FHIR Central Terminology Server for the HSE
By Theresa Barry, National Release Centre Lead for SNOMED CT, HSE Technology & Transformation
Kate Ebrill, Digital Health Executive and Standards Development Interoperability Lead at Australia e-Health Research Centre (AEHRC) and Commonwealth Scientific and Industrial Research (CSIRO), and colleagues, were invited to Cork, on October 28th.. The purpose of this was to meet with the HSE Chief Data and Analytics Office (CDAO) team, Department of Health representatives, the Chief Clinical Information Officer (CCIO), and members of the Shared Care Record team, following the procurement of the HSE’s Central Terminology Server (CTS).
Advancing interoperability through global collaboration
The Data Standards function within Technology & Transformation has connected with the CSIRO team through the SNOMED forums. SNOMED CT is a foundational data standard for interoperability and a key component in meeting the data requirements of the European Health Data Space (EHDS).
CSIRO has developed the Next-Gen FHIR Terminology Server, which is the underlying technology that the HSE has now procured. The purpose of the Cork meeting was to provide an in-depth overview of the CTS how it is set up, what it does, and how it will enable data standardisation and interoperability across all Irish care settings.
Learning from Australia’s Sparked Programme
Kate Ebrill shared insights from Australia’s Sparked Programme, launched in 2023 as an accelerator to enable interoperable data sharing across the Australian healthcare system. Despite extensive investment in digital health, Australian agencies found that much of their data existed as unstructured PDFs, and lacked agreed and adopted standards for describing the core information for patient data. This made it difficult to share or reuse data between systems.
To address this, the Sparked Programme was created to deliver a core set of FHIR standards, developed collaboratively by and for the healthcare community.
“Ontoserver” and “Sparked” are both initiatives of the Australian e-Health Research Centre (AEHRC) but serve different purposes:
- Ontoserver is a clinical terminology server that uses the FHIR standard to manage health codes.
- Sparked is an Accelerator. Funded by the Department of Health Disability and Ageing and delivered in partnership with the Department , Australian Digital Health Agency and HL7 Australia. Sparked is a community collaboration to develop the national data models, SNOMED CT value sets and FHIR Implementation guides that enable connected healthcare.
Ontoserver: underpinning Ireland’s terminology server
Ontoserver, the underlying technology behind the HSE’s Central Terminology Server, was procured in September 2025. This terminology server will:
- Implement FHIR and provide a fast, searchable interface for clinical terminologies such as SNOMED CT.
- Ensure consistent use and understanding of medical terms across systems.
- Enable interoperability and data consistency across the health service.
- Support features such as auto-complete search, FHIR-based APIs, and syndication for distributing content.
National investment and leadership in standards
Kate outlined that, under the 2023–24 Federal Budget, the Australian Government committed $15.7 million over two years to advance national health information sharing priorities. This included:
- $9.3 million for CSIRO to accelerate the development and adoption of national FHIR standards and SNOMED CT.
- An additional $1.9 million provided in the 2024–25 Federal Budget.
CSIRO’s Australian eHealth Research Centre (AEHRC), on behalf of a consortium including the Department of Health, Disability and Ageing, the Australian Digital Health Agency (ADHA), and HL7 Australia (HL7 AU), leads the ongoing management of these standards through Australia’s first FHIR Accelerator – Sparked.
The Sparked Accelerator brings together stakeholders across the healthcare ecosystem to collaboratively develop and adopt national FHIR standards, enabling seamless data exchange, improved coordination across services, and safer, more effective care for all Australians.
Ireland’s progress in data standardisation
Theresa Barry, National Release Centre Lead for SNOMED CT in Ireland, spoke about how this technology will support Ireland’s major digital programmes to standardise data. By making data available in a coded and structured format through APIs, the HSE will centrally manage content and ensure consistency across care settings.
Theresa also provided an overview of the Data Specification Management Process (DSMP) a process that supports stakeholder groups who want to standardise their datasets and prepare for future Electronic Health Record (EHR) systems.
Currently, the Irish Edition of SNOMED CT is available through the CTS. Decisions on additional terminologies will be made on a use-case basis, with prioritisation guided by governance structures.
Technical insight and next steps
The technical team supporting the HSE implementation provided a technical perspective on ensuring low latency and caching for a fast and efficient service
The discussion was warmly welcomed by all attendees,,who appreciated the opportunity to learn from Australia’s experience in leveraging technology, governance, and collaboration to drive interoperability.
With procurement now complete, the HSE is well-positioned to begin implementing this technology creating a significant opportunity to advance data standardisation and interoperability across Ireland’s healthcare system.