FHIR is a flexible standard and represents a framework that needs to be adapted to the national context. FHIR has built-in flexibility so that the standard can be customized, and elements can be added for local requirements. This means that the standard can cover a wide range of local requirements, and at the same time represent an internationally standardised format.
To ensure national semantic interoperability, there is a need to coordinate the use and adaptation of the standard at the national level. Such national coordination is needed to enable the reuse of APIs.
The cooperation model for international standards [3] describes the roles, responsibilities and processes in the healthcare sector in the working process to utilize international standards in Norway. The cooperation model should be the baseline for national coordination of the use of HL7 FHIR in Norway.