadlines for compliance with these regulations.
  • Available Funding: Government funds are available to stimulate the adoption of FHIR, with initiatives like the "Ministry EHR data sharing service" being mentioned.

National Setup

  • Standards Organization: Currently, there is no national organization responsible for health data standards in Japan.
  • Implementation Guides: A base/core FHIR implementation guide is in use for a limited set of use cases, although specific URLs were not provided.
  • Terminology Services: Plans are underway for establishing a national FHIR terminology server, enhancing the consistency and interoperability of health data.

Active Use Cases

  • Local implementations focus on:
    • Prescriptions/Pharmacy
    • Referrals/Continuity of care
    • Public Health Reporting
    • Document Exchange
    • International Patient Summary
  • These use cases highlight areas where FHIR is actively contributing to improved healthcare data exchange and interoperability.

Who's Using FHIR

  • Active Organizations: EHR system vendors are currently engaged with FHIR, highlighting the technology's role in advancing health IT solutions.
  • Reasons for Adoption: The main motivations include regulatory compliance and the potential to improve healthcare outcomes and data exchange efficiency.

Success Stories and Challenges

  • Benefits: While specific success stories were not detailed, the expected benefits of FHIR include significant cost savings, enhanced care coordination, and a more robust digital health ecosystem.
  • Main Difficulties: High investment costs and unclear regulations are noted barriers to FHIR adoption.
  • Future Plans: Anticipated projects include the implementation of the International Patient Summary (IPS) and FHIR bulk data use cases.

Future Plans

  • Progress So Far: Japan has made "quite the progress" expected in the last year regarding FHIR adoption.
  • Next Steps: The development of a national FHIR data model and expanded adoption across the healthcare ecosystem are key focus areas.
  • Expected Changes: Over the next three years, significant benefits from FHIR adoption are anticipated, including cost savings and improved healthcare coordination.

Contributors

  • Michio Kimura, Educator at Kawasaki University of Medical Welfare

This document reflects the current state and future expectations for FHIR in Japan, based on survey responses from stakeholders in the healthcare IT field.

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