openEHR is an open standard specification in health informatics that describes the management and storage, retrieval and exchange of health data in electronic health records (EHRs). In openEHR, all health data for a person is stored in a “one lifetime”, vendor-independent, person-centred EHR. The openEHR specifications include an EHR Extract specification but are otherwise not primarily concerned with the exchange of data between EHR-systems as this is the focus of other standards such as EN 13606 and HL7.
The openEHR specifications are maintained by the openEHR Foundation, a not for profit foundation supporting the open research, development, and implementation of openEHR EHRs. The specifications are based on a combination of 15 years of European and Australian research and development into EHRs and new paradigms, including what has become known as the archetype methodology for specification of content.
The openEHR specifications include information and service models for the EHR, demographics, clinical workflow and archetypes. They are designed to be the basis of a medico-legally sound, distributed, versioned EHR infrastructure.
The architecture of the openEHR specifications as a whole consists of the following key elements:
- information models (aka ‘Reference Model’);
- the archetype formalism;
- the portable archetype query language;
- service models / APIs.
The use of the first two enable the development of ‘archetypes’ and ‘templates’, which are formal models of clinical and related content, and constitute a layer of de facto standards of their own, far more numerous than the base specifications on which they are built. The query language enables queries to be built based on the archetypes, rather than physical database schemata, thus decoupling queries from physical persistence details. The service models define access to key back-end services, including the EHR Service and Demographics Service, while a growing set of lightweight REST-based APIs based on archetype paths are used for application access.
An archetype is a computable expression of a domain content model in the form of structured constraint statements, based on some reference model. openEHR archetypes are based on the openEHR reference model. Archetypes are all expressed in the same formalism. In general, they are defined for wide re-use, however, they can be specialized to include local particularities. They can accommodate any number of natural languages and terminologies.
The openEHR Architecture Overview provides a summary of the architecture and the detailed specifications.