Advancement in Smart Healthcare: Taiwan Achieves National Data Interoperability and AI Readiness

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At a conference led by the National Science Council, the convergence and achievements across three sectors—smart healthcare, sports, and culture—were reported. Notably, the Ministry of Health and Welfare announced its transition into an AI-ready smart healthcare era, establishing a global leading health data governance model. Facing the international challenge of long-term fragmentation in Hospital Information Systems (HIS), Taiwan adopted a unique technical approach: 'maintaining existing systems while achieving interoperability through a data middleware.' This led to the establishment of the Taiwan Core Data Initiative (TWCDI) and practical guidelines (TW Core IG), creating a foundation for the immediate and secure circulation of medical records between different hospital systems. A historic breakthrough in this data interoperability is marked by three major medical groups—Chang Gung, Mackay, and Zhongshan—completing cross-hospital record sharing by the end of 2025. This shared data can directly support AI clinical decision-making. Furthermore, the Ministry introduced the 'FHIR Box' concept, integrating functions for data transformation, storage, and exchange while connecting three spaces: health data, rules, and applications. Taiwan also became the first country outside the US to achieve systematic coding implementation of national-level LOINC, RxNorm, and Large Language Model (LLM)-based medical clinical terminology (SNOMED CT). These achievements demonstrate that Taiwan has achieved diplomatic success in smart healthcare, not merely through technology adoption but by mastering both international standardization and practical application.