In October 2024 I ran a survey asking 15 questions about how organizations used FHIR and FHIR servers.
My purpose was to get a feel for how different organizations were using different parts of FHIR. I was particularly interested in how they extended and customized FHIR for their own use case.
I trimmed out any duplicate responses, and was left with 75 valid sets of answers. It’s not a huge sample and is in no way definitive, but my feeling has always been that some information is better than no information.
The survey was anonymous, with an optional field to add an email address. I had no easy way to link a response to an individual or to a company.
The bulk of the responses came from Europe and North America, as the chart below illustrates. There were no responses from South America.
I’ll be making some comments and drawing some light-weight conclusions on the responses over time. Your conclusions may differ.
Here are the questions I asked.
- Which version of FHIR does your organization use?
- How many production FHIR servers does your organization have or expect to have?
- How many other FHIR servers does your organization have? (QA, Dev, Staging, etc.)
- How many different FHIR resource types do you typically work with?
- Who provides your FHIR servers?
- Have you implemented Smart-on-FHIR in your FHIR servers?
- Have you implemented any kind of element or attribute level access control in your FHIR servers?
- Does an API Management gateway (or similar) sit in front of your FHIR servers?
- Have you installed any Implementation Guides into your FHIR servers?
- Have you created any custom Search Parameters in your FHIR servers?
- Have you created any custom profiles in your FHIR servers?
- Have you created any custom $operations in your FHIR servers?
- Where in the world are you?
- What’s your role in your organization?
- What is the single biggest problem you have experienced working with FHIR?
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