In this episode, I sat down with Max Nussbaumer to talk about why he founded Max Health, why he’s bringing his work from Europe into the U.S. market, and what he believes is about to change in healthcare faster than most people realize.
Max has deep roots in the FHIR ecosystem from academia at the Technical University of Munich, to Firely, to years of consulting across Europe. Now he’s building something bigger: a company focused not just on FHIR infrastructure, but on how that infrastructure enables real, visible impact for patients through AI, Smart on FHIR, and even wearable integrations.
But the real theme of this conversation wasn’t “FHIR adoption.”
It was this:
Healthcare is about to be reshaped not by standards alone, but by what AI can now do with standardized data.
FHIR Is No Longer Niche
Max pointed out something many of us have felt over the past year:
FHIR used to be a niche standard discussed at connectathons and DevDays.Now it’s the plumbing behind consumer AI health integrations from tools like ChatGPT and Claude.
For the first time, health data is entering general-purpose reasoning systems that people use every day. That changes the game. Not because FHIR is new, but because AI can finally use FHIR data at scale.
“Software Is Inflationary”
One of Max’s best lines:
What used to take a year to build can now be built in days.
This is showing up at hackathons, startups, and even among 18-year-old builders experimenting with AI, spatial awareness, and real-time health event detection. The barrier to building healthcare software has collapsed if you understand the underlying problems.
The differentiator is no longer coding skill.It’s domain understanding and knowing what problem is worth solving.
The Real Problem: Incentives, Not Technology
Max made a powerful comparison:
In aerospace, countries cooperate on standards to prevent planes from colliding mid-air.In healthcare, we still don’t have true global data standards because the financial incentives don’t demand it.
Healthcare costs continue to rise (approaching a quarter of U.S. GDP), yet most digital tools help people navigate the system, not reduce the need to use it.
The real opportunity for AI + FHIR is:
* Preventing unnecessary ER visits
* Supporting preventative care
* Giving patients usable access to their data to power their self care
* Enabling decision support before care becomes expensive
Where AI Changes Healthcare First
According to Max, the most immediate impact won’t be in replacing doctors.
It will be in:
* Extracting structured FHIR data from unstructured inputs
* Real-time scene and event understanding (AI + spatial awareness)
* Reducing overload in emergency systems
* Supporting remote diagnostics and distributed care models
* Turning patient data into actionable, evidence-based guidance
We’re moving from:
“How do we move data between systems?”to“How do we use this data to keep people out of the system?”
The Future of FHIR: Less Open, More Precise
We also discussed the direction of FHIR R6 and the move toward tighter, more stable core resources while allowing innovation to happen in defined spaces.
Max’s view: this won’t reduce innovation it will accelerate it. Builders will have more certainty that what they implement won’t shift under them, while AI makes data mapping across standards increasingly trivial.
A Global View
Having worked across Europe and now the U.S., Max sees strengths and weaknesses in both systems. What’s clear is that:
Both systems need better use of data, and patients need more control and transparency.
That’s a central theme of Max Health and why he remains deeply committed to open source and global standardization efforts.
Where to Find Max
* Newsletter: maxhealth.tech
* LinkedIn: Max Nussbaumer
* Conferences, connectathons, and anywhere FHIR builders gather
The Big Takeaway
This episode wasn’t about FHIR history.
It was about this moment.
AI has arrived at the exact time when healthcare finally has a usable data standard. The combination means we can stop talking about interoperability as a goal and start using it as a foundation to solve real problems.
And the people who understand both the data and the problems are about to build very quickly.
