In Brazil, FHIR (Fast Healthcare Interoperability Resources) is emerging as a key standard for the exchange of healthcare data. Currently, the most active version of FHIR in use is R4, with significant initiatives under development to enhance and broaden its application across the healthcare sector. The expectation among health data professionals is for a significant increase in the adoption rate of FHIR in the coming years, supported by regulatory mandates and ongoing development efforts.

Rules and Support

Brazil has established clear regulations mandating the use of standards in electronic health data exchange, specifically advising and in some cases mandating the use of FHIR. Key points include:

  • Regulatory Mandate: FHIR is not only advised but also mandated in certain contexts.
  • Deadlines and Compliance: Currently, there are no specific deadlines or fines for non-compliance mentioned.
  • Funding: Government funds are available to stimulate FHIR's adoption, although no specific details were provided.
  • Regulation Details: Information on these regulations and funds can be found at Rede Nacional de Dados em Saúde.

National Setup

Brazil is taking significant steps to standardize health data exchange:

  • Standards Organization: HL7 Brasil plays a pivotal role, with no direct link provided.
  • Implementation Guides:
    • A base/core FHIR implementation guide is under development.
    • Specific guides include BR-Core and guides for terminology at Terminologia Saude.
  • Terminology Services: A national FHIR terminology server is in production, supporting standardized clinical and administrative terminologies.

Active Use Cases

Brazil is implementing FHIR in various healthcare domains:

  • Local Implementations: Prescriptions/Pharmacy, Public Health Reporting, and Clinical Decision Support.
  • International Standards Use: Brazil adapts the International Patient Summary (IPS) to local needs.
  • Key Projects: The Brazilian National Health Data Network is a notable example of FHIR in action.

Who's Using FHIR

FHIR adoption spans multiple sectors:

  • Organizations: Care providers, payers/insurers, EHR system vendors, diagnostic system vendors, and app developers.
  • Adoption Reasons: Regulation and grants, improving health outcomes, care workflows, and innovation.
  • FHIR Usage: Through FHIR Documents, Rest API, SMART on FHIR, and CDS Hooks, among others.

Success Stories and Challenges

Brazil's journey with FHIR highlights both achievements and hurdles:

  • Benefits: Improved access to information and improved care workflows are notable successes.
  • Real Examples: The Brazilian National Health Data Network demonstrates the practical benefits of FHIR.
  • Difficulties: High investment costs and lack of FHIR knowledge are significant challenges.
  • Future Plans: Development of new FHIR standards and expanded ecosystem adoption are on the horizon.

Future Plans

Looking forward, Brazil anticipates:

  • Progress: Far more progress than initially expected has been made in FHIR adoption.
  • Next Steps: Continued development of national FHIR data models and standards.
  • Changes: Significant cost savings, enhanced care coordination, and a robust digital health ecosystem are expected outcomes.

Contributors

This summary is based on inputs from survey respondents, including Jussara Rotzsch from HL7 Brasil, who provided detailed insights into FHIR's current state and future in Brazil.

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