In New Zealand, FHIR is being used for several key healthcare data exchange use cases. It is not yet the main standard across the whole sector, but adoption is growing steadily. FHIR is strongly promoted as the preferred standard for new digital health solutions.

The most widely used version is FHIR R4. Some implementations still use STU3 or R4B, and a few early adopters are working with R5.

We expect FHIR adoption to increase noticeably in the coming years, supported by national policy direction and ongoing development of new implementation guides.

Rules and support

New Zealand does not have a single law that requires all electronic health data exchange to use a specific standard. Instead, the country uses a mix of policy, procurement rules, and architectural choices to encourage FHIR adoption.

  • Mandatory regulation: No broad legal mandate exists.
  • FHIR policy: Health New Zealand and the Health Information Standards Organisation (HISO) have set a "FHIR-first" policy.
    • Within Health New Zealand, FHIR must be used for new health data exchange solutions.
    • For other health providers, FHIR is strongly recommended for new builds and system modernisation.
  • Privacy and identifiers: Strong regulation exists for privacy and national health identifiers.
  • Deadlines: No formal compliance deadlines are set.
  • Government funding: No dedicated funding programs are currently available to stimulate FHIR adoption. Funding for the national FHIR-based health information exchange platform (Hira) was withdrawn in 2024.

National setup

New Zealand has a clear national structure for health data standards.

  • Standards organization: The Health Information Standards Organisation (HISO) leads health information standards work.
  • HL7 New Zealand: Runs a FHIR Implementation Work Group with Health New Zealand and vendors. The group develops the NZ Base standard and provides implementation advice.
  • Base implementation guide: A national base FHIR guide is published at fhir.org.nz/ig/base. It is used for a limited set of use cases today.
  • Terminology server: A national FHIR terminology server is in production.
  • FHIR Community Process (FCP): No formal FCP activity exists yet. Some organizations are exploring becoming participants, and we expect approved participants within 2-3 years.

Active use cases

New Zealand has developed FHIR specifications for several specific areas:

  • Prescriptions and pharmacy
  • Provider directory
  • Terminology
  • Immunizations
  • Allergy intolerance
  • Patient Summary
  • Diagnostic orders and reports

For international alignment, New Zealand draws on the International Patient Summary to inform its national specifications.

You can explore current implementations here:

Who is using FHIR

The main stakeholders adopting FHIR in New Zealand are:

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

The main drivers for adoption are improving health outcomes, improving care workflows, and supporting innovation.

When it comes to how FHIR is used:

  • FHIR REST API is the dominant exchange mechanism.
  • FHIR Shorthand is widely used for authoring profiles.
  • FHIR Questionnaires and Structured Data Capture (SDC) are used in a growing number of projects.
  • SMART on FHIR (a standard for launching apps inside clinical systems) and Subscriptions are used in some places.
  • FHIR Messaging, Documents, CDS Hooks, CQL on FHIR, SQL on FHIR, Bulk Data, and FHIRcast see little or no use yet.

Both open source and proprietary FHIR software are used, with a slight lean toward open source.

Success stories and challenges

Notable successes:

  • Healthpoint — a provider directory built on FHIR
  • WebTools — a patient-facing application
  • NZ Formulary — medicines reference
  • Health New Zealand APIs — published on the Digital Services Hub

Reported benefits include better access to information, improved healthcare outcomes, and improved care workflows.

Main challenges:

  • Lack of FHIR knowledge across the workforce
  • Changes in political direction affecting funding and priorities
  • High investment cost

Looking ahead:

  • The Shared Digital Health Record (SDHR) is expected to be available in June 2026. See the announcement.
  • A New Zealand Patient Summary based on the International Patient Summary is in development.
  • Discussions are ongoing about whether New Zealand will join the Australian FHIR Accelerator (Sparked).

Future plans

Progress in the last year matched expectations. Key achievements included:

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

For the year ahead, we expect more of the same:

  • Continued development of new FHIR standards for specific use cases
  • Wider FHIR adoption across the healthcare ecosystem

Overall satisfaction with the pace of adoption is neutral. There is cautious optimism that, within three years, FHIR adoption will deliver real benefits such as better care coordination and a stronger digital health ecosystem.

Contributors

  • Daniel Thomson, Health New Zealand | Te Whatu Ora
  • One additional anonymous respondent

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

New Zealand FHIR Registry
The **New Zealand FHIR Registry** is the home for the HL7® FHIR® artefacts that are most important to an interoperable digital health ecosystem in Aotearoa New Zealand. Software developers can freely share and reuse the FHIR profiles and implementation guides posted here. The registry supports the development of FHIR APIs for national digital services such as the National Health Index (NHI), Health Provider Index (HPI) and National Immunisation Solution (NIS), as well as Hira, the national health information platform. The FHIR NZ Base implementation guide is also published here. And all FHIR artefacts endorsed by the [Health Information Standards Organisation (HISO)](https://www.health.govt.nz/our-work/digital-health/digital-health-sector-architecture-standards-and-governance/health-information-standards-0) will be published in the registry. The registry is hosted on the [Simplifier.net](https://simplifier.net/) platform provided by Netherlands company [Firely](https://fire.ly/). Learn more about the tool in the [Simplifier documentation library](https://docs.fire.ly/projects/Simplifier/index.html). Our registry setup follows the example of the [Canadian FHIR Registry](https://simplifier.net/organization/canadianfhirregistry) and the United Kingdom’s [NHS Digital FHIR Registry](https://simplifier.net/organization/nhsdigital). Developers can use FHIR Shorthand command line tools to create and upload definitions or use the Forge GUI tool. The registry will be integrated with the NZ Health Terminology Service and HISO standards resource centre. The registry is co-governed by [Te Whatu Ora](https://www.tewhatuora.govt.nz/) and [HL7 New Zealand](https://hl7.org.nz/). We invite everyone’s participation. Email [standards@health.govt.nz](mailto:standards@health.govt.nz?subject=NZ%20FHIR%20Registry) to request your account (limited to three per organisation initially). The [Sandbox project](https://simplifier.net/nz-sandbox) is the place to get started. The [Community Content project](https://simplifier.net/nz-community-content) is then where you can share your work and collaborate with others.
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