On November 10, Costa Rica's Ministry of Health officially presented PRIS+ (PRISMAS), the Interoperable Health Network Platform, an initiative that seeks to enable the secure exchange of clinical information among the institutions that make up the national health system.
The news is an important step in the country's digital transformation, especially because it begins to deliver on one of the most meaningful aspirations for patients, clinicians and institutions: that clinical information be available when and where it is needed, regardless of the facility where it was generated.
For years, Costa Rica has built significant digital health capabilities. However, much of that information remains spread across systems that cannot necessarily talk to one another.
With PRISMAS, the country begins moving toward a different scenario: a connected health ecosystem, where institutions can exchange information under common rules, open standards and security mechanisms.
What is PRISMAS and how will it work?
According to the information published on its official website, PRISMAS is conceived as a network of networks, designed to connect the different actors in the health system without centralizing patients' medical records.
This approach lets each institution keep managing and safeguarding the information it generates, while giving it standardized mechanisms to share that information with other providers when there is a legitimate and authorized purpose. It is consistent with the federated architecture set out in the Health Interoperability Regulation, in force since October 16, which expressly prohibits creating a centralized repository of medical records.
The architecture contemplates different forms of participation, including directly connected institutions, sub-participants and accredited exchange networks.
The main expected benefits of this model include:
- Continuity of care: making it easier for authorized professionals to consult relevant clinical information about their patients, even if it was generated at another facility.
- Less duplication of procedures: reducing the need to repeat laboratory tests, imaging studies and other evaluations when their results already exist and can be retrieved.
- Greater security and traceability: establishing common mechanisms to control, authorize and audit information exchanges.
- Institutional efficiency: reducing the need to build individual integrations between every pair of organizations.
- Public and private participation: creating the conditions for hospitals, clinics, laboratories and other providers to be part of the same national ecosystem.
PRISMAS contemplates different exchange purposes, including clinical care, emergencies, public health, insurance and patients' own access to their information.
Patient consent is at the center of the model. During the presentation, Minister of Health Alexander Sánchez Cabo explained that the system requires the person's informed consent to authorize the transfer of their data, and the Ministry announced a citizen portal where each person will be able to see where their information was consulted and whom they gave permission to access it.
Are we closer to interoperating with the CCSS's EDUS?
This may well be one of the most relevant aspects of the news.
The Single Digital Health Record (EDUS) of the Costa Rican Social Security Fund (CCSS) is one of the country's most important clinical information assets.
However, having a nationwide digital record within one institution does not necessarily mean that its information can be exchanged in a standardized way with hospitals, clinics and other external providers.
Today that exchange is limited. As we described in Interoperating with EDUS (CCSS), EDUS already delivers an International Patient Summary in HL7 FHIR to third parties, with the patient's consent and on a case-by-case basis. At Meddyg we built an alternative viewer on top of that resource, and confirmed that EDUS data can be worked with using open standards. We also saw the limit: without common rules or a national network, every integration depends on one-off mechanisms.
The presentation of PRISMAS opens a new opportunity to move in that direction.
During the presentation, CCSS Executive President Mónica Taylor Hernández acknowledged the opportunity to build on the progress achieved with EDUS to strengthen the integration of the national health system.
These statements are especially significant because they point to a scenario in which, in the short or medium term, interoperability mechanisms could be developed between EDUS and other clinical information systems in the country.
Imagine, for example, a patient treated at a private hospital being able to authorize access to relevant clinical information previously generated at the CCSS. Or a laboratory result from a private facility being available to support the continuity of their care in the public system.
This is precisely the value of interoperability: information follows the patient, instead of the patient having to carry their information between institutions.
Naturally, the presentation of PRISMAS does not mean these integrations are already operational. Making them real will require institutional agreements, security conditions, access rules, technology adaptations and conformance testing.
Even so, the combination of a national regulatory framework, an exchange platform and the participation of the CCSS is a positive signal for the future of interoperability in Costa Rica.
Open standards: the key to building an interoperable ecosystem
One of the most important elements of this initiative is its alignment with open international standards and with the National Interoperability Implementation Guides.
Chief among them is HL7 FHIR (Fast Healthcare Interoperability Resources), an international standard for representing and exchanging clinical information through modern, standardized mechanisms.
It is complemented by international terminologies and classifications such as SNOMED CT and LOINC, which are essential for exchanged information to keep its clinical meaning.
This has important implications for institutions and technology vendors.
National interoperability should not depend on every facility using the same electronic health record, the same technology platform or the services of a particular vendor.
On the contrary, the goal is to let different systems communicate using common standards and rules, while keeping their technological autonomy.
This principle is especially relevant to the Costa Rican ecosystem, where information systems from different vendors coexist with in-house developments and specialized platforms for laboratories, medical imaging, pharmacies and hospitals.
Adopting open standards lets organizations evolve their existing platforms without necessarily having to replace them to take part in a national exchange network.
The next challenge: preparing institutions to interoperate
The launch of PRISMAS also raises an important question for healthcare providers:
Is our institution ready to exchange clinical information in line with national standards and requirements?
The answer does not depend only on having an electronic health record.
Interoperability requires reviewing how data is represented, which terminologies are used, how patients are identified, what the authentication and authorization mechanisms are, and how systems will be able to exchange information securely.
Hospitals, clinics, laboratories and diagnostic imaging centers will need to progressively assess their capabilities and determine what adjustments they need to take part in this new ecosystem. The regulation gives the Ministry of Health until March 16, 2027 to publish the initial technical specification of the National Model and its Progressive Implementation Plan.
The time to start preparing is now.
Meddyg: supporting institutions on their path to PRISMAS
At Meddyg, we see this milestone as an opportunity to accelerate the adoption of international standards and strengthen the interoperability capabilities of Costa Rica's health sector.
We have the experience and technical capabilities to support public and private institutions as they prepare to join the national interoperability ecosystem. We led the technical design of the first national health interoperability demonstration and have worked with the patient summary that EDUS provides.
Our services range from assessing existing capabilities and identifying gaps to designing and implementing solutions based on HL7 FHIR, clinical terminologies, health information exchange (HIE) architectures and security mechanisms.
We can also support organizations that have existing systems and want to adapt them to exchange information in line with the national guides, without having to replace their entire technology infrastructure.
Our approach is to work on open standards, promote technological independence and build sustainable solutions aligned with each institution's clinical and operational needs.
There is no need to wait for every PRISMAS connection to be enabled before starting to prepare.
Normalizing clinical information, adopting implementation guides, assessing conformance and defining an interoperability architecture are all activities that can start today.
The future of digital health is built by connecting institutions
Costa Rica has taken a new step toward a model of care where clinical information can be available securely, promptly and in a standardized way.
The possibility that EDUS, private hospitals, laboratories, medical imaging centers and other facilities can exchange information is an opportunity to improve continuity of care and the patient experience.
The launch of PRISMAS is an important milestone, although its real impact will be measured by the country's ability to turn this initiative into effective, secure and sustainable exchanges.
At Meddyg we are ready to help health institutions take that next step.
If your organization wants to know how ready it is to interoperate, or needs to adapt its systems to national standards, we can support you from the initial assessment through implementation and technical testing.
Let's talk about how to prepare your institution for national health interoperability.
References
- PRISMAS, Interoperable Health Network Platform, Ministry of Health (in Spanish).
- Executive Decree No. 45960-S-MICITT, Supplement No. 139 to La Gaceta No. 196, October 16, 2026 (in Spanish).
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