In Taiwan, FHIR is becoming a major part of the national digital health landscape. It is already used for several important healthcare data exchanges, and adoption is growing steadily.

Healthcare organizations in Taiwan currently use a wide range of FHIR versions, including DSTU2, STU3, R4, R4B, R5, and even the pre-release R6. R4 and R5 are among the most actively used versions.

Respondents expect FHIR adoption to keep increasing in the coming years, supported by government initiatives and a strong national core implementation guide.

Rules and Support

Taiwan has regulations that require the use of standards for electronic health data exchange. FHIR is specifically mentioned in these rules.

  • Regulation status: Standards are mandated for health data exchange.
  • FHIR in regulation: FHIR is both advised and, in some cases, mandated.
  • Compliance deadline: No specific deadline is set, or it is not widely known.
  • Fines: No fines are imposed for non-compliance.
  • Government funding: Yes, funds are available to support FHIR adoption.

Useful links shared by respondents:

National Setup

Taiwan has a national organization responsible for health data standards: the Ministry of Health and Welfare.

A terminology server helps systems share the same meaning for medical codes and concepts.

Active Use Cases

Taiwan has developed FHIR specifications for many use cases, including:

  • Prescriptions and pharmacy
  • Public health reporting
  • Terminology
  • Diagnostic orders and reports
  • Document exchange
  • Genomics
  • Immunizations
  • Invoice and claim

National specifications are mostly home-grown rather than based on international guides like the International Patient Summary or IHE profiles.

Who Uses FHIR

The main stakeholders adopting FHIR in Taiwan include:

  • Care providers
  • Payers and insurers
  • EHR (Electronic Health Record) system vendors
  • App developers
  • Government agencies
  • Researchers

The main drivers for adoption are:

  • Regulation and government grants
  • Innovation

In practice, the FHIR REST API is the most widely used exchange method. FHIR Messaging, FHIR Documents, SMART on FHIR (a way to securely connect apps to health records), and FHIR Questionnaires are also commonly applied. FHIR Shorthand (a simple language for writing FHIR profiles) is gaining ground.

Both open source and proprietary FHIR software are in use, with a tilt toward proprietary solutions.

Successes and Challenges

Respondents pointed to real-world FHIR successes in Taiwan, including:

  • NHI Core PAS
  • Cancer drug pre-approval workflows
  • International vaccination records
  • Critical illness applications
  • Next-Generation Sequencing (NGS) integration for genomics data

The main benefit so far is improved access to information.

Challenges that slow adoption include:

  • High investment cost
  • Unclear benefits
  • Lack of FHIR knowledge
  • Changes in political direction

AI and FHIR

Respondents see AI and machine learning as helping FHIR adoption. AI is accelerating the mapping and transformation of existing data into FHIR. Views are mixed on whether AI reduces the need for structured data — some strongly disagree, while others strongly agree.

Future Plans

Last year, Taiwan made progress on:

  • Setting up a national standards organization
  • Developing a national FHIR data model
  • New regulation for standards in electronic health data exchange
  • New FHIR standards for specific use cases
  • Pilot projects with healthcare stakeholders
  • Expanded adoption across the healthcare ecosystem

Respondents are split on the pace — some feel the progress matched expectations, while others hoped for more.

Looking ahead, respondents are excited about:

  • Taiwan Core Data for Interoperability
  • CQL (Clinical Quality Language) on FHIR
  • FHIR Bulk Data Access
  • Subscriptions (a way for systems to receive automatic updates)

In the next year, expected next steps include more pilot projects and broader adoption of FHIR across the healthcare ecosystem. Some respondents strongly agree that within three years, Taiwan will see real benefits from FHIR adoption, while others remain neutral.

Contributors

  • YuSheng Lo, Chief Digital Officer, Taipei Medical University
  • One additional respondent chose to remain anonymous

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