In Singapore, the use of FHIR (Fast Healthcare Interoperability Resources) is gaining momentum in the healthcare sector. FHIR is a standard describing data formats and elements (known as "resources") and an application programming interface (API) for exchanging electronic health records (EHR). The use of FHIR in Singapore is currently at a significant level, with the latest version, R4B, rated at 5 for its usage, indicating widespread adoption. The adoption of FHIR is expected to increase in the coming years, with optimistic projections for its continued growth.

Rules and Support

  • Health Data Exchange Rules: Currently, there are no specific regulations mandating the use of standards like FHIR in electronic health data exchange in Singapore.
  • FHIR Requirements: There's an ongoing effort led by Synapxe Pte Ltd, a HealthTech agency under the Singapore Ministry of Health (MOH), to mandate the use of HL7 FHIR at the national level.
  • Deadlines and Fines: There are no deadlines or fines imposed for non-compliance since regulations are not yet in place.
  • Available Funding: No government funds are specifically allocated to stimulate the adoption of FHIR.

National Setup

  • Standards Organization: A division within the Singapore MOH is responsible for health data standards, though it hasn't officially included data exchange standards like HL7 FHIR yet.
  • Implementation Guides: The base/core FHIR implementation guide is widely used, with guides in the process of being published online.
  • Terminology Services: There are no national FHIR terminology servers available, nor plans to establish one currently.

Active Use Cases

  • Local Implementations: FHIR is utilized in various specific use cases such as Prescriptions/Pharmacy, Referrals/Continuity of care, Terminology, Diagnostic Orders/Reports, Immunizations, and Patient Access.
  • Key Projects: The Healthier SG national program is a notable example of FHIR in action, demonstrating its potential to improve healthcare delivery and outcomes.

Who's Using FHIR

  • Active Organizations: Care providers, EHR system vendors, and app developers are among the primary users of FHIR in Singapore.
  • Main Reasons for Adoption: The adoption is driven by the need to improve care workflows, innovate, and lower IT implementation costs.
  • Usage: FHIR is mainly used through REST APIs, showcasing its flexibility and ease of integration into existing systems.

Success Stories and Challenges

  • Benefits: The adoption of FHIR has led to lowered costs and improved access to information. The Healthier SG program is highlighted as a successful use case.
  • Difficulties: A significant challenge is overcoming the initial perception that HL7 FHIR is complex and hard to implement.
  • Future Plans: There are plans to build an HL7 FHIR-based terminology server for internal use by a national IT system.

Future Plans

  • Progress: Singapore has made far more progress than expected in the adoption of FHIR, with expanded use across the healthcare ecosystem.
  • Next Steps: Efforts are underway to mandate the use of HL7 FHIR at the national level and include it as an official responsibility within the MOH.
  • Expected Changes: In the next three years, significant benefits from FHIR adoption are anticipated, including cost savings, enhanced care coordination, and a robust digital health ecosystem.

Contributors

  • Victor Chai, Head of Engineering Capabilities at Synapxe Pte Ltd, provided valuable insights into the current state and future prospects of FHIR in Singapore.

This document provides a snapshot of FHIR's role in transforming Singapore's healthcare landscape, emphasizing its growing adoption, the support framework, and the promising outlook for its impact on healthcare innovation and efficiency.

The above summary is based on the answers to the State of FHIR Survey 2025, organized by Firely and HL7 International.