IE (Ireland) Core Implementation Guide
0.3.0 - draft Ireland flag

IE (Ireland) Core Implementation Guide - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Future of IE Core

Future of IE Core

The IE Core Implementation Guide is a living document that will continue to evolve as Ireland's digital health infrastructure matures. This page reflects priorities following the XT-EHR v1.0.0 release (2025) and the entry into force of the EHDS Regulation 2025/327 and eIDAS 2.0 (Regulation 2024/1183/EU).

Recently Completed

  • IPS STU2 alignment — Updated the hl7.fhir.uv.ips dependency to STU2 (v2.0.0, published October 2025)
  • SMART App Launch v2.2 scopes — Migrated recommended authorization scopes from legacy v1 .read/.write syntax to v2 granular .rs/.cruds scope syntax
  • XT-EHR Obligations Framework guidance — Documented the HL7 FHIR Obligations extension pattern as the recommended machine-readable successor to narrative-only Must Support tables

Immediate Priorities (2025-2026)

The following work items are required for full XT-EHR 1.0.0 alignment and are the next IE Core development priorities:

  1. IECoreMedicationStatement — MedicationStatement profile fully aligned with EHDSMedicationUse v1.0.0; evaluate adherence element enhancements for future FHIR versions
  2. IECoreFlag — Flag/Alert profile aligned with EHDSAlert v1.0.0; alert codes standardized with SNOMED CT
  3. IECoreDeviceUseStatement — New profile mapping to EHDSDeviceUse; needed for the medicalDevices section of the Patient Summary
  4. IECoreConsent — Formal FHIR Consent profile aligned with EHDSAdvanceDirective, supplementing the current ADI DocumentReference approach
  5. XT-EHR Obligations compliance — Formal verification that IE Core PS and HDR profiles satisfy all SHALL obligations in the XT-EHR 1.0.0 Obligations Framework
  6. EUDI Wallet / eIDAS 2.0 integration — Align cross-border patient authentication with EUDI Wallet PID attestations; implement EUDI PID→FHIR Patient mapping per eIDAS 2.0 ARF v2.x; update NCPeH signing guidance to include JAdES/XAdES and IHE DSG profile alignment

Planned Enhancements

Short Term (2025-2026)

  • EUDI Wallet Integration: Full alignment with the EU Digital Identity (EUDI) Wallet architecture (eIDAS 2.0, Regulation 2024/1183/EU) for cross-border patient authentication via MyHealth@EU — targeted for 2026 MyHealth@EU onboarding
  • Shared Care Record Integration: Alignment with HSE's national shared care record programme
  • eReferral: Standardized electronic referral profiles
  • ePrescribing: Enhanced medication prescribing profiles aligned with national ePrescribing systems
  • National Immunization Registry: Integration with Ireland's national immunization information system
  • MedicationAdministration: Profile for EHDSMedicationAdministration
  • HIPS Bill Conformance: Alignment with Health Information and Patient Safety (HIPS) Bill requirements once enacted
  • FAPI 2.0: Implement Financial-grade API 2.0 security profile for EHDS secondary use data spaces and the HL7 Europe Health Data API IG

Medium Term (2026-2027)

  • EU Core 2.0 Re-parenting: Re-base AllergyIntolerance, Condition, Procedure, Immunization, Medication, and DiagnosticReport profiles on HL7 Europe Core profiles when hl7.fhir.eu.base v2.0.0 is published
  • FHIR R5 Migration Path: Planning for FHIR R5 adoption aligned with HL7 Europe's R5 timeline. Key profile changes: MedicationStatement→MedicationUsage, DeviceUseStatement→DeviceUsage, Consent restructure, Encounter reasonCode→reason
  • MyHealth@EU Integration: Full cross-border patient summary exchange via MyHealth@EU infrastructure
  • EU Patient Summary IG adoption: Formal re-parenting once hl7.fhir.eu.eps STU is published
  • EU Hospital Discharge IG adoption: Formal re-parenting once hl7.fhir.eu.hdr STU is published
  • Genomics: Profiles for genomic data exchange
  • Terminology Services: National terminology server for Irish healthcare terminologies
  • EHDS Implementing Acts: Begin alignment with the European Commission's Implementing Acts on the EEHRxF (expected early 2027)

Long Term (2027+)

  • EHDS Full Conformance: Complete conformance with EHDS Implementing Acts on the European Electronic Health Record Exchange Format (EEHRxF) — March 2027 deadline
  • AI/Clinical Decision Support: FHIR-based CDS Hooks integration
  • Population Health: Aggregate data profiles for public health reporting
  • Research Data Exchange: Profiles for clinical research data sharing, aligned with EHDS secondary use requirements

How to Contribute

⚠️ Current Status: This IG is a Proof of Concept maintained by Nithin Mohan. Contributions are welcome, and in the future, when governance is established, the following processes will apply:

The IE Core Implementation Guide welcomes contributions from all stakeholders:

  1. Issue Reporting: Submit issues through the GitHub repository
  2. Ballot Participation: Participate in formal HL7 ballot processes (future, when formally established)
  3. Working Group Membership: Join or establish an HL7 Ireland FHIR Working Group
  4. Implementation Feedback: Share implementation experience and challenges

Versioning

IE Core follows Semantic Versioning:

  • Major versions (x.0.0): Breaking changes or significant restructuring
  • Minor versions (x.y.0): New profiles, extensions, or value sets
  • Patch versions (x.y.z): Bug fixes and clarifications
  • Pre-release (-ballot, -snapshot): Work-in-progress versions for review