In Rwanda, FHIR (Fast Healthcare Interoperability Resources, a standard for exchanging health data) is being used in a limited way. It currently supports a few use cases rather than serving as the main standard for health data exchange.

It is not fully clear which versions of FHIR are most active in the country. Several versions, including DSTU2, STU3, and R4, may be in use across different projects.

Looking ahead, we expect a strong increase in FHIR adoption in Rwanda in the coming years. Interest is growing among digital health stakeholders, and new projects are creating opportunities for wider use.

Rules and support

Rwanda has regulations that support standards-based health data exchange:

  • There are rules in place that mandate the use of standards for electronic health data exchange.
  • FHIR is advised, but not strictly mandated.
  • There is no set deadline for compliance.
  • It is unclear whether fines apply for non-compliance.

Key national policies and frameworks include:

  • Digital Health Governance Framework (Ministry of Health Rwanda): Sets standards for digital health systems, security, and interoperability. It supports HL7 and FHIR.
  • National Data Sharing Policy (2025) (Rwanda Information Society Authority and Ministry of ICT and Innovation): Establishes the legal basis for sharing data across government institutions. FHIR APIs are one way to put this into practice.
  • Rwanda Digital Health Strategy (Ministry of Health Rwanda): Outlines the roadmap for interoperable electronic medical records, a national Health Information Exchange, and HL7/FHIR-based integration.
  • Law No. 058/2021: Protects personal data and privacy, including health data.

The Ministry of Health, the Rwanda Biomedical Centre, and the Rwanda National Ethics Committee oversee health information systems, governance, and research approvals.

National setup

Rwanda does not yet have a single national organization dedicated to health data standards. Instead, several institutions share this work:

  • The Rwanda Standards Board coordinates national standards development.
  • The Ministry of Health, Rwanda Biomedical Centre, and Rwanda Information Society Authority lead sector-specific work.
  • The Rwanda Health Informatics Alliance supports capacity building and awareness.

Other key points about the national setup:

  • The country generally adopts and adapts international standards rather than creating new ones.
  • It is not yet clear whether a national base FHIR implementation guide exists.
  • A national FHIR terminology server is planned but not yet built.
  • Rwanda has one or more FHIR Community Process (FCP) specifications in development.

Active use cases

Rwanda draws on international work to shape its FHIR efforts. IHE profiles (a set of integration guidelines from Integrating the Healthcare Enterprise) serve as a basis for local specifications.

Promising areas for FHIR use in Rwanda include:

  • Interoperability between electronic medical record systems like OpenMRS and national reporting systems like DHIS2.
  • Development of a national Health Information Exchange.
  • Integration of telemedicine platforms with clinical systems.
  • Connecting wearable devices for remote patient monitoring.
  • Supporting AI-driven clinical decision support tools through standardized FHIR APIs.

Who is using FHIR

In Rwanda, government agencies are the main group adopting FHIR today.

The main driver for adoption is improving health outcomes. Stakeholders see FHIR as a way to enable better data sharing across the health system.

A mix of open source and proprietary FHIR software is used, with a slight lean toward proprietary tools.

Success stories and challenges

No specific successful FHIR use cases have been identified yet in Rwanda. The country is still in an early stage of adoption.

The main challenge is a lack of FHIR knowledge among local stakeholders. Building skills and awareness is a clear priority.

Looking forward, Rwanda is excited about several opportunities:

  • Real-time data exchange through FHIR APIs.
  • Better integration between OpenMRS, DHIS2, and other systems.
  • Growth of telemedicine and mobile health apps.
  • Capacity building led by groups like the Rwanda Health Informatics Alliance.

Future plans

Over the last year, Rwanda made progress on developing a national FHIR data model. However, progress has been less than expected, and overall satisfaction with the adoption rate is neutral.

For the coming year, the focus will be on:

  • Launching pilot projects with selected healthcare stakeholders.
  • Continuing to build local expertise in FHIR.
  • Strengthening interoperability across national digital health systems.

There is strong optimism for the next three years. Stakeholders expect FHIR adoption to deliver cost savings, better care coordination, and a stronger digital health ecosystem.

Contributors

  • Peter Bikorimana, Standards and Interoperability Lead, Rwanda Health Informatics Alliance (RHIA)

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