Fast Healthcare Interoperability Resources (FHIR)

Why it matters

FHIR has become the reference standard for national platforms, referrals and data extracts. WHO publishes its SMART Guidelines in layers, and layer 3 is a FHIR implementation guide, so a system that speaks FHIR can consume WHO's digital guidance as it is released [3]. A ministry that specifies FHIR R4 avoids building a custom interface for every new connection.

Key points

• The specification describes resources as "the common building blocks for all exchanges". Release 4 defines 145 resource types [1].
• Resources are represented in JSON, XML or RDF, and can be exchanged through the RESTful API, as documents, as messages or through services [1].
• Profiles and extensions record national decisions on top of the base resources [1].
• In R4, the RESTful API, the JSON and XML formats, and the Patient and Observation resources, among others, became normative [2].
• FHIR exchanges whatever content is agreed; it does not agree the content. National profiles and terminology remain the ministry's work.

In Moana

Moana supports FHIR R4 for exchange with national platforms and other systems, including SMART on FHIR app launch and FHIR bulk export.

Sources

1. FHIR R4 overview for developers, HL7 International, 2019
2. FHIR Version History Fact Sheet, Office of the National Coordinator for Health IT, 2021
3. WHO SMART Guidelines, World Health Organization, accessed 2026