The document outlines the coordination of Sweden's national e-health strategy by Inera, a company that oversees health information exchange among 21 counties and 290 municipalities, with a revenue of approximately 80 million euros. It discusses the architecture and implementation of interoperability through shared APIs, with a focus on FHIR profiles and a virtual national EHR proof-of-concept. The document reveals that while no FHIR protocols are currently in use, future developments, particularly in observations, may shape the e-health landscape in Sweden.

1. Johan Eltes, CTO
johan.eltes@inera.se

2. Sweden on FHIR
FHIR Dev days 2017
johan.eltes@inera.se
Johan Eltes2017 nov 17

3. 21
counties
290
Municipalities
REGIONS AND
MINICIPALITIES IN
COOPORATION FOR E-
HEALTH
 Coordinates the national e-health
on behalf of the public healthcare
payers
 The revenue is approximately 80
million euro
 Inera is a company owned by the
the Swedish Association of Local
Authorities and Regions (SALAR)

4. The priorities of national e-health strategy
Support to
DECISION-
MAKERS
Support to
PROFESSIO
NALS
INFRASTRUC
TURE
Support to
PROFESSIONALS
Support to
DECISION-
MAKERS
Support, engage,
motivate
CITIZENS

5. Existing National HIE infrastructure
Health information exchange platform
Diagnoses Labresults Drugs Varnings
EHR EHR EHR EHR EHR EHREHR
Vaccinations
State agency
(e.g. EHM)
State agency
(eg. Insurance
agency)
400 connected
EHRs
1 billion
exchanges yearly
through 100
shared API:s
Service oriented
architecture for
HIE in operation
since 2010
Virtual national EHR

8. Proof-of-concept: Detailed Clinical Model
building blocks using FHIR profiles
 Current national HL7 GreenCDA web-service profiles/apis
(120) provide true interoperability across 500 connected EHRs
 Except for 2 of them…
Generalized apis for observations and activities modelled at the
level of the CIMI RIM, but Swedish/proprietary reference model
Semantic agreements are documented out-of-band (Blood
pressure, etc)
No formal/computable representation (word documents)

9. The actual proof we are seeking…
Swedish RIM
specification
OpenEHR RIM
Archetype
(clinical building
block)
FHIR profile
Computational
value
Market tool
support
Manual Autom.

10. Towards a Common Nordic Language for Telehealth
Architecture
?

11. National guidelines for tele health
protocols in the Nordics (march 2017)
A B B B C C

12. Summary –National Sweden on FHIR
 No FHIR protocols in use today
 Payload of new api:s are modelled on FHIR resource
specifications and data types (prev. Green CDA)
 Continua 2017 FHIR Observation Upload will likely be the first
deployed FHIR protocols of the national api portfolio
 Considering FHIR as edge API on top of existing HIE for patient
apps (access to national virtual EHR)
 Oucome of Proof-of-concept may impact the overall strategy in
various directions

13. Thank you!