Journal of Innovative Science

Abstract: Healthcare interoperability represents a critical enabler for modern care delivery, with Fast Healthcare Interoperability Resources (FHIR) emerging as the predominant standard for exchanging health information. This literature review systematically examines FHIR implementation patterns, technical architectures, and clinical outcomes across healthcare organizations through analysis of peer-reviewed research published between 2020 and 2025. A comprehensive search of PubMed, IEEE Xplore, and academic databases yielded 127 studies, with 47 meeting inclusion criteria for detailed analysis. Evidence demonstrates that FHIR's resource-based architecture provides significant advantages over legacy HL7 v2.x systems in implementation efficiency and clinical integration. Organizations achieving comprehensive FHIR deployment report substantial improvements in care coordination and clinical decision support, though implementation challenges persist, including legacy system integration complexity and workflow adaptation requirements. Critical analysis reveals significant methodological limitations in existing research, including limited long-term outcome studies and inconsistent economic evaluation approaches. This review identifies key research gaps and provides evidence-based recommendations for future FHIR implementation research and practice.