FHIR R6 Enhancements for Care Coordination, RPM, Prior Auth, and more

Nov 10, 2025

Getting FHIR’ed up for R6

FHIR Release 6 (R6), expected in late 2026, is set to evolve the standard, introducing enhanced long-term stability and expanded data capabilities. R6 delivers sought-after updates including flexible Encounter Classification (allowing multiple class codes for nuanced scenarios like virtual and in-person care) and powerful new resource types.

These new resources, like DeviceAlert (for medical device event notifications) and InsuranceProduct (to represent health insurance plans), broaden FHIR’s reach into untapped areas like device data and payer workflows.

Below is an overview of new FHIR R6 resources and how they can impact key healthcare workflows:

New FHIR R6 Resource	Description	Key Healthcare Workflows Impacted
DeviceAlert	Represents a single alert or alarm condition detected and signaled by a patient-connected health / medical device to create clinician’s awareness of a patient safety risk that needs to be addressed.	Remote Patient Monitoring (RPM) / Telehealth: Real-time alerting for critical device issues (e.g., low battery, sensor failure, or a physiological reading exceeding safe limits from an implant or home monitoring device).
InsuranceProduct	Represents the definitions and details of a health insurance plan, including its benefits, network, and coverage rules.	Payer-Provider Data Exchange & Prior Authorization: Standardizing the information used for determining patient coverage, eligibility verification, and automating the process of obtaining prior authorization from the health plan.
ClinicalAssessment	A record of a clinical assessment performed to determine what problem(s) may affect the patient and before planning the treatments or management strategies that are best to manage a patient’s condition. Assessments are often 1:1 with a clinical consultation / encounter, but this varies greatly depending on the clinical workflow.	Clinical Documentation & Quality Reporting: Consolidating findings from mental health evaluations, risk stratification tools, or comprehensive geriatric assessments into a single, standardized resource for sharing or quality measure reporting; valuable to anyone looking to get a comprehensive understanding of past patient encounters
PersonalRelationship	A resource to formally model the non-patient / non-practitioner relationship between two people, such as a family member, caregiver, or emergency contact.	Care Coordination & Social Determinants of Health (SDOH): More accurately capturing and sharing who is part of a patient’s support network beyond legally defined “RelatedPerson” types; includes support for detailing the duration of certain relationships
MolecularDefinition	Designed to represent the definition of a molecular entity, likely for use in genetic and precision medicine contexts.	Precision Medicine & Research: Standardizing the molecular details of tests or therapies for use in clinical trials, genetic testing workflows, and targeted drug development.

These changes close some important healthcare data exchange gaps and unlock key use cases.

Here at Redox, we’re excited about the potential of FHIR R6. It’s a major step toward unlocking more nuanced workflows in areas like remote patient monitoring and public health reporting.

For the Teams Adopting R6 Solo

If you manage your own integrations and want to leverage R6, you’re looking at a major infrastructure upgrade. It’s achievable, but you need a plan.

What to Expect:

A Mapping Overhaul: Prepare to dedicate engineering time to updating your internal translation layers. The subtle changes to existing resources (like Encounter Classification) and the introduction of new ones (DeviceAlert) require rewriting business logic to maintain compatibility.
The Gotcha: Don’t just focus on the new features; the subtle structural changes often create the most unexpected bugs downstream. Pro tip: Plan for breaking changes and allocate dedicated QA time just for R6 validation. It’s the step most DIY attempts skip!

If You’re Already a Redox Customer (We Got You!)

If your application runs on Redox Engine, there’s no need to panic-migrate. We built our platform to absorb industry evolutions like this so you don’t have to scramble. Some major benefits of working with Redox as your interoperability partner:

Shielded from Complexity: If your data source moves to FHIR R6, stays on R4, or uses an older standard, Redox handles the messy, one-to-many mapping complexity on your behalf.
Enrichment + Orchestration: We combine in-flight enrichment with orchestration capabilities. This means we don’t just translate R6 data; we can add context and use its new fields to dynamically route messages or trigger complex workflows based on the data’s content.
Adopt R6 on Your Schedule: We can incorporate specific R6 capabilities into our unified data model selectively. This allows you to leverage new R6 functionality when you need it without rewriting your core integration code.

The takeaway? We’ll be ready when R6 rolls out. Just talk to your Redox account team to discuss which R6 capabilities make sense for your roadmap. We’ll handle the heavy lift.