The following is based on the answers to the State of FHIR survey 2023 from César Galindo, HL7 Chile.
Regulation
Chile's engagement with FHIR is increasing, especially with regulatory attention. Although FHIR is not specifically mentioned, the Medical Records for Telemedicine regulation and the ongoing discussion in the Chilean Senate about the EHR Interoperability Law (Ley 21.541) indicate a move towards standardized health data exchange. Compliance with the new regulation will be required by August 2024, and it seems there are penalties for non-compliance, although no funds are specifically designated for FHIR adoption.
National Standards Development
HL7 Chile is the principal national standards organization and has developed the FHIR Core-Cl, which is beginning to be utilized by the government and the wider ecosystem. However, there is currently no published national FHIR data model for Chile. The few existing FHIR standards have been developed with the aim of enhancing interoperability and are being adopted at various levels.
FHIR Implementation
FHIR's adoption rate in Chile is moderate but expected to grow. With the absence of a national data model, FHIR implementation has been focused on specific use cases like the National Electronic Prescription service, which showcases the standard's potential to improve healthcare outcomes and information access.
The healthcare ecosystem, including care providers and app developers, is actively engaging in innovation, with patient advocacy groups like Agrupacion de Pacientes de Chile and Grupo de Cyberseguridad de Pacientes contributing to the dialogue on healthcare data availability. While the benefits of FHIR are acknowledged, challenges such as unclear regulations and a general lack of FHIR knowledge are prevalent.
Looking forward, there is optimism for FHIR's role in expanding to other areas such as insurance and billing, as well as mental health. The involvement of stakeholders like the Ministry of Health and CENS Chile is crucial for the complete adoption of FHIR in the country.