In Austria, FHIR is being used for a small but growing number of healthcare data exchange use cases. It is not yet the main standard, but adoption is steady and expected to increase in the coming years.

The most widely used version is FHIR R4. Some use of STU3 remains, and newer versions like R4B and R5 are also being applied. FHIR stands for Fast Healthcare Interoperability Resources, a standard for exchanging healthcare information electronically.

Respondents expect a strong increase in FHIR adoption over the next few years, supported by regulation and an active national standards community.

Rules and Support

Austria has rules in place for electronic health data exchange:

  • Health data exchange is regulated by law.
  • FHIR is advised in regulation, but not yet strictly mandated.
  • There is a deadline for compliance with these rules.
  • Fines can apply if the rules are not met on time.
  • No dedicated government funding is currently available to stimulate FHIR adoption.

National Setup

Austria has a clear national structure for health data standards:

  • Standards organization: ELGA GmbH and HL7 Austria lead national standards work. You can find them at hl7.at and elga.gv.at.
  • National FHIR implementation guide: A core FHIR implementation guide is published and widely used. It is available at fhir.hl7.at.
  • Terminology server: A national FHIR terminology server is in production. This service helps systems use the same codes and meanings for medical concepts.
  • Collaboration: HL7 Austria works closely with DICOM, IHE, and the SNOMED National Release Center. A memorandum of understanding is in place between the main standards organizations.

Active Use Cases

Many FHIR standards are being developed for specific use cases in Austria, including:

  • Prescriptions and pharmacy
  • Terminology
  • Document exchange
  • Provider directory
  • Scheduling
  • Invoice and claim

Austria also builds on international specifications:

  • International Patient Summary
  • European Implementation Guides
  • IHE profiles

Regarding the FHIR Community Process (FCP), a way for groups to publish FHIR specifications under a shared governance model, Austria already has one or more approved FCP specifications.

Who Is Using FHIR

The main organizations adopting FHIR in Austria include:

  • Care providers
  • EHR (electronic health record) system vendors
  • Payers and insurers
  • App developers
  • Clinical registries
  • Government agencies
  • Researchers

The main drivers for adoption are:

  • Regulation and grants
  • Innovation
  • Improving care workflows

In practice, FHIR Messaging and the FHIR REST API are the most common exchange mechanisms. Tools like FHIR Questionnaires, SMART on FHIR (a way to build secure apps that connect to health records), FHIR Shorthand, and CQL on FHIR are also in use. Both open source and proprietary FHIR software are used, with a slight lean toward open source.

Success Stories and Challenges

The main reported benefit so far is improved access to information for patients and providers.

AI and machine learning are seen as somewhat helping FHIR adoption. There is strong disagreement with the idea that AI removes the need for structured data. Respondents see structured FHIR data as an important foundation for AI in healthcare.

The main challenges include:

  • High investment cost
  • Unclear benefits for some stakeholders
  • Lack of FHIR knowledge in parts of the ecosystem

A key future use case is the further integration of FHIR within the national electronic health record system.

Future Plans

Austria has made more progress in the last year than expected. Respondents are satisfied with the current adoption rate.

Major achievements over the past year include:

  • A new regulation that prescribes the use of standards in electronic health data exchange
  • Continued work by the national standards organization
  • Development of new FHIR standards for specific use cases
  • Expanded adoption of FHIR across the healthcare ecosystem

Expected next steps in the coming year:

  • Launch of pilot projects with selected healthcare stakeholders
  • Further development of new FHIR standards
  • New regulation supporting standards-based exchange
  • Wider adoption across the healthcare ecosystem

Respondents agree that within the next three years, Austria will start to see real benefits from FHIR adoption, including better care coordination and a stronger digital health ecosystem.

Contributors

The contributors to this response chose to remain anonymous.

The above summary is based on the answers to the State of FHIR Survey 2026, organized by Firely and HL7 International.