In Czech Republic, FHIR is just starting to be used for exchanging healthcare data. Adoption is still in the early stages, with only a few use cases live so far.

The version in active use is FHIR R5. Looking ahead, we expect a strong increase in FHIR adoption over the coming years.

The role of FHIR in the national digital health strategy is well understood, and momentum is building through national projects and European alignment.

Rules and support

Czech Republic has regulations in place for electronic health data exchange. Here's a quick overview:

  • Standards mandated: Yes, regulation requires the use of standards.
  • FHIR specifically: The regulation doesn't explicitly name FHIR, but new FHIR-based standards will follow the European Health Data Space (EHDS) regulation.
  • Compliance deadline: Yes, there is a deadline.
  • Fines for non-compliance: No.
  • Government funding: Yes. Funding programs help healthcare providers implement FHIR-based standards. These programs are driven by the national interoperability project led by the Ministry of Health.

National setup

The country has a clear structure for developing FHIR standards:

  • National standards organization: NCEZ (National Centre for Electronic Health)
  • National core FHIR implementation guide: Yes, and it's widely used. You can find it at hl7.cz/fhir/cz-core.
  • National terminology server: Currently in development.
  • Other FHIR standards: Many additional FHIR specifications are being developed for specific use cases.

The Czech specifications build on European Implementation Guides. There is no known activity yet around the FHIR Community Process (FCP), but one or more organizations are expected to explore becoming FCP participants within the next 2–3 years.

Active use cases

FHIR work in Czech Republic focuses on practical, real-world projects:

  • Implementation of new national FHIR standards in hospital information systems
  • E-ordering of diagnostic services
  • Alignment with European Implementation Guides for cross-border interoperability

Who's using FHIR

The main organizations adopting FHIR include:

  • EHR system vendors
  • Diagnostic system vendors (imaging and lab)
  • App developers
  • Government agencies

The main drivers for adoption are:

  • Regulation and grants
  • Innovation
  • International interoperability

When it comes to how FHIR is applied, FHIR Documents and FHIR Shorthand (a simple language for writing FHIR profiles) are used most extensively. FHIR Messaging and the FHIR REST API are used to a smaller extent. The mix of open source and proprietary FHIR software is fairly balanced.

Success stories and challenges

Successes so far:

  • New national FHIR standards are being implemented in hospital information systems.
  • E-ordering is moving forward as a concrete use case.

Main challenges:

  • High investment cost
  • Unclear regulations
  • Lack of FHIR knowledge among implementers

Coming up next, we're looking forward to FHIR implementations in:

  • Laboratory data
  • Medical imaging
  • Emergency services

Future plans

Last year brought the progress we expected. Major achievements included:

  • Development of a national FHIR data model
  • Development of new FHIR standards for specific use cases
  • Launch of pilot projects with selected healthcare stakeholders

Overall satisfaction with the current adoption rate is neutral. The outlook for the next three years — including cost savings, better care coordination, and a stronger digital health ecosystem — is cautiously neutral as well. The foundations are being laid, and the coming years will show how quickly the benefits arrive.

Contributors

  • Hynek Kružík, Technical Lead, HL7 Czech Republic

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