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

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.

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.

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.

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.

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.