In Costa Rica, FHIR is being used for a few specific healthcare data exchange use cases. Adoption is still in its early stages, but interest and momentum are growing.
The most active FHIR version is R4, with some implementations also using R5 and R4B. Respondents expect FHIR adoption to increase noticeably in the coming years, driven by national interoperability efforts and new regulation.
FHIR (Fast Healthcare Interoperability Resources) is an international standard for exchanging health data between systems. In Costa Rica, it is becoming the foundation for connecting public and private healthcare information.
Rules and Support
Costa Rica has regulation in place that mandates the use of standards for electronic health data exchange, and FHIR is specifically mandated.
- FHIR is mandated by national regulation
- No compliance deadline has been set
- No fines are imposed for non-compliance
- No dedicated government funds are currently available to stimulate FHIR adoption
- A decision is still pending from the Ministry of Health on whether interoperability will be made fully obligatory
You can read more about Costa Rica's interoperability guidelines on the Ministry of Health Interoperability Guides page.
One respondent noted that using standards in healthcare is a major milestone for the country. However, more specific data governance policies are needed to ensure continuity and improvement.
National Setup
Costa Rica has a national organization responsible for health data standards.
- Lead organization: The Ministry of Health, through its Directorate General of Digital Transformation and the Technical Advisory Committee on Digital Health (Comité Técnico Asesor de Salud Digital)
- Core FHIR implementation guide: Under development and already used in a limited set of cases. See the Costa Rica Core FHIR IG and the Ministry of Health FHIR page
- National terminology server: Not yet available, but in planning
- FHIR Community Process (FCP): Some organizations are exploring participation, and at least one specification is reportedly in development
Active Use Cases
FHIR specifications are being developed in Costa Rica for several use cases, including:
- Prescriptions and pharmacy
- Diagnostic orders and reports
- Imaging
- Immunizations
- Terminology
- Public health reporting
- Clinical registries
- Laboratory tests
Costa Rica's national specifications are based on international standards such as:
- International Patient Summary (IPS)
- European Implementation Guides
- IHE profiles
- WHO SMART Guidelines (PH4H)
Who's Using FHIR
The main groups adopting FHIR in Costa Rica include:
- Care providers
- Payers and insurers (including social security)
- Government agencies
- EHR (Electronic Health Record) system vendors
- Software and app developers
- Diagnostic system vendors (imaging and labs)
- Clinical registries
- Researchers and academia
The main reasons driving FHIR adoption are:
- Regulation and grants
- Improving health outcomes
- Improving care workflows
- Patient data access
- Innovation
FHIR Documents and FHIR Messaging are the most commonly used exchange mechanisms. FHIR REST APIs are being used in some implementations. FHIR Shorthand (a simpler way to write FHIR profiles) and FHIR Questionnaires are also seeing some use.
Most software in use today is proprietary, with some open source adoption.
Success Stories and Challenges
Real examples
- International Patient Summary (IPS) exchange between the public social security system (CCSS) and the National Insurance Institute (INS), as well as between private and public hospitals
- Real-time reporting of mandatory diseases, laboratory results, and immunizations from social security to the Ministry of Health
Clear benefits reported
- Improved access to information
- Improved healthcare outcomes
- Improved care workflows
Main challenges
- High investment costs
- Lack of FHIR knowledge across stakeholders
- Unclear regulations
- Changes in political direction
- Limited understanding of why standards are needed
How AI is influencing FHIR
Opinions are mixed. Some respondents see AI as accelerating mapping to FHIR and increasing interest in structured data as a foundation for AI. Others worry AI could reduce the perceived need to invest in structured data. Most respondents disagree with the idea that AI can replace structured data efforts.
Future Plans
Progress in the past year
- A national FHIR data model is being developed
- New regulation on standards for electronic health data exchange has been introduced
- New FHIR standards for specific use cases have been developed
- Pilot projects have been launched
- Implementation guides have been published (in draft)
Looking ahead
Respondents expect the next year to bring:
- New regulation on standards
- Further development of FHIR standards for more use cases
- More pilot projects with healthcare stakeholders
- Wider adoption of FHIR across the healthcare ecosystem
- Establishment of a formal national standards organization
- Annual networking events to validate implementation guidelines
Upcoming use cases to watch include:
- SNOMED-CT implementation in EDUS (the national electronic health record)
- Laboratory results exchange (including diabetes labs)
- Medical imaging reports
Overall, respondents feel Costa Rica has made more progress than expected in the past year, though satisfaction with the current pace of adoption is mixed. Most respondents agree that within the next three years, Costa Rica will start to see real benefits from FHIR adoption.
DHIT Costa Rica is currently helping coordinate FHIR-related efforts across the public and private sectors.
Contributors
- José Manuel Zamora, CCSS — Innovation Process Management Lead
- Jürgen Schosinsky, Global Life-Centered Hub — Executive Director
- Paul Fervoy, Siftia — Director
- Alejandro Benavides, Meddyg — Chief Executive Officer
- One additional anonymous respondent
The above summary is based on the answers to the State of FHIR Survey 2026, organized by Firely and HL7 International.