Are we ready for Europe? EHDS, IPS, and FHIR® readiness in the Netherlands
Where do we stand with EU Core, IPS, and FHIR® in the Netherlands? This blog identifies the gaps and offers concrete steps to prepare for EHDS by 2029.
By Jorn Duwel, Interoperability Expert at Interoplab
In June 2025, the European FHIR® Implementation Guides achieved “Standard for Trial Use” status. That sounds like good news — and it is. But it immediately raises the question: are we in the Netherlands actually ready for what’s coming?
EHDS: What’s about to happen?
The European Health Data Space (EHDS) requires member states by 2029 to give citizens access to their own health data in a European interoperable format. That directly impacts FHIR® implementations, the ZIBs (Healthcare Information Building Blocks) we use in the Netherlands, and the profiles vendors are building now.
The European specifications are layered:
- Logical Models — technology-independent functional requirements
- EU Base profiles — FHIR® mapping of European baseline requirements
- EU Core profiles — use-case-specific elaboration
This approach resembles the Dutch approach with ZIBs, but the implementation differs on critical points.
Where the tension lies
Version differences. The European specifications work with FHIR® R4 and R5. The Netherlands still sits largely on STU3, with R4 development underway but slow. That means systems being built now may not align with European requirements without modifications.
Profile differences. For the same clinical information, Dutch and European profiles use different extension mechanisms. A concrete example: for coded country values in a Patient profile, we use ext-CodeSpecification, while the European standard uses iso21090-SC-coding. That seems like a detail, but in cross-border data exchange it can lead to information loss.
IPS dependency. EU Core profiles are now formally dependent on the International Patient Summary (IPS) via an imposeProfile extension. Those who don’t implement IPS-compliant systems also fail to meet EU Core.
What this means in practice
The 2029 deadline seems distant. But systems being built now are expected to be in production in four years. If those systems aren’t designed with European requirements in mind, a major revision cycle is inevitable.
Interoplab is developing validation capabilities against EPS and IPS specifications. This allows organizations to assess impact now — without committing to immediate implementation. That buys time to steer.
Concrete steps
- Map your current FHIR® profiles and compare them to EU Base/Core profiles
- Inventory which zib versions you use and how they relate to European Logical Models
- Test your implementations (or have them tested) against IPS profiles — this will be the common foundation
- Actively follow EHDS developments; the specifications are still evolving
Questions about how your organization is preparing for EHDS? Get in touch →