Nasjonal Ikt

Enterprise architect and board member Line Andreassen Sæle and Øyvind Assve, Enterprise Architect at the Oslo University Hospital, are closely involved in the FHIR project. They explain the current Norwegian context in healthcare.

Focus on interoperability

“Our strategy is based on interoperability and cooperation between the hospitals,” says Line. So far, Health data has been exchanged in the national KITH format and in HL7 v2. For the last 5 years patient data have been standardized in HL7 v3 and CDA as well. “These standards are working just fine,” says Øyvind. “However, in CDA most data are stored in PDF format. We aim for a higher granularity and therefore have decided to move forward to FHIR. FHIR will deliver us an efficient and relatively straightforward way to integrate to Norway’s health system.”

Cooperation with Firely

Nasional IKT commissioned Firely to design and write the FHIR profiles for their use case ‘Reporting Diagnoses and Procedures’ in a structured way. Why Firely? Line: “In Norway this knowledge was not available. Firely is deeply involved in the development of the FHIR standard. We organized a workshop to discuss the use case and deduce the requirements for the FHIR Profile.”

FHIR Resources

The Profile – or rather: Conformance Resource, as it is now called in DSTU-2 – uses several FHIR Resources:

  • Patient
  • Practitioner
  • Procedure
  • Condition
  • Encounter

A few examples of how these resources were ‘profiled’ for the Norwegian use-cases are:

  • We constrained the Patient and Practitioner resources to only allow for Norwegian Patient and Practitioner identifiers.
  • Procedures can only be coded using the Norwegian specific codes for Medical or Surgical procedures.
  • Diagnoses must be coded using a code from the Norwegian version of ICD-10.

Implementation Guide

After developing the profile, Firely also built a tool to generate the Implementation Guide in HTML. Developers of the health systems in Norway use this IG for building the interfaces. Line and Øyvind are very content with the cooperation with Firely: “Firely offered practical assistance and delivered as agreed. But they also provided knowledge transfer through training and workshops. The relationship is excellent. We expect to cooperate with Firely in future projects”. The IG website can be found here: