This fall, HL7 Europe published three new HL7 Europe FHIR implementation guides, specifically designed for the European realm to support the European Health Data Space (EHDS): the HL7 Base and Core FHIR IGs (Standard for Trial Use) for FHIR Releases 4 and 5, and the HL7 Europe Extensions package.
The publication followed a balloting process involving all HL7 European affiliates over the summer of 2025. The implementation guides (IGs) can be found here:
- HL7 Europe Base and Core FHIR IG STU 1.0 (R4) [0.1.0]
- https://hl7.eu/fhir/base
- HL7 Europe Base and Core FHIR IG STU 1.0 (R5) [0.1.0]
- https://hl7.eu/fhir/base-r5
- HL7 Europe Extensions FHIR IG STU 1.1 [0.1.1]
- https://hl7.eu/fhir/extensions
The Base and Core FHIR Implementation Guides provide a foundational layer for interoperability across diverse use cases, enabling consistent reuse in national projects, European initiatives, and subsequent HL7 Europe guides. Together with standardised extensions and scoped HL7 Europe implementation guides, they form a coherent, reusable framework that supports the European Health Data Space (EHDS) while remaining aligned with international standards, such as the International Patient Summary (IPS).
The European Health Data Space (EHDS) Regulation (published 5 March 2025) mandates a common framework for health data exchange across EU member states. It is expected to influence standards development and adoption far beyond the EU. The European Electronic Health Record Exchange Format (EEHRxF) arises from the 2019 Recommendation (2019/243) and defines the “exchange format” for cross-border health data exchange.
“These new FHIR IGs build on and continue the ongoing collaborative work to align the HL7 FHIR global specifications with the emerging requirements of the European Health Data Space,” said Giorgio Cangioli, HL7 European Technical Lead. “They are aligned with the current iteration of the Xt-EHR common logical model, with a clear roadmap to maintain this alignment as the model evolves. This work forms a core element of the HL7 FHIR IG ecosystem for the EHDS, aiming at supporting the European Commission’s forthcoming Implementing Acts on the European Electronic Health Record Exchange Format, expected in early 2027. “
HL7 FHIR® (Fast Healthcare Interoperability Resources) is a healthcare data exchange standard created by HL7 International that enables the secure and rapid sharing of electronic health information. An HL7 FHIR implementation guide (IG) is a set of rules and constraints for using FHIR resources in a specific use case, and specifies the required FHIR profiles, value sets, and extensions. EU “Base” profiles serve as the baseline definitions for commonly used concepts in Europe. In contrast, EU “Core” profiles introduce essential constraints that apply across many use cases and are intended for use in most European FHIR implementation guides.
“I am thrilled with the strong engagement of the European expert community in the development and harmonisation of base/core HL7 FHIR IGs, which showcase European requirements in the global digital health ecosystem, largely built on HL7 FHIR,” said Catherine Chronaki, HL7 Europe Secretary General. “We will continue this work at our December HL7 Europe Working Group Meeting in Cologne and look forward to welcoming new participants to the European digital health interoperability community.”
HL7 Europe further supports these efforts by holding working group meetings, webinars, and hands-on events, and through the Community of Practice “Hospitals on FHIR” to support consistent implementation across Europe. HL7 Europe hosted its most recent Working Group Meeting on December 1-5, 2025 in Cologne, Germany.
