More recently, Chile has focused on establishing a robust health data interoperability framework, enabling different healthcare providers and systems to share information securely and efficiently. This has been accompanied by updated regulations and technical standards to ensure data protection while promoting information exchange.

Chile has made remarkable strides in digitizing its healthcare system over the past fifteen years, transforming how health services are delivered and managed. The journey began in the mid-2000s with the nationwide implementation of Electronic Health Records (EHRs) and gained significant momentum in 2019 with the establishment of the Department of Digital Health, which spearheaded the adoption of telemedicine services in the public sector. By late 2022, efforts shifted toward implementing a robust health information exchange (HIE) network, with the adoption of the OpenHIE architectural framework serving as a cornerstone of this transformation.

A key focus of these efforts has been addressing the sensitive issue of referral management through the development of a national interoperable eReferral system. This system allows patients to track the exact status of their specialist referrals, ensuring transparency and improving care coordination. By leveraging existing Digital Public Infrastructure (DPI) components—such as the robust Unique National Identifier for the Client Registry (CR), a centralized Healthcare Registry of Individual Providers for the Provider Registry (PR), a curated Facility List for the Master Facility Registry (MFR), and advanced terminology services provided by Snowstorm and OpenConceptLab—the Interoperability Unit has aligned stakeholders across the public health sector.

These efforts have culminated in the integration of thousands of ServiceRequest resources into a centralized Clinical Data Repository, using HL7 FHIR R4 as the syntactic standard. This achievement was made possible through the collaborative development of an Implementation Guide by the Chilean Chapter of HL7 and the Center for Information Systems in Health (CENS). Together, these innovations are driving Chile’s vision of a fully interoperable and patient-centered healthcare system.

Governance

The Chilean Ministry of Health established a collaborative governance framework for its digital health initiatives, incorporating diverse stakeholders from across the healthcare ecosystem. At its core is a steering committee responsible for setting strategic priorities, defining objectives, and establishing desired outcomes for the comprehensive digital transformation. This structure is supported by specialized advisory groups that provide essential domain expertise to ensure successful implementation.

Steering committee

The steering committee serves as the governing authority for the National Healthcare Information Exchange project. Its mandate encompasses defining and approving overarching policies and strategies, establishing priorities, overseeing budget allocation and investments, and evaluating and monitoring the program's project portfolio. This centralized leadership ensures coordinated advancement of digital health initiatives while maintaining accountability for outcomes.

• Tasks:
• Define and validate the projects priorities and strategies
• Control and approve the budget and investments
• Validate and monitor the project and its individual workstreams

The steering committee is composed by representatives of:

• The Cabinet of the Minister of Health
• The Division of Health Care Network Management 
• The Division of Primary Care
• The Department of Information Technology and Communications
• The Department of Health Statistics and Information
• The Department of Digital Health 

Non-voting advisory members:

• National Center for Health Information Systems (CENS)

The steering committee brings together key leaders from across Chile's healthcare administration to ensure comprehensive oversight of healthcare information exchange initiatives. It includes voting representatives from the Minister of Health's Cabinet, the Division of Health Care Network Management (DIGERA), the Division of Primary Care (DIVAP), the Department of Information Technology and Communications, the Department of Health Statistics and Information, and the Department of Digital Health. Additionally, the National Center for Health Information Systems (CENS) participates as a non-voting advisory member, contributing valuable technical expertise and research-based insights to inform the committee's decisions while maintaining its independent advisory role.
The committee convenes monthly to evaluate the strategy's progress, define priorities, and establish objectives, ensuring continuous alignment with the national digital health vision and timely adaptation to emerging needs.

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