The project “SAFEST Implementation” has been carried out by the regional health authorities in collaboration with the Norwegian Directorate of Medical Products (NOMA). The project has done extensive work, especially in adapting medicines data to the ISO IDMP standards for medicinal product data and the FHIR format. The result is medicinal product data that can be exchanged digitally across countries and systems. The new service also meets the requirements for medicinal product data in the EHDS regulation. In the long term, the new service may replace the FEST service, which currently provides the data foundation for prescribing and dispensing e-prescriptions.
Per Olav Skjesol, chair of the project board and CIO of Central Norway Regional Health Authority, commends the project:
“The regional health authorities and NOMA have built a new arena for cooperation. There have been many stakeholders and different needs to be met. It has been important to create understanding among the parties. Together they have built a strong environment, both in healthcare/pharmaceutical expertise and IT.”
A foundation for national and European interoperability
“The ISO-IDMP and FHIR standards make this service the foundation for national and European interoperability. In ten years, we can celebrate all the services that have been made possible thanks to the deliveries from this project!” says Dag Jordbru, strategic director at NOMA.
From left: Helga Festøy (NOMA), Per Olav Skjesol (Central Norway Regional Health Authority), Dag Jordbru (NOMA), Kjell-Sverre Jerijærvi (South-Eastern Norway Regional Health Authority), and Simen Ulvestad (Netcompany).
Closed-loop medication management and nutrition
In addition to substance, pharmaceutical form, and strength, the FHIR solution delivers product codes at the inner packaging level. These product codes are necessary for closed-loop medication management, ensuring that prescribing and use of medicines in hospitals can be traced precisely.
During 2025, the FHIR service will also provide detailed data on enteral nutrition products, such as nutrients, energy, known allergens, and flavor. Such data has not previously existed in a Norwegian national data source and will be valuable for the work of clinical nutritionists.
Active substance prescribing
The collaboration on the FHIR service will continue in 2026. Then, a solution for active substance prescribing, based on ISO-IDMP, will be introduced. This is essential to enable substance-based prescribing.
“That is when we will truly reap the rewards of the work put into improving core data on substance, pharmaceutical form, and strength,” says Kjell-Sverre Jerijærvi, program architect at South-Eastern Norway Regional Health Authority.
Medicines can then be grouped according to these three characteristics, and hospitals will gain an excellent data foundation for prescribing, preparing, and administering medicines to inpatients. This will support clinical needs for medicines management and interoperability, save clinicians’ time, and increase flexibility in logistics. The data foundation will also facilitate the exchange of medicines data between healthcare stakeholders, in Norway and internationally. Globally, it can be used to manage medicines shortages, detect and signal adverse reactions, and exchange e-prescriptions across borders.
Use of the FHIR service will also reduce local and manual maintenance of this core data and contribute to improved data quality throughout the value chain, Jerijærvi concludes.