International FHIR landscape: US Core, JP Core, KR Core, CH Core, AU Core, VN Core

1. Overview map of more than 15 countries

A National Core FHIR IG is a technical document describing how a country applies HL7 FHIR to its health system. It defines Profiles (constraints on Resources), Extensions (for local data), CodeSystems and ValueSets (local terminology), and Examples that vendors can implement against. The table below lists countries with publicly active national IGs, sorted by maturity.

Source: each country's official IG site (see References). The Southeast Asia cluster — Indonesia with SATUSEHAT, Singapore with Synapxe — is moving to production faster than Vietnam, even though all three started in the same 2022-2024 window.

2. Comparing 5 mature national fhir ig across 12 dimensions

The five IGs below represent five distinct governance models. Numbers come from each IG's official artifacts page as of April 2026.

Note: AU Core inherits all extensions and CodeSystems from AU Base, so the count of artifacts unique to AU Core is very small. Always distinguish AU Core (the slim layer) from AU Base (the full national profile set).

3. US Core 8.0.1 — the ONC top-down mandate

US Core is the most widely deployed national fhir ig in the world. The current 8.0.1 release is published by HL7 International and maps directly to United States Core Data for Interoperability (USCDI) v5. ONC released USCDI v6 in July 2025, with planned uptake into subsequent US Core releases.

The mandate flows from the 2020 ONC Cures Act. Every certified EHR vendor must expose a FHIR R4 API conformant to US Core, along with a minimum set of interactions. The Inferno test suite, developed by MITRE, is the certification gate — failing Inferno means losing the right to sell software into Medicare and Medicaid systems.

The strength is adoption velocity: in just three years, almost every US EHR exposed a FHIR endpoint. The weakness is the cost burden on small hospitals and rural clinics, plus the fast pace of USCDI updates that vendors must chase. Lesson for Vietnam: top-down works, but it must come bundled with a public test suite and a support mechanism for smaller vendors.

4. JP Core 1.2.0 — JAMI-led consensus

JP Core 1.2.0 is Japan's national fhir ig, led by the Japan Association for Medical Informatics (JAMI) together with the FHIR Domestic Implementation Group. The official documentation lives at jpfhir.jp and contains more than 50 Profiles covering Patient, Encounter, Observation, MedicationRequest, AllergyIntolerance, Procedure, and DiagnosticReport.

The governance pattern is Working Group consensus: large hospitals, EHR vendors, and research institutes meet on a regular cadence to align on profiles before publishing. This model fits an East Asian culture that prizes consensus — slower than US Core but with less pushback. Japan's Ministry of Health, Labour and Welfare (MHLW) may reference JP Core in specific circulars, but there is no umbrella mandate equivalent to the Cures Act.

The strength is detailed profiles with full English designations, accessible to international vendors. The weakness is slow rollout: Japanese hospitals still rely heavily on SS-MIX2 and HL7 v2.5. Lesson for VN Core: the JAMI governance model is a strong reference for an HL7 Affiliate Vietnam once it is established.

5. KR Core 2.0.0 STU2 — published by HL7 Korea

KR Core 2.0.0 is the STU2 release published by HL7 Korea at hl7korea.or.kr, used as the reference standard for South Korea's EMR ecosystem. The IG contains roughly 25 Profiles, focused on Patient, Encounter, Observation, MedicationRequest, and Coverage to bridge with the national health insurance system, HIRA.

The standout feature is the link to HIRA — Korea's Health Insurance Review and Assessment service. KR Core designs Coverage and Claim profiles that align with HIRA's data set, allowing health insurance payment flows to run on FHIR. This pattern is directly relevant for Vietnam when mapping the XML 4210 schema (the BHXH data exchange format) onto FHIR Claim.

Adoption is at the pilot stage — there is no full national mandate equivalent to the United States. University hospitals (Seoul National University Hospital, Asan Medical Center) have deployed KR Core endpoints, while provincial public hospitals still rely on legacy standards. Lesson for VN Core: KR Core's Coverage/Claim pattern is a direct reference for VNCoreCoverage.

6. CH Core 6.0.0 — minimal IG bound to mandatory EPD

CH Core 6.0.0 is Switzerland's national fhir ig, published jointly by HL7 Switzerland and eHealth Suisse. Compared to US Core or JP Core, CH Core is more modest in scale but explicitly designed to plug into the Electronic Patient Dossier (EPD) — the legally mandated electronic health record system in force since 2020.

The philosophy is "minimal but real": only profile what is actually used for EPD and DICOM exchange, never try to cover every Resource. That keeps CH Core small, easy to implement, and easy to maintain. Documentation lives at fhir.ch/ig/ch-core, with an artifacts page that lists every current profile.

The lesson for Vietnam is the clearest: a country of about 9 million can sustain a production-grade IG by keeping scope reasonable and prioritizing use cases tied to legal deadlines. VN Core 0.5.0 has reached 52 Profiles covering electronic medical records (Circular 13/2025/TT-BYT) and the BHYT cost-itemization template (Decision 697/QĐ-BYT 2026) — two use cases with concrete legal deadlines that anchor the priority list.

7. AU Core 2.0.0 — two conformance modes

AU Core 2.0.0 is published by HL7 Australia in partnership with the Australian Digital Health Agency (ADHA), with a focus on integrating with My Health Record. Its biggest distinction from other IGs is the dual conformance mode mechanism defined in the general-requirements page.

Profile Only Support requires a system to comply with data structure (must-support, slicing, terminology binding) when emitting or receiving FHIR resources. Profile Support + Interaction Support adds the RESTful interactions (search, read, create, update) per the prescribed CapabilityStatement. A given hospital can declare Profile Only initially, then upgrade to Profile + Interaction later.

This structure is fundamentally different from the often-misunderstood "tier 1/tier 2" model: AU Core does not stratify by profile complexity, it cleanly separates data conformance from interaction conformance. Lesson for VN Core: a clear conformance mode lets hospitals choose a deployment path that matches their capability, instead of forcing everyone to ship a full RESTful API on day one.

8. Brazil RNDS — openEHR and FHIR hybrid

Brazil's Rede Nacional de Dados em Saúde (RNDS) is the only example in this survey using a hybrid architecture: openEHR for richly structured clinical data storage, and FHIR R4 for exchange between systems. The approach embodies what the openEHR community calls "structured storage, flexible exchange."

Brazil's Ministry of Health (Ministério da Saúde) operates RNDS. Every clinical event (immunization, prescription, lab result) is stored as an openEHR archetype, then published as a FHIR Bundle when sharing is needed. The model is more complex than pure FHIR but supports deep clinical querying — something FHIR alone is not optimized for.

The Vietnam lesson here is long-term: if, in the 2030s, Vietnam needs a national health data warehouse capable of deep clinical query for AI and epidemiological research, RNDS is a serious model to study. For 2026-2028, however, sticking with pure FHIR like US/JP/KR/CH/AU Core is the safe choice.

9. VN Core — current state and 2027 roadmap

VN Core is at version 0.5.0 draft, initiated by Omi HealthTech (part of OmiGroup) as a community-led effort. Canonical URL http://fhir.hl7.org.vn/core/, base FHIR R4 (4.0.1), with 52 Profiles, 47 Extensions, 70 CodeSystems, 75 ValueSets, 13 Logical Models, and 152 Examples authored using FSH and the SUSHI compiler.

Compared to regional neighbors, VN Core trails Indonesia (SATUSEHAT in production) and Singapore (Synapxe in pilot) by 18-24 months. That said, Vietnam benefits from arriving later: it can borrow the JP Core governance model, the CH Core minimal philosophy, and the AU Core conformance mode pattern without paying for the early mistakes.

10. Five lessons for Vietnam

1. Reasonable scope, prioritize use cases with legal deadlines. CH Core with an initially tight scope still runs in production, serving the mandatory EPD. VN Core 0.5.0 has reached 52 Profiles covering Patient/Encounter/Coverage/Claim/EOB/Medication/TVM/Device clusters that serve Circular 13/2025 (electronic medical records) and Decision 697/2026 (BHYT cost-itemization template) — both with concrete legal deadlines that anchor priority decisions.
2. The test suite matters as much as the profiles. Without Inferno, US Core could not audit vendors; without Connectathons, JP Core could not resolve interpretation gaps. VN Core must have a working test suite before proposing any kind of mandate.
3. Terminology governance eats nearly half the effort. Localizing ICD-10, a SNOMED CT subset, the 34-province administrative division catalog, BHYT terminology, and the 54-ethnic-group catalog — that is the heaviest lift, not the FHIR profiles themselves. Staffing the CodeSystem work is job number one.
4. Don't go top-down too early. Forcing US Core onto vendors before profiles were truly mature triggered pushback from rural clinics and small vendors. JP Core built consensus first, then adopted (or did not adopt) a mandate — the result was smoother. VN Core should follow the JP/AU path, not the US one.
5. Community and government governance must be hybrid. No country has a national IG built solely by a government agency or solely by the community. The sustainable pattern is community-first foundations, then government endorsement plus enforcement. VN Core is on that path: Omi HealthTech is incubating the work and aims to hand it over to an HL7 Affiliate Vietnam once that body is officially recognized and the Ministry of Health is at the table.

11. Frequently asked questions

12. References and further reading

Official National Core IGs

• US Core 8.0.1 — hl7.org/fhir/us/core
• US Core roadmap and USCDI mapping
• USCDI versions (HealthIT.gov ISP)
• JP Core 1.2.0 — jpfhir.jp
• KR Core 2.0.0 STU2 — hl7korea.or.kr
• CH Core 6.0.0 — fhir.ch/ig/ch-core
• CH Core artifacts page
• AU Core 2.0.0 — hl7.org.au/fhir/core
• AU Core conformance modes
• Brazil RNDS — gov.br/saude
• JP Core source (GitHub)
• CH Core source (GitHub)

Surrounding ecosystem

• FHIR R4 (4.0.1) base specification
• Inferno Framework (ONC test suite)
• ONC Cures Act Final Rule
• SNOMED CT International
• LOINC

Continue reading on hl7.org.vn