The Fast Healthcare Interoperability Resources (FHIR) standard is increasingly being utilized in the United States to facilitate the exchange of healthcare data. Currently, version R4 of FHIR is the most actively used, with a noticeable implementation score of 5. However, earlier versions like DSTU2 and STU3 are still in question, while R5 is beginning to see some use. The adoption of FHIR is expected to grow in the coming years, as indicated by a positive outlook from industry respondents.
Rules and Support for FHIR
The United States has regulations in place that mandate the use of standards in electronic health data exchange, specifically mentioning FHIR:
- Health Data Exchange Rules: Yes, there are specific regulations mandating the use of FHIR.
- FHIR Requirements: FHIR is mandated within these regulations.
- Compliance Deadline: Yes, there's a set deadline for compliance.
- Fines: No fines are imposed for non-compliance before the deadline.
- Government Funding: No, there are no government funds available to stimulate FHIR adoption.
For more information on these regulations, visit the ONC Health IT Certification Program.
National Setup for FHIR
In the United States, the development and adoption of FHIR standards are supported by multiple national organizations:
- Standards Organizations: Multiple, including HL7, IHE, and DirectTrust.
- Implementation Guides: The US Core Implementation Guide is widely used.
- Terminology Services: Currently, there is no national FHIR terminology server available, nor plans for one.
Active Use Cases for FHIR
FHIR standards in the US cover a wide range of healthcare data exchange scenarios:
- Prescriptions / Pharmacy
- Referrals / Continuity of care
- Provider directory
- Public Health Reporting
- Diagnostic Orders/Reports
- Consent
- Clinical Decision Support
- Imaging
- Immunizations
These cases show FHIR's versatility in addressing various healthcare data interoperability needs.
Who's Using FHIR
FHIR is being adopted by a diverse set of organizations across the healthcare ecosystem:
- Care Providers & EHR System Vendors: Actively implementing FHIR for better interoperability.
- App Developers: Leveraging FHIR to create innovative healthcare applications.
The primary reasons for FHIR adoption include regulatory requirements and the desire to improve healthcare outcomes and access to information.
Success Stories and Challenges
While there are clear benefits to FHIR adoption, such as lowered costs and improved access to information, challenges remain:
- Benefits: Better access to healthcare information and improved care workflows.
- Challenges: High investment costs and a lack of clear understanding of FHIR's benefits.
The survey underscores the need for more education on FHIR and its potential impact on healthcare.
Future Plans for FHIR
The United States is on a path towards expanded adoption of FHIR, with new standards being developed for specific use cases and a push for wider adoption across the healthcare ecosystem. However, progress has been slower than expected, leading to some dissatisfaction with the current rate of FHIR adoption. Looking ahead, stakeholders remain neutral about the immediate benefits but acknowledge the potential for significant cost savings and enhanced care coordination in the long term.
This document provides an overview based on survey responses and aims to present a clear picture of the current state and future expectations for FHIR adoption in the United States.
The above summary is based on the answers to the State of FHIR Survey 2025, organized by Firely and HL7 International.
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McKesson Technology - CDS
See the training materials at https://github.com/Mckesson-cds/simplifier-training
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Welcome to the ACME corporation, where we make the best, and we mean the best, and the most reliablest of all products!
(**note**: this is a fake organisation for demonstration purposes only)
Here you can give an overview of your organization and point to all relevant FHIR links and procedures.
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Surescripts & 174;
The Nation's Most Trusted and Capable Health Information Network
For 20 years, we've served the nation with an industrial-strength health information network desgined to increase safety, lower costs and improve quality.
The Surescripts Network Alliance & 174;
The Surescripts Network Alliance unites virtually all electronic health records (EHR) vendors, pharmacy benefit managers (PBMs), pharmacies and clinicians,
plus an increasing number of health plans, long-term and post-acute care organizations, specialty hubs and specialty pharmacy organizations.
The Surescripts network
Every Surescripts solution–and every Surescripts Network Alliance participant–benefits from the industy–leading readability,
security and scalability of the Surescripts network.
For more information, see [surescripts.com](https://surescripts.com)
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The National Committee for Quality Assurance (NCQA).
WHY WE’RE HERE
* Our Mission: Improve the quality of health care.
* Our Vision: Better health care. Better choices. Better health.
NCQA:
* Points the way to health care that science says works.
* Studies how well health plans and doctors provide scientifically recommended care.
* Identifies organizations that are run in ways that make care better.
OUR WORK:
* Saves thousands of lives.
* Helps millions of people stay healthy.
* Saves the country billions of dollars.
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