In Latvia, the adoption of FHIR (Fast Healthcare Interoperability Resources) for exchanging healthcare data is still in its early stages, with a score of 3 out of 5 indicating moderate use. The most recent version of FHIR being utilized is R4B, rated with the highest usage score of 5, suggesting that this is the primary version in use for healthcare data exchanges. Despite the current limited adoption, there is an optimistic outlook for FHIR, with expectations of increased adoption in the coming years.

Rules and Support

  • Health Data Exchange Rules: Currently, Latvia does not have specific regulations that mandate the use of standards, including FHIR, for electronic health data exchange.
  • FHIR Requirements: There's no mention of FHIR in current regulations.
  • Deadlines and Fines: No deadlines or fines are imposed for non-compliance since FHIR is not specifically required by regulation.
  • Funding: There are no government funds available to stimulate the adoption of FHIR. The focus is on the strategy of Digital Health without FHIR-oriented funding.
  • Cabinet Regulation No. 134, related to eHealth, is mentioned as the main piece of regulation but does not specifically mention any standards. Cabinet Regulation No. 134

National Setup

  • Standards Organization: Latvia has no specialized organization for health data standards. The Ministry of Health decides on health standards, with other organizations like the Disease Prevention and Control Center maintaining standards like ICD-10 and planning for SNOMED CT. Ministry of Health, Disease Prevention and Control Center
  • Implementation Guides: There are no national or regional base/core FHIR implementation guides developed in Latvia.
  • Terminology Services: A national FHIR terminology server is available and in production.

Active Use Cases

  • Local Implementations: FHIR-based systems in Latvia are mainly based on the generic FHIR specification without specific Implementation Guides (IGs).
  • International Standards Use: SNOMED GPS is used for cross-border and laboratory data exchange within Latvia.
  • Key Projects: Laboratory domain and oncology registry have been mentioned as successful FHIR use cases.

Who's Using FHIR

  • Organizations: EHR system vendors and clinical registries are active users of FHIR.
  • Reasons for Adoption: The main reason for adopting FHIR is faster integration with care provider systems.
  • Usage: The FHIR Rest API has a usage score of 4, indicating significant use in the country.

Success Stories and Challenges

  • Benefits: Faster integration with care provider systems has been highlighted as a clear benefit.
  • Real Examples: Laboratory domain and oncology registry projects are cited as successful FHIR use cases.
  • Main Difficulties: High investment cost, unclear benefits, and lack of FHIR knowledge are the main challenges faced.
  • Future Plans: There is an interest in developing referral and booking systems using FHIR.

Future Plans

  • Progress So Far: Latvia has made less progress than expected in FHIR adoption in the past year.
  • Next Steps: The country aims for expanded adoption of FHIR across the healthcare ecosystem.
  • Expected Changes: Significant cost savings, enhanced care coordination, and a more robust digital health ecosystem are anticipated benefits from FHIR adoption in the next three years.

Contributors to this survey preferred to remain anonymous.

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