In Luxembourg, FHIR (Fast Healthcare Interoperability Resources, a standard for exchanging healthcare data) is used in only a few healthcare scenarios. Adoption is still in its early stages.

The versions currently in use are R4B and R5. These are recent releases of the FHIR standard.

Looking ahead, we expect a strong increase in FHIR adoption over the coming years.

Rules and Support

Luxembourg has rules for health data exchange, but they take a light approach to FHIR specifically:

• There are regulations requiring standards for electronic health data exchange
• FHIR is not specifically mentioned in these regulations
• There is no deadline for compliance
• There are no fines for non-compliance
• There are no government funds available to support FHIR adoption

National Setup

Luxembourg has a clear national structure for health data standards:

• The national organization responsible for health data standards is Agence eSanté
• A national base FHIR implementation guide exists and is used in a limited set of cases. You can find it on the eSanté Luxembourg Simplifier page
• A few additional FHIR standards have been developed for specific use cases
• A national FHIR terminology server (a service that manages medical codes and vocabularies) is currently in planning
• There is no known activity yet around the FHIR Community Process (FCP), an international program for developing FHIR specifications

Active Use Cases

Luxembourg is building on international work to develop its national FHIR specifications:

• Provider Directory is a key focus area in Luxembourg
• National specifications draw on European Implementation Guides
• National specifications also use IHE profiles (Integrating the Healthcare Enterprise, a framework for healthcare data sharing)

In terms of exchange methods, the FHIR REST API (a way for systems to request and share data) is used to some extent. FHIR Messaging and FHIR Documents are not yet in use. FHIR Shorthand, a tool for writing FHIR profiles, is also being used.

Who's Using FHIR

The main groups adopting FHIR in Luxembourg are:

• Care providers
• EHR (Electronic Health Record) system vendors
• App developers
• Government agencies

The main driver for adoption is regulation and grants. Software in use is a mix of open source and proprietary, with a slight lean toward open source.

Success Stories and Challenges

A clear success story is the Healthcare Provider Directory search, which gives users a standardized and easy way to find healthcare providers.

The benefits seen so far include standardization and ease of use.

However, several challenges slow down wider adoption:

• High investment cost
• Unclear benefits for stakeholders
• Unclear regulations
• Lack of FHIR knowledge

Future Plans

Progress over the past year has been much less than expected, and overall satisfaction with the adoption rate is low.

Looking ahead, the next steps for Luxembourg include:

• Developing new FHIR standards for specific use cases
• Expanding FHIR adoption across the healthcare ecosystem

The European Health Data Space (EHDS), a European Union initiative to enable health data sharing across member states, is the most anticipated upcoming use case.

The outlook for the next three years is cautiously neutral. While there is hope that FHIR will deliver real benefits, there is no strong confidence yet that significant cost savings or improved care coordination will follow.

Contributors

The contributor to this survey 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.