In the Dominican Republic, the adoption level of FHIR (Fast Healthcare Interoperability Resources) for exchanging healthcare data is still in the early stages, with a reported usage level of 2 on a scale where 0 is not used at all and 5 is fully adopted. Despite this, there is a strong expectation of increased adoption in the coming years. The specific versions of FHIR, such as DSTU2, STU3, R4, R4B, R5, and R6, are either not in use or their usage status is unknown, indicating a nascent stage of FHIR integration into healthcare systems.

Rules and Support

  • Health Data Exchange Rules: Currently, there are no regulations that mandate the use of standards, including FHIR, for electronic health data exchange.
  • FHIR Requirements: No specific requirements or mentions of FHIR in regulations.
  • Deadlines: No deadlines have been established as there's no formal regulation in place.
  • Available Funding: Government funding to stimulate FHIR adoption is available, primarily through loans from organizations like AIDB or The World Bank, rather than national funds.
  • More Information: Despite the lack of formal regulation, there's a National Digital Health Strategy prioritizing such initiatives. However, efforts are not coordinated due to the absence of official regulation.

National Setup

  • Standards Organization: The national organization responsible for health data standards is accessible at www.msp.gob.do.
  • Implementation Guides: There are no base/core FHIR implementation guides for the country.
  • Terminology Services: A national FHIR terminology server is in planning but not yet available.

Active Use Cases

  • Local implementations of FHIR are not well documented, but there is a significant interest in utilizing FHIR for national projects, such as the National EHR (Electronic Health Record).
  • The only specified international standard use case is the "International Patient Summary".

Who's Using FHIR

  • Active Organizations: Mainly EHR system vendors are currently engaging with FHIR, indicating an interest from the tech side rather than direct healthcare providers.
  • Reasons for Adoption: The primary motivations include improving care workflows and fostering innovation within the health sector.

Success Stories and Challenges

  • Benefits: There's an acknowledgment of improved access to information, particularly highlighted by the successful use case of COVID-19 vaccine data management.
  • Challenges: The main difficulties lie in unclear benefits, regulations, and a lack of FHIR knowledge, which hinder broader adoption.
  • Future Plans: The National EHR project is anticipated as a significant future use case for FHIR, aiming to streamline health data exchange across the country.

Future Plans

Despite facing more challenges than expected, which led to much less progress last year, there is a positive outlook for FHIR adoption. Planned efforts include:

  • Launching pilot projects with selected healthcare stakeholders.
  • Developing new FHIR standards for more specific use cases.
  • Expanding the adoption of FHIR across the healthcare ecosystem. The anticipation is that within the next three years, these efforts will lead to significant cost savings, enhanced care coordination, and a more robust digital health ecosystem.

Note: As the survey response requested anonymity, contributor names are not listed.

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