In Togo, FHIR is not yet widely used to exchange healthcare data. The country is in the early stages of digital health development, with most activity happening through small pilot projects rather than nationwide rollouts.

When FHIR is used, implementations are based on versions R4 and R5. These appear mainly in local pilots using open-source tools.

Looking ahead, we expect a strong increase in FHIR adoption in Togo over the coming years. Momentum is building as digital health frameworks take shape.

Rules and support

Togo has some regulation in place for electronic health data exchange, but it does not specifically mention FHIR.

  • A general law covers data protection, consent, individual rights, and breach notification (2019 law)
  • FHIR is not mentioned in current regulation
  • Compliance deadlines for FHIR adoption are not defined
  • No government funds are currently available to support FHIR adoption
  • Implementing rules on interoperability have not yet been published

The technical and governance frameworks for interoperability are still being developed.

National setup

Togo has a national organization responsible for health data standards: the Centre National de Santé Digitale (CNSD).

  • Learn more about the national digital health centre
  • There is no national base FHIR implementation guide yet
  • There is no known national FHIR terminology server
  • There is no current activity around the FHIR Community Process (FCP), a structured way for countries and organizations to publish FHIR specifications

The current focus is on data protection and cybersecurity rather than FHIR-specific guidance.

Active use cases

Togo's FHIR work is happening through small, local pilot projects rather than national programs.

  • Pilots using HAPI FHIR (an open-source FHIR server) and OpenMRS (an open-source medical records system)
  • Targeted exchanges of patient data between pilot sites, including consultations and lab results
  • European Implementation Guides serve as a reference for some work

These are local experiments. They help structure data and test interoperability, but they have not yet shown large-scale impact.

Who's using FHIR

The main stakeholders driving FHIR adoption in Togo are:

  • Government agencies

The main reasons for adopting FHIR include:

  • Regulation and grants
  • Improving health outcomes
  • Improving care workflows
  • Patient data access
  • Innovation

FHIR software in Togo is used almost exclusively as open source, reflecting the reliance on tools like HAPI FHIR and OpenMRS.

Success stories and challenges

What's working

Pilot projects using HAPI FHIR and OpenMRS have:

  • Improved healthcare outcomes in local settings
  • Helped structure patient data between consultation and lab sites
  • Tested interoperability concepts in practice

Main challenges

  • High investment cost to scale FHIR beyond pilots
  • Lack of FHIR knowledge among local teams
  • Connectivity issues, including electricity and network coverage in rural areas
  • Continued reliance on paper as a safety backup

Looking forward

We're hoping to see:

  • Continued pilots around OpenMRS and HAPI FHIR
  • More structured exchanges between consultations and labs across multiple sites in Lomé
  • Possible bidirectional data flow with the Ministry of Health for cohort monitoring of conditions like HIV and TB

For these small flows to become a real system, donors need to align their funding with sustainable interoperability rather than isolated proof-of-concept projects.

Future plans

Last year, Togo made the progress it expected. The main achievement was the launch of pilot projects with selected healthcare stakeholders.

In the coming year, we expect:

  • Expanded adoption of FHIR across the healthcare ecosystem

Over the next three years, we agree that Togo can benefit from FHIR adoption. This could lead to better care coordination and a stronger digital health ecosystem, especially if training, governance, and sustainable funding are prioritized.

Contributors

  • Magnoudewa Laoukpessi, Chief Executive Officer, Centre de formation la percée

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