Taiwan Achieves National Healthcare Data Interoperability with FHIR: Building a Global Model for Health Data Governance in the AI Era

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Taiwan's Ministry of Health and Welfare (MOHW) has built the foundation for ensuring nationwide medical data interoperability. This was achieved by utilizing its self-developed FHIR technology—Fast Healthcare Interoperability Resources—along with national-level data standards and innovative platforms. Addressing the long-standing issue of fragmented hospital information systems (HIS), Taiwan adopted a unique technical approach: maintaining existing systems while achieving interconnection through a 'data middle platform.' Specific achievements include the implementation of the Taiwan Core Data for Interoperability (TWCDI) and its corresponding Implementation Guide, along with automated FHIR tools. This enables real-time and secure circulation of patient records across different medical systems. Notably, by late 2025, historical cross-hospital record linkage was completed among three major medical groups—Chang Gung, Mackay, and Zhongshan—giving the capability to directly support AI clinical decision-making. Furthermore, MOHW introduced the concept of 'FHIR Box,' integrating data transformation, storage, and exchange functions. This connects the health data space, health rules space, and health application space, laying the groundwork for automated National Health Insurance reporting, infectious disease reporting, and evidence medicine. Internationally, Taiwan is pioneering global leadership by implementing LOINC (Logical Observation Identifiers Names and Codes) and RxNorm (drug standard terminology system), alongside systematizing clinical terms using LLM SNOMED CT—the first country outside the US to achieve this. This demonstrates Taiwan's role as a global leader in healthcare data governance.