In Norway, FHIR (Fast Healthcare Interoperability Resources) is becoming a key standard for healthcare data exchange. Its usage varies across different versions, with R4 being the most actively used. There's a growing expectation that FHIR adoption will increase in the coming years, driven by its potential for improving healthcare data interoperability.

Rules and Support

• Health Data Exchange Rules:
  • Some regulations mandate the use of national standards in health data exchange.
  • FHIR is advised in certain contexts but not specifically mentioned in regulations.
• FHIR Requirements and Deadlines:
  • No specific deadlines or fines for non-compliance mentioned.
• Available Funding:
  • Government funds are available for supporting FHIR adoption, particularly in the municipal sector. About EUR 90,000 is expected to support FHIR through HL7 Norway. More about funding

National Setup

• Standards Organization:
  • The Directorate of Health oversees health data standards. Helsedirektoratet
• Implementation Guides:
  • A widely used base/core FHIR implementation guide exists. HL7 Norway Basis
• Terminology Services:
  • Currently, there is no national FHIR terminology server, but plans are in place to develop one.

Active Use Cases

• Successful local implementations include the HelseNorge-app and services for digital home monitoring.
• Norway participates in international projects, such as the European SPOR IG, indicating a growing alignment with international standards.
• Key projects include NOMA's FHIR Distribution Services from the SAFEST project.

Who's Using FHIR

• Active Organizations:
  • Healthcare providers, EHR system vendors, and app developers are actively using FHIR.
• Main Reasons for Adoption:
  • Improving health outcomes, enhancing care workflows, and fostering innovation are the primary motivators.
• How They're Using FHIR:
  • FHIR is utilized in messaging, documentation, REST APIs, and for SMART on FHIR applications among others.

Success Stories and Challenges

• Benefits:
  • FHIR has led to improved access to information and has the potential to lower costs.
• Real Examples:
  • The HelseNorge app and central medication service are noted success stories.
• Main Difficulties:
  • Challenges include high investment costs, unclear regulations, and a lack of FHIR knowledge.
• Future Plans:
  • Plans for a central national medication registry and further development of FHIR standards are underway.

Future Plans

• Progress So Far:
  • While progress varies, there has been a significant adoption in some areas, and the healthcare ecosystem is gradually expanding its use of FHIR.
• Next Steps:
  • Development of new FHIR standards for specific use cases and the launch of pilot projects with healthcare stakeholders are planned.
• Expected Changes:
  • Significant benefits from FHIR adoption are anticipated in the next three years, including cost savings and enhanced care coordination.

Contributors

• Øyvind Aassve, Integration Architect at Sykehuspartner
• Line Saele, Enterprise Architect at Folkehelseinstituttet

The above summary is based on the answers to the State of FHIR Survey 2025, organized by Firely and HL7 International.