Lessons Learned from Public Health FHIR Pilots: Challenges and Path to Sustainable Data Exchange

Details

In the United States, various state and local public health agencies have undertaken pilot projects utilizing the FHIR standard to explore data exchange capabilities. This effort is detailed in a report by the Association of State and Territorial Health Officials (ASTHO). Key challenges identified at the operational level include varying levels of initial knowledge regarding FHIR, emphasizing the critical need for workforce training. Technically, pilots are demonstrating bi-directional exchange for records like death and immunization data to reduce data silos. However, significant hurdles noted include funding cycles that do not align with the planning and implementation costs required for FHIR adoption, and the necessity of building reusable infrastructure capable of supporting broad public health functions rather than just single use cases. Consequently, the report strongly recommends developing agency-level FHIR roadmaps and adopting a long-term perspective to ensure standardized system design and sustained interoperability.