By Professor Rachel Dunscombe, CEO, HL7 International
LinkedIn: Rachel Dunscombe
LinkedIn: Health Level Seven International
Ask a university student interested in technology to name the careers available to them, and they can probably tell you something about artificial intelligence, cybersecurity, software engineering or data science.
Ask about healthcare interoperability, and the answer may be very different. That’s a problem for healthcare.
Interoperability has become part of the infrastructure underlying modern healthcare. It supports everything from patient access and care coordination to digital health, value-based care and increasingly, artificial intelligence. Governments around the world are incorporating interoperability into national health strategies, while healthcare organizations and technology companies are expanding their use of standards such as HL7 FHIR.
Yet the workforce needed to implement, govern and sustain that infrastructure is not developing at the same pace.
Recent workforce modeling conducted by HL7 International estimates that global demand for core FHIR-skilled practitioner-equivalent roles could grow from approximately 120,000 today to 420,000 by 2031. Beyond those specialists, as many as 1.1 million people working in adjacent roles may need meaningful FHIR literacy.
The numbers are planning estimates, not a precise forecast. But the direction is clear: healthcare needs more interoperability talent, and competing for the professionals who already have those skills will not be enough.
Make the Career Visible Earlier
Part of the challenge is visibility. Students interested in solving difficult technical problems have many obvious career paths competing for their attention. Healthcare interoperability rarely receives the same exposure, even though the work sits at the intersection of technology, clinical care, policy, data and some of healthcare’s most consequential challenges.
We need to change that.
That does not mean every computer science student needs to become a FHIR engineer. Healthcare needs a much broader spectrum of capability, from developers and integration engineers with deep technical expertise to clinicians, informaticians, security professionals, product leaders and policymakers who understand how interoperable data affects their work.
Introducing those possibilities earlier gives students the opportunity to see interoperability not simply as a technical specialty, but as a career through which they can influence how healthcare works.
Move Beyond Teaching the Specification
We also need to think differently about how we prepare people for these roles.
Knowing a standard and knowing how to implement it are not the same thing. In practice, interoperability professionals must understand how policy requirements become technical requirements; how APIs, terminology, authentication and implementation guidance work together; and how decisions made during implementation affect real clinical and operational workflows.
Healthcare needs professionals who are the Swiss Army knives of interoperability, combining deep expertise in standards such as FHIR with a working understanding of complementary standards and frameworks, including SNOMED CT, LOINC, IHE and openEHR. That kind of expertise is difficult to develop through theory alone.
Students need opportunities to build, troubleshoot and make decisions. They need exposure to practitioners who can explain why an implementation that looks straightforward on paper becomes complicated in the real world. And increasingly, they need to understand how interoperability intersects with AI, including data quality, transparency and responsible use.
In other words, education needs to develop policy-to-implementation literacy: the ability to follow the path from what healthcare is trying to accomplish to the standards and technology required to make it work.
Give Students Something They Can Build
This thinking is behind initiatives such as HL7 International’s new Break the Code program, which gives students at participating academic institutions hands-on experience building FHIR applications.
The point is not simply to teach students FHIR. Participants build working applications, gain exposure to other standards through collaborations with standards organizations, learn from industry practitioners and can publish their work as portfolio artifacts demonstrating what they know how to do.
The early response has reinforced how much appetite exists for this kind of experience. More than 45 academic programs across the United States, Canada and Europe committed to the inaugural cohort.
But no single program or organization can solve a workforce challenge of this scale. Universities, standards organizations, healthcare providers, technology companies and governments all have a role in creating clearer pathways into interoperability careers. Employers can also help by providing applied learning opportunities, supporting mentorship and recognizing demonstrable skills alongside traditional qualifications.
Build the People Alongside the Infrastructure
Healthcare’s interoperability ambitions are growing. So are its ambitions for AI, connected care and digital transformation. All of them ultimately depend on people who understand how to make data move reliably, securely and meaningfully across an increasingly complex ecosystem.
We cannot build that workforce only after shortages become acute.
Healthcare has spent decades developing the standards that allow our systems to communicate. The next generation needs the opportunity to learn how to put those standards to work, and to see interoperability as a field where they can build a career while helping build the future of healthcare.