In Switzerland, FHIR is gaining ground but is not yet the main standard for exchanging health data. It is used for several specific use cases, with strong momentum building through national programs.
The most widely used version is FHIR R4. Earlier versions like STU3 see little use, while newer versions such as R5 and R6 are starting to appear in early experiments.
Respondents expect a strong increase in FHIR adoption over the coming years, driven by new regulation and national digital health initiatives.
Rules and Support
Switzerland has regulation that requires standards for electronic health data exchange, and FHIR is specifically mandated in some areas.
- Mandatory FHIR use: FHIR is required in the Swiss Electronic Patient Record (EPR) regulations, including its exchange formats and APIs
- Deadline: Yes, the regulation includes a compliance deadline
- Fines: No fines are imposed if the deadline is missed
- Government funding: Limited – some respondents report no dedicated funds, while others note funding through national programs
- Key resources:
A new Swiss Health Data Space (SwissHDS) initiative is also expected to require FHIR, although that regulation is still being written.
National Setup
Switzerland has organized structures for FHIR standards development, though views differ on how centralized this is.
- Standards organization: eHealth Suisse plays a key coordinating role
- National base implementation guide: The CH Core implementation guide is widely used. An implementation guide is a document that explains how to apply FHIR for a specific country or use case.
- Terminology server: A national FHIR terminology server is currently in development
- FHIR Community Process (FCP): Switzerland already has approved FCP specifications, and several organizations are exploring becoming FCP participants. The FCP is a global process for publishing and approving FHIR specifications.
Active Use Cases
Switzerland develops FHIR specifications for many specific use cases, including:
- Prescriptions and pharmacy
- Referrals and continuity of care
- Public health reporting
- Diagnostic orders and reports
- Imaging
- Immunizations
- Allergy intolerance
- Document exchange
- Terminology
- International Patient Summary (IPS), electronic pregnancy passport, transition of care, and emergency records
Swiss FHIR work builds on several international standards:
- International Patient Summary (IPS)
- European implementation guides
- IHE profiles (interoperability profiles from Integrating the Healthcare Enterprise)
For exchanging data, FHIR Documents is the most established mechanism. FHIR REST APIs are used in a limited way today but are expected to grow. FHIR Shorthand (a concise language for writing FHIR profiles) is widely used by specification authors, and FHIR Questionnaires see moderate use.
Who's Using FHIR
The main adopters in Switzerland include:
- Care providers
- EHR system vendors
- Government agencies
- Researchers
- App developers
The main reasons for adoption are:
- Regulation and grants
- Improving health outcomes and care workflows
- Patient data access
- Innovation, including the arrival of FHIR APIs
Successes and Challenges
Success stories include:
- CH ELM: a Swiss Federal Office of Public Health project that lets laboratories send notifications of communicable diseases electronically
- Immunization and medication exchange
- Digital transformation away from paper-based processes
- Improved access to information and better care workflows
Main challenges:
- High investment costs
- Unclear benefits for some stakeholders
- Unclear regulations in some areas
- Lack of FHIR knowledge among developers and implementers
- A need for more education and investment by app developers
On AI and structured data: Most respondents see AI as helping FHIR efforts, not replacing them. AI is increasing interest in FHIR as a foundation for trustworthy data and accelerating the work of mapping data to FHIR.
Future Plans
Switzerland made meaningful progress last year, though some respondents feel it was less than hoped. Achievements included new regulation, development of more specific FHIR standards, and pilot projects with healthcare stakeholders.
Looking ahead, expected next steps are:
- Establishment of a national standards organization
- Development of a national FHIR data model
- New regulation prescribing standards for electronic health data exchange
- More FHIR standards for specific use cases
- Pilot projects with selected healthcare stakeholders
- Expanded adoption of FHIR across the healthcare ecosystem
Use cases respondents are most looking forward to:
- End-to-end electronic medication process
- Swiss Health Data Space
- Clinical ordering workflows
- Broader use of the International Patient Summary
Most respondents agree or strongly agree that within three years, Switzerland will see real benefits from FHIR adoption, including cost savings, better care coordination, and a stronger digital health ecosystem.
Contributors
- Patrick Jolo, eHealth Suisse
- Oliver Egger, ahdis ag
- One anonymous contributor
The above summary is based on the answers to the State of FHIR Survey 2026, organized by Firely and HL7 International.