FHIR Implementation Guide for the Norwegian Municipal Sector - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
EHDS
Why This Matters For The Municipal Sector
The European Health Data Space (EHDS) is the EU framework and regulation for digital health data. Its goal is to enable use of health data across countries and actors, both for care delivery (primary use) and for safe and lawful reuse (secondary use). For municipalities, this is relevant when data from care and support services is to participate in a shared European health data infrastructure.
The municipal sector has large and varied data sets, including home care, nursing homes, child health services, rehabilitation, substance use and mental health services. Work on EHDS increases the need for such data to be described and shared in an interoperable and standardized way. This is one of the reasons for this implementation guide.
Status In The EU
- The EHDS Regulation was adopted and published in the EU Official Journal on 5 March 2025, entering into force on 26 March 2025.
- Implementation will happen gradually through implementing acts and national processes.
- The first group of priority data for primary use is covered from 2029, with further categories from 2031; see the European Commission's timeline.
Norwegian implementation follows the EEA and legislative processes. The Government opened consultation on implementation in Norwegian law on 8 June 2026; its EEA note of 10 June still described assessment for incorporation. EU entry into force therefore does not establish that all requirements already apply to Norwegian municipalities. See the consultation and EEA note. Status checked on 31 August 2026.
What EHDS Sets Out To Do
- Primary use: citizens should have simple access to their own health data and be able to share them across borders when needed in a care pathway.
- Secondary use: authorities, researchers and innovation communities should be able to access data in a safe, lawful and controlled way for defined purposes.
- Interoperability: Electronic health record (EHR) systems within the scope of the requirements are to support European specifications for exchange of health information, the European EHR Exchange Format, so data can flow between countries and vendors.
The terms primary use and secondary use follow the definitions in the EHDS regulation, where primary use relates to care delivery and secondary use relates to reuse of data for research, innovation, health administration and policy.
What This Means For Municipal Data
For the municipal sector, work on EHDS points towards:
- clearer expectations for structure and semantics in shared data
- reuse of national and European profiles where they exist
- increased need for traceability, quality and documented concepts
Why FHIR Is Central
EHDS is based on shared, machine-readable structures and common semantics. This guide uses HL7 FHIR R4 as its technical foundation for structured exchange. A Norwegian municipal IG must:
- start from Norwegian base profiles (no-basis) where they exist
- describe municipal patterns and minimum data so data can be reused across actors
- support European interoperability without creating local isolated solutions
Consequence For This Guide
This IG does not by itself demonstrate EHDS compliance. FHIR R4 and the municipal profiles are modelling choices in this guide, not requirements prescribed by EHDS.
This means that the guide:
- should be normative, but pragmatic
- should describe how municipal data is modelled in FHIR, not create everything from scratch
- should contribute to shared understanding between municipalities and specialist health services
- should provide a basis for meeting requirements introduced through EHDS implementation
Relation To National Best Practice (Normative)
- EHDS alignment in this IG SHALL build on national profiling principles from HL7 Norway.
- Where Norwegian base profiles (no-basis) exist, they SHOULD be used before new municipal variants are established.
- New EHDS-related needs for profiles or extensions SHOULD be handled through the HL7 Norway FHIR process.
Further Work (Guidance)
- Map which municipal data categories are relevant to EHDS-prioritized data areas.
- Ensure that municipal concepts can be expressed with FHIR resources and Norwegian base profiles.
- Identify where Norwegian profiles are missing and propose additions in a coordinated way.
- Establish minimum data sets and data quality expectations in collaboration with national actors.
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