Taiwan's Medical Data Infrastructure: Building an Ecosystem with FHIR and SMART on FHIR

Details

Taiwan faced structural issues with fragmented electronic health records, necessitating the construction of standardized software infrastructure rather than just developing individual apps. To address this, the Ministry of Health and Welfare is promoting a transition to 'Next-Generation EHR' using FHIR as its foundational pillar. The core of this effort is SMART on FHIR, which enables medical applications to be truly 'plug-and-play' across various Electronic Health Record (EHR) systems. This allows developers to achieve a "Write once, run anywhere" environment by writing code once and supporting multiple different EHRs. Technically, it establishes secure authentication and authorization layers using OAuth 2.0 and OpenID Connect (OIDC), enabling granular access control based on the Principle of Least Privilege (SMART Scopes). Built upon this technical foundation is the national application marketplace, the Taiwan Health App Space (THAS). This platform has gathered 115 standardized applications, including AI diagnostic support and Clinical Decision Support systems, accelerating data-driven innovation in healthcare by integrating it into clinical workflows.