The following is based on the answers to the State of FHIR survey 2023 from Guilherme Zwicker, HL7 Brazil.

Regulation

In Brazil, the regulatory landscape is gradually orienting towards the adoption of FHIR. The Rede Nacional de Dados em Saúde (RNDS - National Network of Health Data) does not explicitly mention FHIR in its regulations, yet the standard is mandated within its framework. There are currently no specific deadlines for compliance nor are there any fines for not meeting them. Additionally, there are no known funds allocated specifically to stimulate the adoption of FHIR.

National Standards Development

HL7 Brazil and the Brazilian National Standards Organization, ABNT, are the main organizations driving the development of health data exchange standards, including FHIR. The national FHIR data model is in the process of being developed and can be referenced through the RNDS Simplifier. There are a few other FHIR standards being developed for specific use cases, though not all are derived from the national FHIR data model.

FHIR Implementation

The adoption of FHIR is expected to increase significantly, with respondents rating its current use in healthcare data exchange as minimal but growing. The RNDS and ConectSUS are notable FHIR use cases that highlight the standard's potential to improve access to information, healthcare outcomes, and possibly reduce costs. However, challenges such as unclear benefits, regulations, and a lack of FHIR knowledge present hurdles to its wider implementation.

Despite no active patient advocacy focusing on health data standards, the movement towards FHIR suggests a budding awareness and interest in its implementation. The emphasis on innovation indicates a forward-thinking approach to healthcare data management in Brazil.