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openEHR Fundamentals

The core features of the EHRServer the compliance with the the openEHR standard. So if you are planning to use the EHRServer, it is good to know a little about openEHR to get the most out of the EHRServer. Here we go!

  1. Introduction
  2. Specifications
  3. Community
  4. Tools
  5. Other resources

1. Introduction

openEHR is an open standard that specifies all the architectural components needed to create health information systems that are interoperable, highly maintainable, and very flexible. The architecture has 3 main components: information, knowledge and services. The specifications are maintained by the openEHR Foundation, though it's Specifications Program.

2. Specifications

The main component of the openEHR specs is the Information Model. It defines the complete hierarchy of data structures, from the EHR to the individual data types. The IM is very generic, flexible and relatively small, and it allows to represent different data structures for a virtually infinite number of scenarios.

The second component is the Knowledge Model, that is composed by the Archetype and Template Models. openEHR Archetypes are semantic definitions of clinical concepts that can be used to record clinical information. For example, there are Archetypes for Blood Pressure, Heart Rate, Diagnosis, Lab Order Request, Medication Prescription, Triage, Procedure, etc. You can find a lot of Archetypes in the international Clinical Knowledge Manager (CKM). Archetypes define the concept, the purpose and context of use, the data structure to record information about that concept, data constraints that allow data validation, translations to different languages, and references to standard terminologies. Yes, openEHR takes advantage of terminologies like SNOMED CT, ICD10, CIAP-2, etc.

Archetypes represent individual concepts. When we want to create the definition of a full clinical document in openEHR, we create a Template. Templates use Archetypes, but you can specify which parts of each referenced Archetype should be included in the Template and which parts should not. In a way, Templates are like huge Archetypes, but the purpose is different. Also Templates allow only one language, so to define documents for different languages, you need to create different Templates.

The Service Model is formally under construction. It's architectural components are defined, and most of them are part of the current openEHR implementations, but there is no normative specification. We have services around: EHR, Demographics, Terminology, Audit, Identity, Security, Knowledge, Notification and Workflow. One of the specs related to Services that is almost complete is the openEHR REST API specification. When this specification is realeased, we plan to implement a compliant REST API. For now the EHRServer REST API is very close to the openEHR REST API specs.

For more information check the openEHR Specifications.

3. Community

openEHR has a great international community composed by informaticians and clinicians from around the globe, from Uruguay to Japan, from Spain to Australia.

The community creates and maintains most of the openEHR-related tools and apps. And if you need help, the community is there for you, just register on the mail lists.

4. Tools

There are a set of open and free tools that are used a lot to work with openEHR. Among these tools, you can find:

  1. Archetype Editor: create and edit Archetypes, allows to add translation to more languages.
  2. Template Designer: create and edit Templates and generate their final form: Operational Templates*.
  3. Clinical Knowledge Manager: find Archetypes that where created by the community, contribute improvements, allows to translate Archetypes online.

* Operational Template is the form of Template used by the EHRServer. Check this guide for more information. And you might find this presentation useful.

Find more info about the tools here.

5. Other resources

What is openEHR?
A good introduction to the openEHR world
Who is using openEHR?
Summary about the companies and organizations that implemented openEHR
openEHR origins
The openEHR genesis
What on earth is openEHR? (blog)
Nice article for newcomers
openEHR introduction (presentation)
A very comprehensive introcdutory presentation
openEHR on GitHub
Find code and resources about openEHR.