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Using FHIR means syntactically interoperability. Same structure, uses json, things generally in the same place.
Semantic interoperability means that the 2 systems can understand each other… just using FHIR is NOT enough for this. Different value sets and ways of representing the same information mean that 2 systems view of the same data may be very different.
I liken this to when I walked into a bar in a small town in Northern Ireland. I was speaking English, the bartender was speaking English, but we could not understand each other. We eventually figured things out but it was TOUGH to communicate even though we were ostensibly speaking the same language.
This is what FHIR apis from 2 different vendors are like. Same “language” remarkably different dialects
Any person working in healthcare software, which I did for 15 years, knows that for every standard there is a myriad of vendor implementations, bugs, hacks, workarounds, and just saying "System A speaks FHIR and System B does too" does not mean you can just load an EHR dataset from A into B and have all the information usable.
Like Zigbee, in theory like every company supports it but in practice moat imlementations is not compatiable with each-other
Now, how much they share is potentially open to debate.
They still require massive amounts of implementations.
For example, condition in the US is likely to use ICD-10. Procedures, especially those billed are going to use CPT or HCPCS.