In Dominican Republic, FHIR is just starting to take root. The country uses FHIR for a small number of use cases, and adoption is still in its early stages.

When FHIR is used, implementations vary across versions R4, R4B, and R5. Most national development work currently focuses on R5, the latest stable release.

Looking ahead, respondents expect a strong increase in FHIR adoption over the coming years. Energy is building around national projects, even though progress so far has been slower than hoped.

Rules and Support

Here is what the regulatory landscape looks like today:

  • No regulation currently mandates the use of standards for electronic health data exchange.
  • Because there is no mandate, there are no deadlines and no fines in place.
  • Government funding is available to support FHIR adoption, largely through international partnerships.

You can read more about the supporting projects here:

One respondent noted that health data regulation still needs significant work, and that multi-sector collaboration has been limited so far.

National Setup

The Dominican Republic has a clear national home for health data standards:

  • Standards organization: The Ministry of Public Health leads this work. Visit the Ministry of Public Health.
  • National Digital Health Strategy: A roadmap has been built based on the international support projects. Read it at the National Digital Health Strategy site.
  • Base FHIR implementation guide: A national core guide is under development, but it is not yet published.
  • Terminology server: A national FHIR terminology server is in development. This server will help systems use consistent codes for diagnoses, medications, and other health concepts.

Active Use Cases

National FHIR work in the Dominican Republic covers a wide range of use cases, including:

  • Prescriptions and pharmacy
  • Referrals and continuity of care
  • Provider directory
  • Public health reporting
  • Terminology
  • Document exchange
  • Immunizations
  • Clinical registries
  • Patient access
  • Scheduling
  • Allergy intolerance
  • Health workforce

The country builds on international standards to avoid reinventing the wheel:

  • International Patient Summary — a shared format for key patient information across borders.
  • IHE profiles — internationally agreed patterns for exchanging health data.

Who's Using FHIR

The main adopters of FHIR in the Dominican Republic include:

  • Care providers
  • Payers and insurers
  • EHR (electronic health record) system vendors
  • Diagnostic system vendors, such as imaging and lab providers
  • App developers
  • Government agencies

People adopt FHIR for several reasons:

  • Meeting regulation and accessing grants
  • Improving health outcomes
  • Improving care workflows
  • Giving patients access to their data
  • Driving innovation

On the FHIR Community Process (FCP) — a way for groups to publish FHIR specifications outside HL7 — the country already has one or more approved participants, and that role is expected to continue over the next few years.

Success Stories and Challenges

A key success story so far is the Shared Health Record. Reported benefits include:

  • Lower costs
  • Improved healthcare outcomes
  • Improved care workflows

The main challenges slowing FHIR adoption are:

  • Unclear benefits for some stakeholders
  • Unclear regulations
  • Lack of FHIR knowledge in the workforce
  • Changes in political direction

Use of open source versus proprietary FHIR software is mixed, with a noticeable lean toward open source tools in some parts of the ecosystem.

Future Plans

Progress over the past year has been slower than expected. Respondents describe themselves as ranging from neutral to very dissatisfied with the current pace.

Still, real steps have been taken:

  • Pilot projects launched with selected healthcare stakeholders
  • Early work on a national FHIR data model
  • New regulatory thinking on standards-based data exchange
  • Expanded adoption of FHIR across the healthcare ecosystem

Looking forward, the country is preparing for:

  • A National Electronic Health Record
  • A National Cancer Registry
  • Public Health Reporting and National Health Surveillance
  • Electronic Health Prescriptions
  • Establishment of a formal national standards organization
  • New regulation that prescribes the use of standards
  • Development of more specific FHIR standards

On AI and machine learning, respondents see no major impact on FHIR work yet, and they disagree with the idea that AI removes the need to invest in structured FHIR data. Structured data still matters.

Overall, respondents agree that within the next three years, the Dominican Republic will start to see real benefits from FHIR adoption, including cost savings, better care coordination, and a stronger digital health ecosystem.

Contributors

  • Joel Tavarez, Ministry of Public Health of Dominican Republic (Health Interoperability Specialist)
  • One respondent chose to remain anonymous.

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