In New Zealand, FHIR (Fast Healthcare Interoperability Resources) is increasingly being used to exchange healthcare data. Active versions include R4, with a notable use level of '5', indicating strong utilization, while R4B and earlier versions see varied use. The country anticipates further adoption of FHIR in the coming years, driven by regulatory support and growing recognition of its benefits for healthcare data interoperability.

Rules and Support

  • Health Data Exchange Rules:
    • Regulations mandate the use of standards for electronic health data exchange.
    • FHIR is specifically recommended by these regulations.
  • FHIR Requirements and Deadlines:
    • No specific deadline for compliance.
    • No fines for non-compliance before a deadline.
  • Funding:
    • Currently, no government funds are available to stimulate FHIR adoption.
  • Regulatory Details:

National Setup

Active Use Cases

  • Local Implementations:
    • Prescriptions / Pharmacy
    • Provider Directory
    • Terminology
    • Immunizations
    • International Patient Summary
  • International Standards Use:
    • New Zealand utilizes international FHIR standards for specific use cases like patient summaries and pharmacy prescriptions.
  • Key Projects:

Who's Using FHIR

  • Active Organizations:
    • Health NZ
    • Various healthcare vendors
  • Main Reasons for Adoption:
    • Improving health outcomes
    • Innovation
  • How They're Using FHIR:
    • EHR system vendors and app developers are actively implementing FHIR to improve interoperability and data exchange in healthcare.

Success Stories and Challenges

  • Benefits:
    • Improved access to information
    • Improved care workflows
  • Real Examples:
    • New Zealand Patient Summary (IPS Derivation)
    • FHIR Pathology Results API
  • Main Difficulties:
    • Lack of FHIR knowledge
    • Changes in political direction
    • Funding issues for major projects like Hira
  • Future Plans:
    • Development of new FHIR standards for more specific use cases
    • Expanded adoption across the healthcare ecosystem

Future Plans

  • Progress so Far: Less progress than expected last year.
  • Next Steps:
    • Continue to develop new FHIR standards
    • Look to expand the use of FHIR across more healthcare domains
  • Expected Changes:
    • Significant expected benefits from FHIR adoption in the next three years, including cost savings, better care coordination, and a more robust digital health ecosystem.

Contributors

  • Peter Jordan, Board Secretary at HL7 New Zealand

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

New Zealand FHIR Registry
The **New Zealand FHIR Registry** is the home for the HL7® FHIR® artefacts that are most important to an interoperable digital health ecosystem in Aotearoa New Zealand. Software developers can freely share and reuse the FHIR profiles and implementation guides posted here. The registry supports the development of FHIR APIs for national digital services such as the National Health Index (NHI), Health Provider Index (HPI) and National Immunisation Solution (NIS), as well as Hira, the national health information platform. The FHIR NZ Base implementation guide is also published here. And all FHIR artefacts endorsed by the [Health Information Standards Organisation (HISO)](https://www.health.govt.nz/our-work/digital-health/digital-health-sector-architecture-standards-and-governance/health-information-standards-0) will be published in the registry. The registry is hosted on the [Simplifier.net](https://simplifier.net/) platform provided by Netherlands company [Firely](https://fire.ly/). Learn more about the tool in the [Simplifier documentation library](https://docs.fire.ly/projects/Simplifier/index.html). Our registry setup follows the example of the [Canadian FHIR Registry](https://simplifier.net/organization/canadianfhirregistry) and the United Kingdom’s [NHS Digital FHIR Registry](https://simplifier.net/organization/nhsdigital). Developers can use FHIR Shorthand command line tools to create and upload definitions or use the Forge GUI tool. The registry will be integrated with the NZ Health Terminology Service and HISO standards resource centre. The registry is co-governed by [Te Whatu Ora](https://www.tewhatuora.govt.nz/) and [HL7 New Zealand](https://hl7.org.nz/). We invite everyone’s participation. Email [standards@health.govt.nz](mailto:standards@health.govt.nz?subject=NZ%20FHIR%20Registry) to request your account (limited to three per organisation initially). The [Sandbox project](https://simplifier.net/nz-sandbox) is the place to get started. The [Community Content project](https://simplifier.net/nz-community-content) is then where you can share your work and collaborate with others.
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