In Chile, FHIR is widely used to exchange healthcare data. It has become a key standard in the country's digital health work. Most users have adopted FHIR R4, the fourth major release of the standard.

We expect FHIR adoption to grow strongly in the coming years. There is national conviction about its importance, and momentum is building across the healthcare system.

Rules and Support

Chile has clear rules supporting health data exchange and FHIR use:

  • Two key laws are in place:
    • Ley 21.668 on Interoperable Electronic Clinical Records
    • Ley 21.545 on Telemedicine Systems
  • Both laws include technical norms and regulations for implementation.
  • The Ministry of Health has published three FHIR Implementation Guides as normative standards.
  • FHIR is specifically mandated in regulation.
  • No deadline for compliance is set, and no fines apply.
  • Government funds are available to support FHIR adoption.

We are on the right path, but we need to strengthen governance and grow the skilled workforce in this area.

The National Setup

Several organizations support health data standards in Chile:

The national base FHIR implementation guide is widely used:

A national FHIR terminology server is in production. This service helps systems use consistent medical codes when sharing data.

Active Use Cases

Chile is developing FHIR specifications for many use cases, including:

  • Prescriptions and pharmacy
  • Terminology
  • Diagnostic orders and reports
  • Document exchange
  • Immunizations
  • Clinical registries
  • Patient access
  • Scheduling

National FHIR work builds on international standards such as the International Patient Summary and IHE profiles (a set of interoperability guidelines from Integrating the Healthcare Enterprise).

Regarding the FHIR Community Process (FCP), a structured way to develop and approve FHIR specifications, one or more organizations in Chile are exploring becoming participants. In the next 2-3 years, we expect to have one or more FCP specifications in development.

Who's Using FHIR

The main groups adopting FHIR in Chile are:

  • Care providers
  • EHR (Electronic Health Record) system vendors
  • Clinical registries
  • Government agencies

The main reasons for adopting FHIR include:

  • Regulation and grants
  • Improving health outcomes
  • Improving care workflows
  • Innovation

How FHIR is used in practice varies. FHIR Messaging and FHIR Shorthand (a tool for writing FHIR profiles) are widely applied. Subscriptions, FHIR Documents, the FHIR REST API, and FHIR Questionnaires also see notable use. SMART on FHIR and CDS Hooks (tools for apps and clinical decision support) are still gaining ground. The mix of open source and proprietary FHIR software leans toward open source.

Success Stories and Challenges

A clear success story is interoperable waiting lists, which have improved access to information and care workflows.

The main challenges for FHIR adoption are:

  • Unclear benefits for some stakeholders
  • Lack of FHIR knowledge
  • Changes in political direction

Looking ahead, we are excited about several use cases:

  • Hospital ward waiting lists
  • Oncology waiting lists
  • Drug prescriptions and dispensing
  • The National Immunization System

AI and FHIR

The rise of AI and machine learning is strongly helping FHIR and structured data efforts in Chile. There is growing interest in FHIR as a foundation for AI. We disagree with the idea that AI reduces the need for structured data.

Future Plans

In the last year, Chile achieved several milestones:

  • Developed a national FHIR data model
  • Created new FHIR standards for specific use cases
  • Launched pilot projects with healthcare stakeholders
  • Expanded FHIR adoption across the healthcare ecosystem

We made more progress than expected last year, and we are satisfied with the current adoption rate.

For the coming year, we expect:

  • Establishment of a national standards organization
  • Development of new FHIR standards for more specific use cases
  • Launch of new pilot projects
  • Expanded adoption across the healthcare ecosystem

We agree that within the next three years, Chile will see real benefits from FHIR adoption, including cost savings, better care coordination, and a stronger digital health ecosystem.

Contributors

  • César Galindo, President, HL7 Chile

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