In Norway, FHIR is gaining traction as a key standard for healthcare data exchange. It is used for several important use cases, and adoption is growing steadily across the healthcare sector.

R4 is the most widely used version of FHIR in Norway. Some organizations also work with R4B and R5, while a few still use older versions like DSTU2 and STU3.

Respondents expect FHIR adoption to increase in the coming years. Most see clear momentum, though the pace varies depending on the sector.

Rules and Support

Norway has regulation in place for electronic health data exchange. Here is what you need to know:

• Health data exchange standards are required by law.
• FHIR is advised, and in some contexts mandated, but not strictly enforced everywhere.
• There is no fixed deadline for compliance.
• No fines apply if organizations are not compliant.
• Government funding is available to support FHIR adoption.

You can learn more about the funding program here: Helseteknologiordningen. The relevant regulation is published at Lovdata.

One concern raised: because FHIR is advised rather than required, some vendors are waiting for clearer requirements before investing. The European Health Data Space (EHDS) is expected to help resolve this.

National Setup

Norway has a clear national structure for health data standards:

• The national body responsible for health data standards is Helsedirektoratet (the Directorate of Health).
• A national base FHIR implementation guide exists and is widely used. You can find it at HL7 Norway Best Practice and HL7 Norway Basis.
• A national FHIR terminology server is in development.

The FHIR Community Process (FCP) is not yet active in Norway. Some respondents expect specifications to be in development within the next 2 to 3 years.

Active Use Cases

Norway has developed FHIR specifications for several specific areas, including:

• Prescriptions and pharmacy
• Diagnostic orders and reports
• Public health reporting
• Immunizations
• Patient access
• Scheduling
• Allergy intolerance

Norwegian specifications build on international standards, particularly the International Patient Summary and European Implementation Guides.

Who Uses FHIR

The main groups adopting FHIR in Norway include:

• Care providers
• EHR (electronic health record) system vendors
• Diagnostic system vendors, such as imaging and lab providers
• App developers
• Clinical registries
• Government agencies

Drivers for adoption vary, but key reasons include:

• Regulation and grants
• Improving health outcomes
• Improving care workflows
• Patient data access
• Innovation

In terms of how FHIR is applied, the FHIR REST API is the most common exchange mechanism. FHIR Shorthand (a tool for writing FHIR profiles) and FHIR Questionnaires are also gaining ground. Tools like SMART on FHIR, CDS Hooks, and Bulk Data are used in more limited ways. Most software in use is proprietary, though some respondents would like to see more open source adoption.

Success Stories and Challenges

FHIR has already delivered real benefits in Norway. Notable examples include:

• helsenorge.no, the national patient portal
• The national medication registry
• Critical information sharing services
• The SAFEST project

These projects have lowered costs, improved access to information, and improved care workflows.

The main challenges include:

• High investment cost
• Lack of FHIR knowledge
• Changes in political direction
• Limited resources to follow up on FHIR recommendations

AI and machine learning are seen as somewhat helping FHIR adoption. There is growing interest in FHIR as a foundation for AI, and respondents disagree with the idea that AI removes the need for structured data.

Future Plans

Last year, Norway made progress in several areas:

• Development of new FHIR standards for specific use cases
• Launch of pilot projects with healthcare stakeholders
• Expanded adoption of FHIR across the ecosystem

For the coming year, respondents expect:

• A national FHIR data model to take shape
• More FHIR standards for specific use cases
• New regulation prescribing standards in health data exchange
• Continued expansion of FHIR adoption
• More FHIR in the context of EHDS
• Greater FHIR adoption in municipalities and primary care

Looking three years ahead, respondents are cautiously optimistic about FHIR delivering cost savings, better care coordination, and a stronger digital health ecosystem in Norway.

Contributors

• Line Andreassen Saele, HL7 Norway (Chair)
• Øyvind Aassve, Sykehuspartner (Integration architect / FHIR lead)
• One anonymous respondent

The above summary is based on the answers to the State of FHIR Survey 2026, organized by Firely and HL7 International.