Using FHIR for data sharing: A scoping review of challenges and facilitators in healthcare settings.

Abstract

The sharing and integration of digital data are essential for optimizing the quality of clinical decision-making in healthcare. Fast Healthcare Interoperability Resources (FHIR) is a relatively novel standard in healthcare, playing a key role in enhancing the interoperability of healthcare information systems. However, using FHIR faces some challenges in the healthcare environment, hindering its optimal utilization. Identifying challenges and facilitators is crucial in enhancing its use and contributes to more efficient interoperability between health information systems (HISs). Therefore, this scoping review aims to identify these factors using the existing literature to provide a better understanding of this subject in healthcare settings. This scoping review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. Four databases of the Web of Science (WoS), PubMed, Scopus, and Google Scholar were searched until 15 Apr 2025, without any time limitation, to retrieve relevant articles on this topic. The data on challenges and facilitators were obtained using qualitative content analysis. The results were presented using descriptive statistics, tables, and narrative synthesis. After searching the databases, applying the eligibility criteria, and conducting manual searches, eight articles were selected for data extraction and analysis. Seventy-three challenges and 43 facilitators related to the use of FHIR in healthcare were identified. The challenges were classified into organizational, technical, individual, data management, and legal, ethical, and regulatory. The facilitators were categorized into four categories: organizational, legal and regulatory, data management, and technical factors. This scoping review highlights the challenges and facilitators that influence the adoption of FHIR in healthcare environments. Managers, policy-makers, designers of healthcare information systems, and other stakeholders can consider these factors to establish a guideline or roadmap to address critical barriers, such as technical and organizational challenges, to enhance the chance of FHIR adoption for data sharing between different HISs in healthcare settings.