In Tonga, the current usage of FHIR (Fast Healthcare Interoperability Resources) for exchanging healthcare data is at its nascent stage, with no active FHIR versions being utilized as of the survey. Despite this, there is a positive outlook for the adoption of FHIR standards in the coming years, indicating a growing interest in leveraging FHIR for healthcare data interoperability.

Rules and Support

  • Health Data Exchange Rules:
    • There is regulation in place that mandates the use of standards in electronic health data exchange.
    • FHIR is not specifically mentioned in the regulation.
    • It is not clear if there's a deadline for compliance or if fines are imposed for non-compliance.
  • Support for FHIR Adoption:
    • Government funds are available to stimulate the adoption of FHIR.
    • Bills such as PHIPA (Patients Health Information Private Act) are awaiting Royal Assent approval.

National Setup

  • Standards Organization: Currently, it is not known if there is a national organization in Tonga responsible for health data standards.
  • Implementation Guides and Terminology Services:
    • There are no base/core FHIR implementation guides for Tonga.
    • There is no national FHIR terminology server available, and no plans for one have been mentioned.

Active Use Cases

There are no specific local implementations, international standards use, or key projects mentioned. However, there is anticipation for future FHIR implementation use cases.

Who's Using FHIR

FHIR's potential adoption in Tonga seems to be in the early stages with no detailed information on active organizations or specific reasons for its adoption mentioned. However, EHR system vendors are recognized as potential users.

Success Stories and Challenges

  • Benefits and Real Examples: No successful FHIR use cases have been reported yet.
  • Main Difficulties:
    • High investment costs and unclear benefits were cited as challenges.
    • The lack of specific FHIR knowledge and unclear regulations also pose significant barriers to adoption.
  • Future Plans: Despite challenges, there is a strong agreement that FHIR adoption will lead to significant cost savings, enhanced care coordination, and a more robust digital health ecosystem in the next three years.

Future Plans

  • Progress So Far: The country has made much less progress than expected in the last year regarding FHIR adoption.
  • Next Steps:
    • Development of a national FHIR data model.
    • Development of new FHIR standards for more specific use cases.
    • Expanded adoption of FHIR across the healthcare ecosystem is anticipated.
  • Expected Changes: There is a strong belief that FHIR adoption will significantly benefit the country by improving healthcare innovation and creating a more unified and secure digital health ecosystem.

Contributors to this survey from Tonga preferred to remain anonymous.

The above summary is based on the answers to the State of FHIR Survey 2025, organized by Firely and HL7 International.