In Turkey, the use of FHIR (Fast Healthcare Interoperability Resources) for exchanging healthcare data is currently minimal. The versions of FHIR in active use include R4, R4B, and R5, with R4 being the most utilized. Despite the slow start, there is an expectation for increased adoption of FHIR in the coming years. However, there's a noticeable absence of regulatory mandates or government incentives to drive this adoption forward.

Rules and Support

  • Health Data Exchange Rules: There is strong regulation for sharing electronic health records in Turkey, but these do not enforce or specifically require the use of FHIR or other standardized data exchange standards.
  • FHIR Requirements: No specific FHIR-related requirements are mentioned in the current regulations.
  • Deadlines and Fines: No deadlines or fines are imposed for non-compliance with data exchange standards since FHIR is not specifically mandated.
  • Available Funding: There are no government funds available to stimulate the adoption of FHIR.

National Setup

  • Standards Organization: Turkey currently does not have a national organization responsible for health data standards.
  • Implementation Guides: There are no base/core FHIR implementation guides developed for Turkey.
  • Terminology Services: No national FHIR terminology server is available, nor are there plans to establish one.

Active Use Cases

  • The National Chronic Disease Management System in Turkey is one of the key projects that leverages FHIR. It uses FHIR servers and profiles to enhance care workflows for various chronic diseases.

Who's Using FHIR

  • App Developers: They are involved in creating applications that may utilize FHIR for health data exchange.
  • Adoption Reasons: The main drive for FHIR adoption includes technical innovation and the development of applications that require standardized health data exchange formats.
  • Usage: FHIR is being used in specific areas like FHIR Messaging and FHIR Rest API to improve interoperability in healthcare applications.

Success Stories and Challenges

  • Benefits: The adoption of FHIR in the National Chronic Disease Management System has shown improved care workflows.
  • Challenges: The main difficulties include unclear benefits of FHIR adoption, a lack of knowledge about FHIR within the healthcare and tech communities, and the absence of regulatory mandates for standard use.
  • Future Plans: Despite the challenges, there is an expectation for increased FHIR adoption, although the respondent is very dissatisfied with the current adoption rate and strongly disagrees that significant benefits will be seen in the next three years.

Future Plans

  • Progress So Far: Adoption of FHIR in Turkey is still in its early stages, with minimal usage and development of FHIR standards.
  • Next Steps: The focus may need to shift towards increasing awareness and knowledge about FHIR, as well as considering the development of national standards or regulations to support its adoption.
  • Expected Changes: Increased adoption of FHIR is expected in the coming years, although specific plans or projects have not been detailed.

Contributors

This survey response was provided by Anil Sinaci from SRDC Software Corporation, sharing insights on the current state and future expectations of FHIR in Turkey.

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