In Colombia, FHIR (Fast Healthcare Interoperability Resources) is becoming a key player in the healthcare data exchange landscape. Currently, the most active FHIR version is R4, with minimal usage of earlier versions like DSTU2. There's a clear expectation that the adoption of FHIR will increase significantly in the coming years. This growth is partly due to regulations mandating the use of standards in electronic health data exchange, specifically advising FHIR.
Rules and Support
The Colombian government has laid out specific rules and support mechanisms for FHIR adoption:
- Health Data Exchange Rules: Legislation mandates the use of standards for electronic health data exchange, with FHIR being specifically advised.
- FHIR Requirements: The government has released a FHIR Implementation Guide to support adherence to these standards.
- Deadlines: A deadline of 5 years from January 31, 2020, has been set for achieving interoperability of medical records across the country.
- Available Funding: No government funds are currently available to stimulate FHIR adoption.
- Regulations and Guides:
National Setup
While there's no national organization responsible for health data standards, Colombia has made significant strides in FHIR implementation:
- Implementation Guides: A base/core FHIR Implementation Guide is in use for a limited set of cases, available here.
- Terminology Services: Planning is underway for a national FHIR terminology server.
Active Use Cases
Colombia has several active FHIR use cases, including:
- Local Implementations: Insurance companies like SURA and Ecopetrol have successfully implemented FHIR within their networks.
- International Standards Use: Colombia has published FHIR CORE Implementation Guides and is working on adopting international patient summaries.
- Key Projects: The District Health Secretariat of Bogotá is among the government agencies defining FHIR guidelines for local healthcare networks.
Who's Using FHIR
FHIR adoption in Colombia is led mainly by private healthcare organizations, including:
- Active Organizations: Insurance companies (SURA, Ecopetrol, Keralty) and large technology companies (Microsoft, Google, AWS) are key adopters.
- Reasons for Adoption: The main reasons include improving interoperability, leveraging cloud services for healthcare data, and streamlining billing and claims processes.
- How They're Using FHIR: These organizations use FHIR for a variety of purposes, from managing patient records to supporting billing and claims.
Success Stories and Challenges
Successes and challenges highlight the journey of FHIR adoption in Colombia:
- Clear Benefits: Improved access to information and streamlined workflows are significant benefits of FHIR adoption.
- Real Examples: SURA's and Ecopetrol's FHIR implementations serve as real-world examples of these benefits.
- Main Difficulties: Unclear regulations and political changes pose challenges to broader FHIR adoption.
- Future Plans: Innovative projects like the Blood Bank of Bogota's Data Governance model showcase the future direction of FHIR implementation.
Future Plans
Looking ahead, Colombia aims to expand FHIR adoption through:
- Progress So Far: The country has made more progress in FHIR adoption than expected, especially within private healthcare organizations.
- Next Steps: Planned initiatives include developing a national FHIR data model and launching pilot projects with healthcare stakeholders.
- Expected Changes: Significant cost savings, enhanced care coordination, and a robust digital health ecosystem are anticipated benefits of continued FHIR adoption.
Contributors
- Mario Enrique Cortes, Chair and Country Executive Director, HL7 Colombia
The above summary is based on the answers to the State of FHIR Survey 2025, organized by Firely and HL7 International.