In Hong Kong, FHIR is used in a few specific healthcare use cases rather than as a main standard for health data exchange. FHIR (Fast Healthcare Interoperability Resources) is a standard for exchanging health information electronically.

The main version in use is FHIR R4. A self-developed FHIR server is already running in a government agency.

Adoption is expected to grow in the coming years, although progress has been slower than some had hoped.

Rules and Support

  • There is no national regulation that mandates the use of standards in electronic health data exchange.
  • FHIR is not required by law.
  • There are no government funds available to stimulate FHIR adoption.
  • Hong Kong does have the eHealth Record Sharing System, which sets rules for sharing health data between the private and public sectors.

National Setup

  • Standards organization: HL7 Hong Kong is responsible for health data standards in the country.
  • Implementation guides: A base/core FHIR implementation guide exists and is used in a limited number of use cases. Resources are available through the eHealth Office and HL7 Hong Kong.
  • Terminology server: A national FHIR terminology server is in production. This service helps systems use consistent medical codes and terms.
  • FHIR Community Process (FCP): There is no known FCP activity in Hong Kong today, and no change is expected in the next 2–3 years.

Active Use Cases

Hong Kong builds on the International Patient Summary, an international standard that defines a minimum set of patient data that can be shared across borders.

National FHIR development for more specific use cases is still limited.

Who's Using FHIR

The main groups adopting FHIR in Hong Kong are:

  • Care providers
  • EHR (Electronic Health Record) system vendors
  • Diagnostic system vendors, such as imaging and lab providers
  • Government agencies

The main driver for adoption is regulation and grants.

How FHIR is being applied:

  • FHIR Messaging and FHIR Documents are used moderately.
  • FHIR REST API (a way for systems to request and exchange data directly) is used to a smaller extent.
  • The use of other FHIR tools, such as SMART on FHIR, CDS Hooks, and Bulk Data, is not well known.

There is a mix of open source and proprietary FHIR software, leaning slightly toward proprietary solutions.

Successes and Challenges

There are no widely recognized successful FHIR use cases to highlight yet.

The main challenges for FHIR adoption are:

  • High investment cost, including the cost of adopting open source FHIR
  • Unclear benefits
  • Unclear regulations
  • Changes in political direction

Looking ahead, there is interest in use cases that deliver concrete, measurable outcomes from FHIR implementation.

Future Plans

Over the past year, the main achievement was the expanded adoption of FHIR across the healthcare ecosystem. Overall progress matched expectations, although satisfaction with the current adoption rate remains low.

Expected next steps in the coming year include:

  • Developing a national FHIR data model
  • Launching pilot projects with selected healthcare stakeholders
  • Expanding FHIR adoption further across the healthcare ecosystem

There is a neutral outlook on whether Hong Kong will fully reap the benefits of FHIR — such as cost savings and better care coordination — within the next three years.

Contributors

  • Clube Ng, CEO, eHealth Research Institute Ltd

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