In Brazil, FHIR is already established as a key standard for exchanging healthcare data. It is used for several important use cases, and adoption continues to grow across the healthcare system.

The active version of FHIR in Brazil is R4, with some early use of R5. Both versions support modern healthcare data exchange needs.

Looking ahead, we expect a strong increase in FHIR adoption in Brazil in the coming years.

Rules and Support

Brazil has clear regulations supporting health data standards:

  • Regulation requires the use of standards for electronic health data exchange
  • FHIR is officially advised (but not strictly mandated)
  • No compliance deadline has been set
  • No fines apply for non-compliance
  • Government funds are available to support FHIR adoption

You can learn more here:

The Ministry of Health includes a secretariat called SEIDiGI, which manages the interoperability architecture. Brazil also has a published national digital health policy and strategy.

National Setup

Brazil has a strong national structure for FHIR development:

  • Standards organization: The Ministry of Health's SEIDiGI oversees health data standards
  • Base implementation guide: A national core FHIR guide is available and used in a limited set of use cases. View it at HL7 Brasil FHIR
  • Terminology server: A national FHIR terminology server is in production
  • FHIR Community Process (FCP): One or more organizations are exploring becoming participants

Active Use Cases

Brazil is developing FHIR specifications for several areas:

  • Prescriptions and pharmacy
  • Referrals and continuity of care
  • Terminology
  • Diagnostic orders and reports
  • Consent
  • Clinical decision support
  • Immunizations

Brazilian specifications build on international standards, including:

  • International Patient Summary
  • International Patient Access

Who's Using FHIR

The main groups adopting FHIR in Brazil are:

  • Government agencies
  • Researchers

The key reasons for adoption include:

  • Regulation and government grants
  • Improving health outcomes
  • Improving care workflows
  • Patient data access
  • Driving innovation

In terms of technical approaches, FHIR Shorthand (a simple language for writing FHIR profiles) is widely used. SMART on FHIR (for secure app integration), CDS Hooks (for clinical decision support), and SQL on FHIR (for analytics) are seeing moderate use. FHIR REST APIs and Bulk Data exchange are in earlier stages. Open source and proprietary FHIR tools are both in use, with a slight lean toward open source.

Success Stories and Challenges

The biggest success story is the RNDS (National Health Data Network). This project has improved access to health information across Brazil.

However, there are clear challenges:

  • Unclear benefits for some stakeholders
  • Lack of FHIR knowledge in the workforce
  • Changes in political direction that affect priorities

Looking forward, terminology projects are a top priority.

Future Plans

In the past year, Brazil achieved:

  • Development of a national FHIR data model
  • New regulation prescribing the use of standards
  • Development of new FHIR standards for specific use cases

Overall, progress has been slower than hoped, and satisfaction with the current adoption rate is low.

In the coming year, we expect:

  • New regulations on standards in electronic health data exchange
  • Expanded adoption of FHIR across the healthcare ecosystem

There is cautious optimism about whether FHIR will deliver cost savings, better care coordination, and a stronger digital health ecosystem within three years.

Contributors

  • Jussara Rotzsch, Chair, HL7 Brasil

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