The county of Sogn and Fjordane has long experience with electronic message exchange between the first line of service and a hospital, but now they are about to realize the paper loose electronic interaction.  There are still technical challenges to solve, but in three pilot municipalities they are in the process of implementing a successful but long awaited process. This process has already proven to be so much more than a straightforward top-down technology introduction process envisioned at the project start-up in 2006. Both in the three pilot projects and in the remaining 23 municipalities and 2 nodes of cross municipality first line health service cooperation remain organizational challenges. An additional challenge will be to include electronic messaging to/from care services.  This must build on experience the municipalities of Stryn and Florø attained from the national Elin-k project and requires a certain progress in the national program developing software tools.