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Official URL: https://eahp-official.github.io/EAHP_Interoperabillty/ImplementationGuide/eahp-interoperability-ig				Version: 0.0.1
Draft as of 2026-05-13				Computable Name: EAHPInteroperabilityIG

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Background

Hospital pharmacies across Europe increasingly rely on automation devices — Whole Pack Robots (WPR), Automated Dispensing Cabinets (ADC), Unit Dose Robots (UDR) — to manage medication storage, dispensing, and traceability. These devices are typically procured from different vendors and are expected to operate as an integrated system within the hospital pharmacy.

In practice, communication between devices from different vendors requires bespoke, point-to-point integrations. Each integration is developed and maintained independently, creating significant cost, fragility, and barrier to procurement flexibility.

The EAHP Special Interest Group (SIG) on Interoperability in Pharmacy Automation was established to address this gap. The SIG brings together hospital pharmacists, automation vendors, and standards experts from across Europe. Its mandate is to define a vendor-neutral, pharmacist-validated standard for communication between automation devices — enabling plug-and-play interoperability across competing products.

The SIG operates in two phases. Phase 1 established governance structures, shared definitions, and functional Standard Operating Procedures (SOPs) for each target use case. Phase 2, of which this Implementation Guide is the primary output, translates those SOPs into a FHIR-based technical specification.

Motivations for the EAHP interoperability implementation guide

The primary motivation for this IG is to enable and accelerate the adoption of pharmacy automation across European hospitals by removing the interoperability barriers that currently make automation more complex and more costly than it needs to be. While integration between pharmacy automation devices is technically possible through customised HL7 or proprietary message formats, no shared, vendor-neutral standard has existed that allows devices to interoperate without bilateral customisation.

Two barriers stand out as the most significant:

Fragmented integrations. Automation devices typically communicate with the Pharmacy Management System (PMS) through point-to-point, proprietary connectors — one per device. While adding a new device does not require rebuilding all existing connectors, each new connector must be developed from scratch, is specific to the combination of device and PMS, and cannot be reused when either system is upgraded or replaced. Across a market with dozens of device vendors and multiple PMS platforms, this creates a large and fragmented integration landscape with no shared components, no portability, and no economies of scale.

Integration cost and complexity. In the absence of a shared standard, the cost of connecting automation devices falls entirely on the hospital — through middleware procurement, bespoke development, and ongoing maintenance. This cost is a barrier to automation adoption, particularly for smaller institutions, and diverts pharmacy IT resources away from higher-value work.

A shared FHIR-based protocol addresses both barriers directly. By replacing bilateral custom integrations with a single common interface, it reduces the cost and effort of connecting devices, makes it easier to add new devices or switch vendors, and allows pharmacy IT teams to focus on clinical value rather than plumbing.

Beyond reducing integration burden, the IG brings additional benefits. A standardised message exchange creates a structured, machine-readable audit trail for every medication movement across the automation network — replacing fragmented, system-specific logs with a consistent and complete traceability record.

The result is a standard that is simple enough for any automation vendor to implement, specific enough to guarantee interoperability across implementations, and deliberately scoped to automated refilling workflows between pharmacy automation devices. This focused scope is intentional: the IG is designed as a foundation and a prime building block on which future SIG phases will expand — progressively covering increasingly complex workflows, without requiring the core protocol to be redesigned. At the EAHP Congress in Barcelona (March 2026), ten vendors demonstrated this in a live showcase — covering 14 devices and 56 device-to-device combinations — with zero per-vendor customisation. This IG formalises that protocol.

Integration Overview

An overview of the integration with some sample messages is available here: Overview and sample messages

About FHIR Shorthand

The FSH IG includes the following information:

1. This page, providing introductory material (informative content).
2. ​FHIR Shorthand Overview – Introduction to FSH language and SUSHI (a reference implementation and de facto standard FSH compiler) (informative content).
3. ​FHIR Shorthand Language Reference – The syntax and usage of the FHIR Shorthand language (formal content).
4. ​Quick Reference Card – A cheat sheet for FSH syntax and examples (informative content).
5. FSH Grammar – An ANTLR v4 representation of the FSH syntax (informative content).
6. ​Change Log – A history of changes to the FHIR Shorthand specification (informative content).
7. Full Implementation Guide Zip File – A downloadable zip file containing the HTML and supporting files for this full specification.

The following materials, useful for learning and applying FHIR Shorthand but not part of the language specification, are found on FSHSchool.org:

1. SUSHI User Guide – SUSHI ("SUSHI Unshortens ShortHand Inputs") is a reference implementation and de facto standard interpreter/compiler for FHIR Shorthand. SUSHI produces Health Level Seven (HL7®) Fast Healthcare Interoperability Resources (FHIR®) profiles, extensions, and other artifacts needed to create FHIR Implementation Guides (IG).
2. GoFSH User Guide – GoFSH is a tool that turns FHIR artifacts into FSH. Using GoFSH, existing FHIR artifacts or complete Implementation Guides can be transformed into FSH, automatically.
3. FSH Visual Studio Code Extension Overview – The FSH Visual Studio Code extension provides syntax highlighting, code snippets, path completion, and other features that improve FSH authoring efficiency.
4. FHIR Shorthand Tutorials – A step-by-step hands-on introduction to producing an Implementation Guide (IG) with FHIR Shorthand and SUSHI.
5. FHIR Shorthand Seminar – A comprehensive overview of FHIR IG authoring basics for people who are interested in being able to independently create FHIR IGs.
6. FSH Online – A coding playground for FSH, an online environment that allows you to write FSH and convert it to FHIR artifacts, convert FHIR artifacts to FSH, access examples, and share FSH code with others.
7. FSH Finder – A list of public GitHub repositories that contain FSH code, refreshed daily.

​Note that the Language Reference is the formal specification, and if there is any conflict between that and any other written or programmatic materials, the former is considered the source of truth.

Version Number

FHIR Shorthand follows the same modified semantic versioning approach as FHIR. See the documentation on versioning in FHIR Releases and Versioning for more detail. Implementers are encouraged to clearly indicate what version or versions of the FSH specification they implement.

Issue Reporting and Contributions

• FSH language issues and suggestions can be made in the HL7 Jira. When filing FSH language or IG issues, use project="FHIR" AND Specification = "Shorthand (FHIR) [FHIR-shorthand]".

• SUSHI bugs, issues, and suggestions can be made here.

• GoFSH bugs, issues, and suggestions can be made here.

• If your FSH project is not listed in FSH Finder, log an issue here or submit a pull request on the list of organizations in settings.yml.

• FSH examples for inclusion in FSH Online can be contributed here.

Participants

Organization	Role
Alphatron	Reviewer
Sinteco	Contributor
BD	Contributor
Deenova	Contributor
JVM	Contributor
GPI	Contributor
Grifols	Contributor
Omnicell	Contributor
Stockart	Contributor
Swisslog	Contributor