In Samoa, FHIR is used for a few healthcare data exchange use cases. It is not yet the main standard, but adoption is growing. FHIR stands for Fast Healthcare Interoperability Resources, a standard that helps health systems share data.

Several FHIR versions are in use across the country, with R4 and R5 being the most active. Older versions like DSTU2 and STU3 are also present, while R4B sees moderate use.

A strong increase in FHIR adoption is expected in the coming years. This growth ties into wider Pacific regional efforts to improve digital health.

Rules and Support

Health data exchange in Samoa is shaped by the following:

  • Regulation exists that mandates the use of standards in electronic health data exchange.
  • FHIR is not specifically mentioned in the regulation.
  • No compliance deadline is set.
  • No fines apply for missing requirements.
  • No government funds are currently available to support FHIR adoption.

Across Pacific Island Countries, regulations vary and tend to be generic. There is a regional movement to develop minimum data regulation requirements. Once established, these would give individual countries a base they can adapt to local needs.

National Setup

Here is how national standards work in Samoa:

  • Standards organization: The Ministry of Health is responsible for health data standards in most Pacific Island Countries.
  • Core FHIR implementation guide: Samoa does not yet have a national base FHIR implementation guide.
  • Specific FHIR standards: A few FHIR standards are being developed for specific use cases.
  • Terminology server: No national FHIR terminology server exists, and there are no current plans for one.

The Pacific region will start developing regional standards, which will address many areas of health data exchange.

Active Use Cases

FHIR specifications are being developed in Samoa for these areas:

  • Prescriptions and pharmacy
  • Diagnostic orders and reports
  • Clinical decision support
  • Imaging
  • Immunizations
  • Patient access

No specific international specifications (such as International Patient Summary or IHE profiles) are currently used as the basis for national work, though connecting the Pacific through the International Patient Summary is a key future goal.

Who's Using FHIR

The main groups adopting FHIR in Samoa are:

  • EHR (electronic health record) system vendors
  • Diagnostic system vendors, such as imaging and lab providers
  • Government agencies

The main reasons for adopting FHIR include:

  • Improving health outcomes
  • Improving care workflows
  • Patient data access
  • Innovation

Most exchange happens through FHIR Messaging, FHIR Documents, and FHIR REST APIs at a basic level. SQL on FHIR has slightly more traction. Open source and proprietary FHIR software are used in roughly equal measure.

FHIR Community Process

One or more organizations are exploring becoming participants in the FHIR Community Process (FCP), a structured way for groups to develop and approve FHIR specifications. Within 2 to 3 years, Samoa expects to have one or more approved FCP participants.

AI and FHIR

The rise of artificial intelligence (AI) and machine learning (ML) is neither helping nor hindering FHIR efforts directly. However, AI is increasing interest in FHIR and structured data as a foundation for AI applications. The view is that AI does not reduce the need to invest in FHIR.

Success Stories and Challenges

Success story: The Tamanu EHR is used by 8 Pacific Island Countries. Roll-out is at varying stages and not yet complete, but it has already improved care workflows.

Main challenges for FHIR adoption include:

  • Unclear benefits
  • Unclear regulations
  • Lack of FHIR knowledge

Looking ahead: Connecting the Pacific through the International Patient Summary is the most anticipated upcoming use case.

Future Plans

Progress over the past year matched expectations, and satisfaction with the adoption rate is positive. Key achievements last year included:

  • Development of a national FHIR data model
  • Development of new FHIR standards for specific use cases
  • Launch of pilot projects with selected healthcare stakeholders

Next steps expected in the coming year:

  • Further development of a national FHIR data model
  • More FHIR standards for specific use cases
  • Additional pilot projects
  • Expanded adoption of FHIR across the healthcare ecosystem

There is strong agreement that within three years, FHIR adoption will deliver real benefits: cost savings, better care coordination, and a stronger digital health ecosystem.

Contributors

  • Rumanusina Francine Maua, Health Information Systems Adviser, The Pacific Community (SPC)

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