Countries Outline Interoperable, Standards-Based Health Systems on Day Two of Regional Open Digital Health Summit 2025
Regional focus on national digital health architectures grounded in open standards and FHIR
The second day of the Regional Open Digital Health Summit 2025 in New Delhi featured detailed technical discussions and country presentations as health leaders from across the South-East Asia region highlighted progress in developing interoperable and scalable digital health architectures based on open standards and open-source technologies.
Day two focused on translating broader vision into operational steps, with sessions covering national digital health architectures, interoperability using Fast Healthcare Interoperability Resources, open-source health solutions, disease surveillance systems, and electronic health records. Representatives from Bangladesh, Bhutan, India, the Maldives, Nepal, Sri Lanka, Thailand, and Timor-Leste shared practical insights, challenges, and innovations in establishing digital public health systems.
Consensus on adopting FHIR for health data exchange
The first session noted a regional consensus to adopt FHIR as the primary standard for exchanging health data. Delegates recommended a phased shift to FHIR using adapters and iterative testing to update older systems while reducing IT-related risks. Speakers highlighted the need for strong governance mechanisms within digital health architecture to avoid vendor-driven fragmentation and support scalability. Key national components such as terminology services, patient registries, consent management, health information exchanges, and standardised formats were identified as areas still under development in several countries.
Country presentations on digital health transformation
Throughout the day, countries presented various approaches to digital health system development. India outlined its experience with HMIS, Care Expert, and Care 3.0 as configurable enterprise platforms. Sri Lanka described advancements in implementing surveillance systems and electronic health records using HL7 FHIR, SNOMED CT, ICD-11, and DICOM standards. Bangladesh, Bhutan, Nepal, and the Maldives showed how open and modular infrastructure is being customised to local requirements with increased use of digital IDs, cloud technologies, and shared registries. Thailand discussed its work in adapting disease surveillance systems and addressing integration challenges across health programs. Timor-Leste presented its plans for building a national digital health architecture aligned with open standards and regional practices.
Programmatic approaches to open-source digital health solutions
In the session on the programmatic perspective of implementing open-source digital health solutions, speakers pointed to a shift from isolated pilots to unified, programmatic digital health ecosystems. Experts demonstrated how frontline technologies, telemedicine platforms, digitally enabled cause-of-death systems, drone networks for diagnostics and medicine delivery, and configurable surveillance tools can be incorporated into an integrated public health framework.
Advancing digital surveillance
The session on advancing digital surveillance identified ongoing issues related to fragmented data, inconsistent case definitions, and limited interoperability across countries. Adoption of WHO SMART Guidelines, Digital Adaptation Kits, and HL7 FHIR standards was emphasised as essential for developing integrated and responsive surveillance ecosystems.
Electronic health records and implementation strategies
During discussions on electronic health records, panelists noted that implementation is more effective when systems are modular, scalable, and flexible, whether built as local platforms, open-source ecosystems, or configurable enterprise solutions.
Governance and legislative ecosystems
Sub-national perspectives
At the sub-national level, discussions covered governance, legislative frameworks, and ethical considerations for sustainable digital health transformation. Panelists recommended measures such as incentives, public-private partnerships, CSR funding, and community involvement. The session expressed confidence that digital health has the potential to reshape healthcare delivery in ways similar to the impact of digital payments on financial inclusion.
National perspectives
The national-level session underscored that technology alone cannot achieve universal health coverage. Trust, governance, and legislation must guide implementation. Experts from India, Sri Lanka, and Thailand highlighted the importance of data protection laws, citizen-centric frameworks, and legal recognition of digital health records to build confidence in digital systems. The session supported the transition to platform-based digital public infrastructure using open standards like HL7 FHIR to ensure interoperability and prevent vendor lock-in. Governments were encouraged to regulate emerging technologies such as Health AI and Software as a Medical Device while strengthening cybersecurity and digital literacy. Panelists stated that sustainable digital health depends on accountable governance and resilient systems that prioritise citizens.