In Australia, FHIR is well established and used across a growing number of healthcare data exchange use cases. It is not yet the single dominant standard, but adoption is broad and accelerating.

Most implementations use FHIR R4. A small number of older STU3 implementations still exist, but R4 is clearly the version of choice.

The outlook is very positive. We expect a strong increase in FHIR adoption in the coming years, supported by new legislation, government investment, and a growing community of implementers.

Rules and support

Here is how health data exchange is regulated and supported in Australia:

  • There is no current regulation that mandates the use of standards for electronic health data exchange.
  • However, as of 2025, a legislative foundation for mandating healthcare data and interoperability standards has become law. The federal government has strongly indicated it will move to mandate FHIR.
  • No compliance deadlines or fines are in place yet.
  • Government funding is available to support FHIR adoption.

National setup

Australia has a strong national infrastructure for FHIR standards development:

  • Standards organizations and partners:

  • National implementation guides:

  • Terminology services:

    • A national FHIR terminology server is in production.

  • FHIR Community Process (FCP):

    • Australia already has one or more approved FCP specifications, and expects to maintain this position over the next 2–3 years.
    • HL7 Australia runs an Australian FHIR Management Framework, including an FCP-compliant Australian FHIR Community Process (AFCP) and the Australian FHIR Coordination Committee (AFCC).
    • A Technical Steering Committee oversees standards work across four HL7 Australia Work Groups.

Active use cases

Many FHIR standards have been or are being developed in Australia for specific use cases, including:

  • Referrals and continuity of care
  • Provider directory
  • Terminology
  • Diagnostic orders and reports
  • Clinical decision support
  • Patient Summary

Australian guides build on international work, including:

  • International Patient Summary (IPS)
  • SMART App Launch
  • Structured Data Capture (SDC)
  • Bulk Data Access

Key projects from the Sparked FHIR Accelerator (now in its fourth year, with over 1,400 participants and more than 28,000 in-kind community hours):

  • Two versions of AU Core
  • One version of eRequesting
  • One version of the Australian Patient Summary
  • Two versions of the Australian Clinical Data for Interoperability (AUCDI) specification

Who's using FHIR

The main groups adopting FHIR in Australia are:

  • Care providers
  • EHR (electronic health record) system vendors
  • Diagnostic system vendors (such as imaging and lab systems)
  • App developers
  • Government agencies
  • Researchers

The main drivers for adoption are:

  • Improving health outcomes
  • Improving care workflows
  • Innovation

How FHIR is being used: The FHIR REST API and SMART on FHIR are widely applied, along with FHIR Questionnaires/SDC and FHIR Shorthand (a tool that makes authoring FHIR profiles easier). FHIR Documents, CDS Hooks, SQL on FHIR, and Bulk Data are in moderate use. FHIR Messaging, Subscriptions, FHIRcast, and CQL on FHIR are not yet commonly used.

A healthy mix of open source and proprietary FHIR software is in use, with neither side dominating.

Success stories and challenges

Successful use cases include:

  • The National Clinical Terminology Service (NCTS)
  • AU Core-based eRequesting
  • FHIR Questionnaires and Smart Forms

Key benefits seen so far:

  • Lower costs
  • Improved access to information
  • Better care workflows
  • Improved use of terminology

Main challenges:

  • Unclear regulations
  • Lack of FHIR knowledge in the wider community

Looking ahead, upcoming use cases include:

  • Patient Summaries
  • Care Plans
  • Encounter Records
  • eReferrals
  • Provider Directory

Future plans

Progress over the last year has exceeded expectations, and overall satisfaction with FHIR adoption in Australia is positive.

Major achievements in the past year:

  • Development of a national FHIR data model
  • Development of new FHIR standards for specific use cases
  • Expanded adoption of FHIR across the healthcare ecosystem

Expected next steps in the coming year:

  • New regulation prescribing the use of standards in electronic health data exchange
  • Development of new FHIR standards for more specific use cases
  • Continued expansion of FHIR adoption across the ecosystem

Over the next three years, we expect FHIR adoption to deliver real benefits, including cost savings, better care coordination, and a stronger digital health ecosystem.

Contributors

  • Kate Ebrill, Board Chair, HL7 Australia
  • Reuben Daniels, Board Director, HL7 Australia

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