OpenEHR is an electronic medical record that creates specifications, open source software and tools. In the clinical space, it creates high-quality, re-usable clinical models of content and process - known as archetypes - along with formal interfaces to terminology. It enables ICT to effectively support healthcare, medical research and related areas. Today ICT is used ubiquitously elsewhere, but is far from effective in Healthcare. The main problem in health is the lack of shareable and computable information.
OpenEHR IS an ongoing project prevailing in European, and South American. It can divide into two major parts. One is core part, the other is non-core part. Core part includes Requirements and Architecture, including Reference Model, Archetype Model, Service Model. Also, in Non-core part includes general part, focusing on workflow, and Implementation part focusing on program and template develop.
OpenEHR is governed by the openEHR Foundation both legally and fiduciarily. Strategic and operational decisions are determined by the Management Board. Based on the division of activities, four programs are managed by the Management Board including specification program, clinical models program, software program and localisation program.
OpenEHR is an international, not-for-profit ,Foundation, based in United Kingdom at University College London, working towards:
- Making the interoperable, life-long electronic health record a reality
- Improving health care in the information society.
OpenEHR now is constituted by four major programs such as Specification Program, Clinical Models Program, Software Program, and Localization Program detailed below.
Specification Program This program is responsible to develop, manage and maitain specifications library in support of open, interoperable and computable health information systems. It achieves its goals by:
- develping new technical specifications
- accepting and adapting donated specifications
- managing and maintaining the openEHR specifications
- making all specifications openly available and free to use
Clinical Models Program Clinical models consisting of archetypes and templates are the basis for computer systems to represent clinical information and further to communicate between health care systems. The Clinical Models Program aims to review and compile clinical models for openEHR.
Software Program The openEHR Software Program aims to support software development related to openEHR specifications. Currently, most projects are self-governed and self-funded by various organizations. Through openEHR Software Program, different parties can share experience and ideas via software focused mailing lists and specification focused mailing lists.
Localization Program The Localization Program aims to reach out and support local openEHR communities. Works usually involves translation and adaptation of specifications and related components to suit local needs.
- Developing open specifications, open-source software and knowledge resources
- Engaging in clinical implementation projects
- Participating in international standards development
- Supporting health informatics education
The principal challenge for health ICT is to represent the semantics of the sector, which are far more complex than in other industries. It requires a knowledge-oriented computing framework that includes ontologies, terminology and a semantically enabled health computing platform in which complex meaning can be represented and shared. At the same time it must support the economically viable construction of maintainable and adaptable health computing systems and patient-centric electronic health records (EHRs).
The openEHR Foundation is a non-profit charity based in the United Kingdom at University College London. It is now a community of more than 1200 people working on an open specification for a shared electronic health record, currently release 1.0.2. openEHR utilises a two level modelling approach developed in Australia. This approach means that the rules about how to represent clinical information in an openEHR record are captured in Archetypes which can be shared and evolve, while the parts from which these models are constructed are unchanging and in the fully specified reference model. The result is that software can be built on the rich and stable reference model, and the changing and evolving clinical concepts can be managed in a knowledge environment - called the archetype repository.
Archetypes carry with them rules that check the quality of the data and they can be used at data entry to ensure data quality. The display information is carried separately enabling the same information to be displayed in a different manner for different purposes. This makes the approach very flexible, so that personal health records can be displayed in a manner suitable for individual patients, sort of like skins for software programs.
The benefits of this approach is that the richness of clinical concepts can grow with time, without needing to change the software at a fundamental level. Also, openEHR records can be carried on a USB stick or communicated in any way necessary. Australia conducted the first major trials of openEHR in larger scale situations around 2004/5. Last year the UK NHS, although currently using HL7 CDA to carry clinical content, began to use the openEHR formalism to capture clinical content specifications. The ability to generate relatively low fidelity communications (such as CDA) from the high fidelity openEHR environment is proving to generate interest in this more comprehensive approach to storing and utilizing personal health information. Implementations are now underway in the Netherlands with early work in Scotland, Denmark, Sweden, Chile as well as Australia.
According to openEHR official website - openEHR, it has been used by various parties including:
openEHR has several industry partners, called openEHR Industry Partners which support the openEHR foundation with resources in both human power and financial. They primarily focus on product compliance and quality and develop conformance specification for openEHR . Example partners include:
- Cambio Healthcare Systems
- Critical Software
- Infinnity Solutions
"So many systems describe themselves as electronic healthcare records and yet share little common concept of what such an entity is and what it is for." - David Ingram October 2002
With this guiding principle and the experiences acquired from an early framework when GEHR was established in Europe in 1989, openEHR was envisioned to rise above the intervening influences from political, academic, and commercial forces to introduce a system that will be based on open standards, influenced more by clinical requirements established in ISO standards bodies for electronic healthcare records.
As with any system and standard in flux, the development of EHR is plagued with similar pitfalls, such as redefinition of terminologies, interfaces, and processes that may have resulted to the "reinvention of wheels" in the process for some contributors in the field, as anyone who has been involved in the defining end-to-end clinical workflows might attest. Simply, the importance of collecting implementation outcomes and hashing out optimized systems out of them remains a critical component of these endeavors in the field of EMR.
The Origins of openEHR
- The Good European Health Record (GEHR) Project Proposal
- Participants in the GEHR Project
- The Accomplishments of the GEHR Project
- Interface between the GEHR Project & Tech Committee
- From GEHR to Synapses in Europe
- Australia awakens the world EHR community
- From GEHR and Synapses to Synex, Medicate and 6-winit in CHIME and UCL
- The threads of openEHR
- First Ideas for the openEHR Foundation
There are different tools used in the development of the system.
- Java 1.5
- Java 1.6
- Apache Tomcat
- Postgresql RDBMS
- Eclipse Development Environment & Platform
- Eclipse BIRT
- Python / Zope
Contributing to openEHR
Since openEHR is open source software, contributions from the community is vital. You can get involved through organisational membership as Industry Partner, or members of your team can become part of openEHR as Individual members. More details can be found at the Membership page.
- David Ingram. The Origins of openEHR. Retrieved: September 12, 2010. .
- Open EHR website