In Côte d'Ivoire, FHIR is not yet being used to exchange healthcare data. FHIR is a modern standard for exchanging health information between systems. At this stage, no FHIR versions are actively in use across the country.

Despite the slow start, there is strong optimism about the future. Respondents expect a significant increase in FHIR adoption in the coming years.

Work is underway to build the foundation needed to make FHIR a practical reality in the country's digital health landscape.

Rules and Support

The regulatory landscape for health data exchange in Côte d'Ivoire is still developing:

  • Health data exchange rules: There are no current regulations that mandate the use of standards for electronic health data exchange.
  • FHIR requirements: FHIR is not yet mentioned in any regulation.
  • Deadlines: No compliance deadlines exist at this time.
  • Funding: No government funds are currently available to stimulate FHIR adoption.

Work is in progress to develop a regulatory framework for health data in the country.

National Setup

The national infrastructure for FHIR standards is still in early stages:

  • Standards organization: There is no national organization yet responsible for health data standards.
  • Implementation guides: No national base or core FHIR implementation guide exists.
  • Terminology services: There is no national FHIR terminology server, and no plans currently in place to develop one.
  • FHIR Community Process (FCP): No known FCP activity exists in the country today. However, within 2–3 years, the country expects to have one or more approved FCP participants.

Active Use Cases

There are no known successful FHIR use cases in Côte d'Ivoire at this time. The country is still in the awareness and advocacy phase. Respondents expressed hope that concrete implementation projects will emerge soon.

Who's Using FHIR

While FHIR adoption is in its earliest stages, the main stakeholders expected to drive adoption include:

  • Care providers
  • Payers and insurers
  • Diagnostic system vendors (such as imaging and laboratory systems)
  • Clinical registries
  • Government agencies
  • Researchers

The main drivers for future FHIR adoption are:

  • Regulation and grants
  • Improving health outcomes
  • Improving care workflows
  • Patient data access

A mix of open source and proprietary FHIR software is expected to play a role, leaning slightly toward open source.

Successes and Challenges

There are no documented FHIR success stories yet. The country faces several significant challenges:

  • High investment cost: Adopting FHIR requires major upfront resources.
  • Unclear benefits: Stakeholders are not yet convinced of the value.
  • Unclear regulations: A lack of clear rules creates uncertainty.
  • Lack of FHIR knowledge: Training and expertise are limited.
  • Changes in political direction: Shifting priorities slow progress.

Current efforts focus on training on FHIR and advocacy to build awareness and skills across the healthcare ecosystem.

On AI and structured data, respondents disagree with the idea that AI reduces the need to invest in FHIR. Structured data remains important, even as AI tools grow.

Future Plans

Progress over the past year was much less than expected, and overall satisfaction with the current adoption rate is very low. However, there are clear ambitions for the year ahead:

  • Establish a national standards organization
  • Introduce new regulation that prescribes the use of standards in electronic health data exchange
  • Launch pilot projects with selected healthcare stakeholders
  • Expand FHIR adoption across the healthcare ecosystem

Looking three years ahead, respondents agree that Côte d'Ivoire will start to see real benefits from FHIR adoption. These benefits include cost savings, better care coordination, and a stronger digital health ecosystem.

Contributors

  • Innocent Martial NANAN, President, SIBIM (Health Informatics & Digital Health Association)
  • Franck Olivier KOUASSI, Network Systems and Infrastructure Design Engineer, Ministry of Health

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