In Slovenia, FHIR (Fast Healthcare Interoperability Resources) is beginning to be utilized for exchanging healthcare data, although its usage is still in the early stages. Currently, FHIR version R4 is actively being used, indicating a move towards adopting more modern standards for health data interoperability. The country expects to see an increase in the adoption of FHIR in the coming years, driven by developments in national regulations and the digital health landscape.

Rules and Support

• Health Data Exchange Rules:
  • There are regulations mandating the use of standards in electronic health data exchange, but FHIR is not specifically mentioned.
  • A deadline is in place for compliance with these regulations, and fines are imposed if the regulations are not met by the deadline.
• FHIR Requirements:
  • While not directly mentioned in the current regulation, efforts are underway to integrate FHIR standards more deeply into the national healthcare IT infrastructure.
• Available Funding:
  • Government funds are available to stimulate the adoption of FHIR, aiming to improve interoperability and healthcare outcomes.
• Important Regulations:
  • Healthcare databases act mandates participation in the national EHR according to national standards, with NIJZ appointed as the eHealth authority. More information can be found on NIJZ's website.

National Setup

• Standards Organization:
  • NIJZ (National Institute of Public Health) is responsible for the governance and development of EHR and health data standards in Slovenia. Visit NIJZ.
• Implementation Guides:
  • A base/core FHIR implementation guide is under development, intended to support vendors and healthcare providers.
• Terminology Services:
  • A national FHIR terminology server is currently in development, indicating a move towards standardized health data language.

Active Use Cases

• Local Implementations:
  • Slovenia is using FHIR for demographic and administrative data since 2023.
  • Successful use cases include up-to-date demographic data provisioning and the implementation of care teams.
• International Standards Use:
  • Slovenia is engaged in developing FHIR standards for specific use cases, such as patient consent and patient access.
• Key Projects:
  • Deployment of a national FHIR-based operational data repository. More details can be found in this blog post.

Who's Using FHIR

• Active Organizations:
  • The National Institute of Public Health (NIJZ) and the Medical Chamber of Slovenia are key players in FHIR's adoption.
• Main Reasons for Adoption:
  • Improving interoperability, enhancing care workflows, and fostering innovation in healthcare IT.
• How They're Using FHIR:
  • FHIR is being used primarily for administrative and demographic data, with plans to expand into clinical data.

Success Stories and Challenges

• Clear Benefits:
  • Improved access to information and more efficient care workflows have been noted as direct benefits of FHIR adoption.
• Real Examples:
  • The implementation of up-to-date demographic data provisioning has been highlighted as a successful use case.
• Main Difficulties:
  • Challenges include a lack of FHIR knowledge and the complex regulatory and business landscape of healthcare.
• Future Plans:
  • Further development of administrative features based on healthcare teams and convergence with OpenEHR are anticipated.

Future Plans

• Progress So Far:
  • Slovenia has made less progress than expected in the last year regarding FHIR adoption.
• Next Steps:
  • Development of a national FHIR data model and new FHIR standards for specific use cases.
• Expected Changes:
  • Significant cost savings, enhanced care coordination, and a more robust digital health ecosystem are anticipated benefits in the next three years.

Contributors

• Lucija Tepej Jočić, NIJZ, National Institute of Public Health
• Iztok Štotl, Medical Chamber of Slovenia

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