Digitising health history: The creation, function and implementation of the Norwegian Health Archives Registry

Context: The Norwegian Health Archives Registry (NHAR) is a national initiative dedicated to digitising, centralising, and providing access to historical full-text patient health records (PHRs) for research purposes. Established in 2019, NHAR includes PHRs from the deceased population in Norway’s specialist healthcare services, offering a unique long-term data source for future research. NHAR has now digitised 1.7 million paper-based PHRs, covering medical history dating back to 1875. The registry is now expanding to include digital-born PHRs. Aim: This article describes NHAR’s innovation potential as a health registry, its data management processes, and the integration of artificial intelligence (AI) tools to facilitate data management and research in compliance with strict health data regulations. Practice innovation: NHAR’s data value chain includes structured metadata acquisition, large-scale digitisation and secure data delivery for research. The workflow includes a custom optical character recognition (OCR) tool tailored to Norwegian medical terminology, concept-based search tools for unstructured clinical full text and robust strategies for long-term data management. A novel AI-based de-identification system automatically detects and masks personal identifiers in digitised PHRs. Lessons learned: Despite these innovations, challenges persist in processing handwritten and historical PHRs due to OCR limitations and language-specific complexities. Key challenges include improving data quality, enhancing OCR accuracy and refining AI tools for information retrieval, data extraction and de-identification. Conclusion: NHAR offers significant potential for interdisciplinary research across various medical fields. Implications for health information management practice: NHAR establishes a foundation for secure access to historical health data and introduces advanced data management strategies to facilitate future research.