Interoperability of ICT systems is one of the success factors on the path towards the digitalisation of healthcare. Finland has long traditions on implementing system integrations that comply with message-based solutions and national Kanta architecture, primarily based on the HL7 v2 standard. On a national level, these standards have contributed to many well-functioning solutions, but does the former leadership in quick adoption of standards prevent Finland from adopting new, more modern solutions?  

Globally progressing FHIR standard for healthcare is not adopted in Finland fast enough 

Over the past five years, the HL7 FHIR standard (Fast Healthcare Interoperability Resources) has, with the United States in the lead, gained wide acceptance as the preferred model standard for healthcare interoperability. It has been implemented all over the world in several countries on national and regional levels. More recently, the international HL7 organisation has started to take a strong preference on the FHIR standard.  

In Finland, the application of FHIR standards has progressed very slowly despite its global success and obvious benefits. An efficient and systematic implementation of the FHIR should now be kicked off in Finland as well. The CleverHealth Network ecosystem led by Helsinki University Hospital (HUS) considers it essential that the adoption of the FHIR standard is now accelerated by means of wide collaboration between  companies, healthcare service providers and authorities. HUS ICT Development Director Mikko Rotonen says: “The transformation taking place in our social and health care brings along massive amounts of interoperability work for the ICT systems and parts of it could already be implemented using FHIR-compliant ICT systems. Whilst application guidelines and national profiles are being built, the time would be perfect to introduce the FHIR standard in our country.”  

Modern FHIR standards contribute to the international compatibility of the operating environment in Finnish healthcare  

There is a clear need to adapting the FHIR standards to the Finnish ICT system environment. It has also become evident that new ways to introduce FHIR-based applications to health care professionals and citizens are needed. Joona Pylkäs, Head of Data and Analytics at TietoEVRY, explains: “FHIR enables the transition of healthcare sector to API-led integration architecture, where applications and systems are using service interfaces based on their own needs or requirements. The API-led architecture provides, among other things, speed and flexibility: a new actor can join an ecosystem at any given time, and point-to-point integrations become unnecessary in the extent currently required.” 

As Finnish ICT companies are becoming more international, it will be beneficial for them that the FHIR standard is applied in a sufficiently consistent manner in Finland in relation to the most important international reference and market areas. Public procurement procedures also play a crucial role in the emergence of new, internationally competitive solutions. Interoperability of the ICT systems is important for both large and small equipment suppliers. Tuomas Kalliomäki, National Sales Manager at BCB Medical, says: "In the future, Finnish device manufacturers that comply with the FHIR standard will have better opportunities for growth and internationalisation as the integration of components into ICT systems becomes more flexible and effortless." 

Easier implementation of applications for patients and system developers alike 

The adoption of a harmonized FHIR standard can also be seen in the daily lives of patients. For example, a diabetic patient can select a commercial FHIR-based application to help them in their everyday life, and the health information can be easily integrated into the healthcare system without the need for coding, potentially taking a lot of time and money.  

The benefits of a shared healthcare standard are obvious both at the information system level and in practice, so the national implementation of the HL7 FHIR standard should be launched as soon as possible, with stakeholders driving the work. The CHN ecosystem and HUS want to be involved in taking this forward. 

More information: Technology Officer Pekka Kahri, HUS (first name.surname@hus.fi)