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 is 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 simple way to integrate to Norway health system.”

Cooperation with Furore

Nasional IKT commissioned Furore to design and write the FHIR profiles for their use case: Reporting Diagnoses and Procedures in a structured way. Why Furore? Line: “In Norway this knowledge was not available. Furore is deeply involved in the development of the FHIR standard. We organized a workshop to discuss the use case and deduct 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 where ‘profiled’ for the Norwegian use-cases are:

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

Implementation Guide

After developing the profile, Furore also built a tool to generate the Implemention 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 Furore: “Furore 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 Furore in future projects”. The IG website can be found here: http://www.hl7.no/fhir/profiles/0.3