The Nordic region is uniquely positioned for collaborative health‑data research, thanks to universal healthcare systems and robust data infrastructures. The VALO NSCLC pilot study—funded by the Nordic Council of Ministers—set out to demonstrate the feasibility of federated analytics using the OMOP Common Data Model (CDM) across three university hospitals in Norway, Denmark, and Finland, with Sweden and Iceland as observers.

Importantly, the VALO NSCLC pilot is a key component of the broader VALO – Value from Nordic Health Data project, which (as described by Sitra) aims to establish common principles for implementing the European Health Data Space (EHDS) regulation in the Nordic countries, streamline RDI activities, and test cross‑border use of health data—with federated OMOP analyses as a practical mechanism to harmonise and utilise data across sites.

Key Lessons Learned:

• Technical Implementation: OMOP CDM adoption is a multi‑year journey, not a short‑term project. The pilot revealed that technical infrastructure compatibility and local environment configuration are more challenging than conceptual understanding. Reusable ETL solutions and systematic documentation are critical for accelerating future implementations.
• Data Availability: A three‑tier data‑readiness framework emerged. While basic clinical data (diagnoses, medications, demographics) are widely available, advanced oncology variables (biomarkers, performance status, patient‑reported outcomes) are systematically absent, limiting the feasibility of modern research.
• Governance and Coordination: Regulatory knowledge is fragmented and role‑dependent, creating risks for compliance and execution. Consortium‑wide coordination, especially for vocabulary versioning and governance, is essential for scientific validity in federated analyses.
• Operational Insights: The federated approach enabled analyses comparable to traditional multi‑site studies in a fraction of the time—but required substantial coordination overhead. The importance of dedicated project management, integrated cross‑functional teams, and real‑time communication infrastructure was underscored.

Recommendations for Future Nordic Collaboration:

• Invest in infrastructure alignment and technical‑environment assessment before project initiation.
• Standardize data capture for key prognostic variables, especially ECOG performance status, smoking history, and biomarkers.
• Establish consortium‑level governance for vocabulary synchronization and knowledge sharing.
• Adopt a phased capability‑development approach, recognizing the three‑year maturity curve for OMOP implementation.
• Prioritize feasibility assessments based on data‑tier requirements, and conduct cohort‑definition testing during protocol development.

Session Takeaways:
Participants will gain actionable insights into the practical realities of building a federated health‑data network in the Nordics. The session will provide a roadmap for overcoming technical, organizational, and governance challenges, and highlight strategic investments needed for sustainable, high‑impact collaborative research. The VALO pilot’s experience directly informs the broader VALO project’s mission to create a harmonized, value‑driven Nordic health‑data ecosystem. We will conclude with an invited discussion featuring Swedish observers (e.g., Karolinska University Hospital and Karolinska Institutet) sharing reflections and next steps for advancing OMOP conversions and federated analytics in Sweden.