In Uganda, the adoption of FHIR (Fast Healthcare Interoperability Resources) is gaining momentum. 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 most active version currently being utilized is DSTU2, with significant interest in adopting further versions shortly. The expectation is for a rapid increase in FHIR adoption across the country, fueled by regulatory support and the need for more efficient healthcare data exchange.

Rules and Support

  • Health data exchange rules: Uganda has regulations that mandate the use of standards in electronic health data exchange.
    • FHIR is advised within these regulations.
  • Deadlines: Compliance deadlines are set within these regulations, but no fines are imposed for non-compliance.
  • Funding: Currently, there are no government funds available to stimulate the adoption of FHIR.

National Setup

  • Standards Organization: The Ministry of Health Uganda Division of Health Information Management is responsible for health data standards in Uganda.
  • Implementation Guides: A base/core FHIR implementation guide is under development, indicating the country's commitment to adopting FHIR standards.
  • Terminology Services: Uganda has a national FHIR terminology server in production, enhancing interoperability across systems.

Active Use Cases

  • Local implementations focus on:
    • Prescriptions/Pharmacy
    • Public Health Reporting
    • Diagnostic Orders/Reports
    • Clinical Decision Support
    • Imaging
    • Immunizations
    • Clinical Registries
    • Patient Access
    • International Patient Summary
  • International standards are being incorporated, facilitating global interoperability.

Who's Using FHIR

  • Several organizations are actively using FHIR, including healthcare facilities and diagnostic system vendors.
  • Main reasons for adoption include improving care workflows and leveraging FHIR to innovate healthcare services.
  • FHIR is utilized in various capacities, from data exchange to supporting clinical decision-making processes.

Success Stories and Challenges

  • Benefits: The use of FHIR in Uganda is still at an early stage, and specific success stories are not detailed. However, the anticipation of significant cost savings, enhanced care coordination, and a more robust digital health ecosystem is strong.
  • Main Difficulties: The primary challenge is the lack of FHIR knowledge among stakeholders, coupled with high investment costs and unclear benefits.
  • Future Plans: There is a strong desire for the exchange of patient shared health records, indicating a move towards more collaborative and patient-centered care.

Future Plans

  • Progress So Far: Uganda has made more progress than expected in the last year regarding FHIR adoption.
  • Next Steps: The development of new FHIR standards for specific use cases and the expanded adoption of FHIR across the healthcare ecosystem are key focuses.
  • Expected Changes: Within the next three years, Uganda anticipates reaping significant benefits from FHIR adoption, including cost savings and improved healthcare coordination.

Contributions to this overview were made possible by insights from healthcare professionals in Uganda, reflecting their experiences and expectations around FHIR's impact on the country's healthcare landscape.

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