The National Health Insurance Administration (NHIA) launched the NHI MediCloud System 2.0 in December 2024. On December 30, 2024, the NHIA hosted the event, "The Cancer Drug Prior Authorization Application Using Electronic Medical Records: Implementation Results Demonstration," to share the initial outcomes of digital transformation in cancer care.
These outcomes include the collection of next-generation sequencing (NGS) declaration data, applications for catastrophic illness certificates for cancer patients, and the digitalization and interoperability of clinical cancer treatment data—such as prior authorization requests for cancer drugs and treatment effectiveness follow-ups.
This transformation aims to establish a patient-centered system that integrates relevant data to enhance treatment effectiveness and improve data transparency. The system serves as the foundation for developing a precision medicine ecosystem, enabling hospitals to provide holistic care. Furthermore, this ecosystem can act as a critical database for future assessments of new cancer drug technologies, clinical trials, medical research, and drug development—ultimately advancing the level and quality of cancer care in Taiwan.
The NHIA hosted "The Cancer Drug Prior Authorization Application Using Electronic Medical Records: Implementation Results Demonstration" and invited Minister Tai-Yuan Chiu of the Ministry of Health and Welfare to deliver the opening remarks. Director Bor-Sheng Ko of the Department of Hematology and Oncology at National Taiwan University Hospital—a long-term partner in the planning and evaluation of cancer drug reimbursement—shared an innovative model for reviewing digital healthcare data.
Additionally, four collaborating hospitals—Koo Foundation Sun Yat-Sen Cancer Center, MacKay Memorial Hospital, Linkou Chang Gung Memorial Hospital, and Taichung Veterans General Hospital—shared their practical experiences in converting electronic medical records to meet FHIR standards and mapping them to international standard codes. This exchange aimed to enhance data interoperability and foster collaboration in cancer treatment among institutions.
Minister Chiu stated in his remarks that improving the cancer survival rate is not only a major public health challenge but a shared goal that healthcare workers and the government must strive to achieve. Minister Chiu expressed his gratitude to the NHIA for collaborating with the hospitals to implement the "National Cancer Prevention and Control Program" to continue developing digital infrastructures. Director General Chung-Liang Shih of the NHIA said that the interoperability of healthcare data is one of the keys to digital transformation. The adoption of the FHIR standard enables the effective compilation of cancer patients' full medical records from diagnosis and treatment to outcome and follow-up.
With a standardized medical record format, doctors can access patients' medical records from different hospitals, as well as their medication records on the cloud, improving the accuracy of diagnoses and prescriptions. This enhances the effectiveness of cancer treatments and the overall quality of healthcare. In addition, de-identification is easier to achieve with digitalized data in FHIR format. The NHIA plans to implement an online, double-blind review mechanism for cancer drug prior authorization in 2025 to enhance both efficiency and fairness in the review process. The NHIA will also plan to introduce AI-based tools to assist in expert reviews in the future to accelerate the process and achieve precise reimbursement.
In his remarks, Minister Chiu stated that improving the cancer survival rate is not only a major public health challenge but also a shared goal that healthcare professionals and the government must work together to achieve. He expressed his gratitude to the NHIA for collaborating with hospitals to implement the National Cancer Prevention and Control Program and for its ongoing efforts in developing digital infrastructure.
Director General Chung-Liang Shih of the NHIA emphasized that healthcare data interoperability is a key factor in digital transformation. The adoption of the FHIR standard enables the effective compilation of comprehensive medical records for cancer patients, covering diagnosis, treatment, outcomes, and follow-ups.
With a standardized medical record format, doctors can access patients' medical records from different hospitals, as well as their medication records on the cloud, improving the accuracy of diagnoses and prescriptions. This enhances the effectiveness of cancer treatments and overall healthcare quality. Additionally, digitalized data in FHIR format makes de-identification easier.
To further enhance efficiency and fairness in the review process, the NHIA plans to implement an online, double-blind review mechanism for cancer drug prior authorization in 2025. In the future, the NHIA also aims to introduce AI-based tools to assist in expert reviews, accelerating the process and ensuring precise reimbursement.