In Bangladesh, FHIR is just starting to take hold. The country uses FHIR for only a few specific cases right now. When FHIR is used, it follows the R4 version, which is the most common modern release of the standard.

FHIR (Fast Healthcare Interoperability Resources) is a global standard for exchanging healthcare data. In Bangladesh, awareness is growing, and the country is laying early groundwork for wider use.

Looking ahead, we expect a strong increase in FHIR adoption in the coming years. Healthcare organizations are showing more interest, and early development work is underway.

Rules and Support

Bangladesh does not yet have formal rules for health data exchange. Here is the current situation:

  • Regulation: There are no regulations that require standards for electronic health data exchange.
  • FHIR requirements: Since there are no rules, FHIR is not mandated.
  • Deadlines: No compliance deadlines exist.
  • Funding: No government funds are currently available to support FHIR adoption.

A clear need exists for a Health Data Governance Policy Framework to guide future work.

National Setup

The national infrastructure for FHIR is still being built.

  • Standards organization: There is no national organization responsible for health data standards yet.
  • Core implementation guide: A base FHIR implementation guide for Bangladesh is under development. You can view it here: Bangladesh FHIR Core Package.
  • Terminology server: A national FHIR terminology server is in development. This service will help share standard medical codes and terms.
  • FHIR Community Process (FCP): There is no known FCP activity in Bangladesh today. Within 2–3 years, we expect one or more organizations to start exploring FCP participation.

Active Use Cases

Bangladesh is starting small and focused. Work is underway on:

  • Discharge Summary: A FHIR-based discharge summary is in progress.
  • International Patient Summary (IPS): The country is building on this international standard to support patient data sharing.

The plan is to adopt FHIR use cases one at a time, step by step.

Who's Using FHIR

A wide mix of organizations are showing interest in FHIR:

  • Care providers
  • Payers and insurers
  • EHR system vendors
  • App developers
  • Clinical registries
  • Government agencies
  • Researchers

Main reasons for adoption:

  • Improving health outcomes
  • Giving patients better access to their data
  • Driving innovation in healthcare

Early implementations use a mix of open source and proprietary FHIR software.

Successes and Challenges

Early wins:

  • Improved access to health information through early FHIR work, such as the discharge summary use case.

Main challenges:

  • Unclear regulations make planning difficult.
  • Limited FHIR knowledge across the healthcare sector.
  • High investment costs needed for proper implementation.

Looking forward:

  • The Patient Discharge Summary is the next major use case on the horizon.
  • AI and machine learning are seen as helpful tools. They are speeding up the mapping and transformation of data into FHIR formats.

Future Plans

Progress over the past year matched expectations. Satisfaction with the current adoption rate is neutral, reflecting realistic hopes for a country in the early stages.

Next steps for the coming year:

  • Develop new FHIR standards for specific use cases.
  • Continue building the national core implementation guide.
  • Advance the terminology server toward production.

Within the next three years, we expect FHIR to deliver real benefits: better care coordination, cost savings, and a stronger digital health ecosystem.

Contributors

  • Md. Aminul Islam, Assistant Professor & Head, Bangladesh University of Health Sciences (BUHS)

The above summary is based on the answers to the State of FHIR Survey 2026, organized by Firely and HL7 International.