Ministry of Health Builds FHIR Ecosystem and Holds Server Performance Competition for Electronic Medical Records Exchange

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The Ministry of Health and Welfare (MOH) held the '1st International FHIR Server Performance Competition' to address the highly fragmented nature of Taiwan’s electronic medical record systems. The competition involved domestic and international teams testing the endurance and efficiency of servers handling 1 million electronic medical records. According to MOH officials, Taiwan has dozens of existing electronic medical record systems, which are often siloed within individual hospitals, creating significant data interoperability challenges. To solve this, the MOH is promoting efforts for local teams to develop tools that convert legacy electronic records into the FHIR standard format, reducing reliance on foreign technologies. FHIR (Fast Healthcare Interoperability Resources) is an internationally recognized medical data exchange standard, noted for its usability and support for mobile/resource-constrained environments. Taiwan has integrated FHIR into hospital accreditation criteria, and pilot implementations have occurred at demonstration hospitals (such as Taichung Zhongshan, Linkou Chang Gung, and Taipei Mackay), successfully enabling standardized cross-hospital electronic record exchange. The performance competition was designed to simulate peak system load, conducted as a 24-hour endurance race. Teams measured the time required to connect their systems after loading one million records into a standard platform. This process tests the practical processing capability of the FHIR server for connecting clinical decision support systems and SMART on FHIR applications. The results are expected to build a faster and more stable medical data exchange environment, improving patient convenience during cross-hospital care and reducing administrative burdens.