We often mention that our solutions are built according to the openEHR standard. But what is openEHR and why is it important? The principles behind openEHR are known to be a tad complex - time for a short (and, hopefully, simple!) introduction.
A brief definition of openEHR
Basically, openEHR (or "open Electronic Health Record") is an open standard for modeling, storing and handling healthcare data. It is effectively a set of documents that can be used to build information and interoperability solutions in healthcare, such as EHR's and other healthcare information systems.
Why is openEHR necessary?
Healthcare IT faces several challenges. The root cause of many of these problems lies in the availability of data. How do you get complete and timely information to the right stakeholders (internal and external care providers, the patients themselves, informal caregivers), in the right form, with the right permissions, access logs and insight into changes made to that information? Also, beyond the care process, how can we ensure that research is done with datasets that are as complete as possible?
The community behind openEHR, openEHR International, aims to achieve open, vendor-independent specifications for a platform for electronic health records, medical data and research data.
The more healthcare IT is built based on a standard like openEHR, the easier it becomes to connect different systems, to avoid vendor lock-in and to achieve an EHR-landscape which optimally supports the healthcare provider.
But what does openEHR have to offer to achieve this goal?
Two layers
Healthcare is not an exact science - this means that the medical content side of software (a.k.a. the information model) must be flexible. After all, advancing insights are constant, and even per specialty there are varying information requirements.
The beauty of openEHR is that it consists of two 'layers' (according to the "two-level modeling" principle) - a technical layer and a medical information model. Whereas in most software such things are technically intertwined, openEHR keeps the two layers separate. This way, the information model can remain enormously flexible - parts can easily be added or modified without revising the technical layer, and the technical layer can be innovated without having to change the medical information model along with it. Software systems basically implement only the technical layer - as such, these systems can remain smaller and more manageable than systems where the information model and the technical layer are intertwined.
To ensure that the flexible medical information can be read and interpreted technologically, openEHR makes use of so-called archetypes. In the words of Heather Leslie, Clinical Modeller at CSIRO, "In openEHR, an archetype is the model (or pattern) for capturing medical information - a machine-readable specification of how patient data should be stored using the openEHR reference model."
Healthcare specialists help build the medical information model and tech professionals build the technical layer. This way, all specialists can do what they are best at and we bring together the best from both worlds.
An international community
So, even a mature standard like openEHR is constantly evolving. Various medical specialists and technicians from all over the world are collaborating on the further development of openEHR - it is being widely supported and people are actively learning from each other, both through active (online) collaboration and through conferences, for example.
It is also particularly inspiring to look at the deployment of openEHR in other countries. For example, the NHS is already deploying parts of the framework and openEHR has been selected as the foundation for the national healthcare ICT in Sweden. In addition, there are developers around the world, such as CODE24, who are deploying openEHR as the foundation for their solutions.
What about HL7 FHIR? And zibs?
There are quite a lot of standards relating to the provision and exchange of healthcare data. Each standard has its own strengths. HL7 FHIR focuses on the secure exchange of healthcare data between applications and systems, while openEHR deals with the standardised storage of healthcare data and making it securely available (i.e.: data availability). In addition, the Netherlands has also been developing zibs: healthcare information building blocks. The zibs are the medical information models we use in the Netherlands and have much in common with the aforementioned openEHR architecture types, but these building blocks can also act as a connecting factor between data storage and data exchange.
There is obviously much more to say about this - Nictiz is currently investigating how the various standards can optimally support each other, in order to arrive at an ideal scenario for the Dutch healthcare information system. Read about this, for example, the "Research future scenarios zibs".
Need to go deeper?
In this article, we have attempted to give a sneak peek into the basics of openEHR. There is obviously much more to tell about it - we will certainly devote future articles to openEHR, but if you want to dive deeper into this topic already, be sure to check out the website of openEHR International.
