As the last part of my series on Thailand’s government-sector healthcare EMR systems concludes, I want to highlight a few issues that I haven’t yet addressed. One of them is the problem of non-standard “12/18 files.”
The non-standardized MOPH reporting architecture, often referred to as the “12 Files” or “18 Files” system: represents Thailand’s legacy method of health data reporting under the Ministry of Public Health (MOPH). These terms describe how health facilities submit patient and service data to MOPH databases, not through interoperable standards like HL7 or FHIR, but via a set of fixed-format text files (.txt or .dbf).
Another issue relates to the private healthcare sector, particularly large private hospital chains that operate independently from government systems. From my experience, most of these organizations maintain their own internal communication and record systems, which are generally closed and difficult to integrate with outside networks.
These issues; both in government and private sectors, show that Thailand’s healthcare data systems still face deep fragmentation. While the move toward open standards like HL7 and FHIR is promising, true interoperability will require addressing these legacy structures and encouraging private sector participation. I will explore possible transition paths and policy implications in future articles.