Transitioning Hospital EHRs to FHIR Standard for Healthcare Information Exchange

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The Ministry of Health and Welfare (MOHW) in Taiwan is promoting the integration of electronic health record (EHR) information using FHIR, an international standard for medical data exchange. Previously, different hospitals operated with various EHR systems, creating significant challenges in information sharing. MOHW introduced FHIR because it allows medical records to be broken down into 'small chunks' of data that can be read instantly when needed, rather than transferring entire files. This initiative enables rapid sharing of past medication and test results when a patient visits multiple hospitals, preventing redundant tests and easing the burden on healthcare staff. According to MOHW officials, since there are 40-50 different EHR systems in Taiwan, integrating them with foreign technology would cost billions. Therefore, the government plans to assist hospital system transformation by having domestic teams develop tools to convert existing systems into FHIR format. Currently, three demonstration hospitals—Taichung Zhongshan, Linkou Chang Gung, and Taipei Mackay—have completed the implementation of FHIR EHRs. The technology is also noted for its compatibility with mobile devices and resource-limited systems, aligning with global trends. Major international bodies are adopting this standard; for instance, the US government has legally mandated its use, and the EU plans related measures by 2027. Taiwan has incorporated FHIR into its hospital accreditation criteria to align with these international standards.