Comparison of openEHR and HL7 FHIR standards
Abstract
Health informatics is characterized by the need tosecurely store, process and transmit large amounts of sensitive
medical data while ensuring interoperability with other systems.
Among many standards used in such systems there are two which
have gained interest in recent years and cover most of those
needs: openEHR and HL7 FHIR. In this paper, both standards
are discussed and compared with each other. The architecture of
both systems, the similarities and differences, methods of data
modeling and ensuring interoperability were presented.
References
“Iso - iso 18308:2011 - health informatics — requirements for
an electronic health record architecture.” [Online]. Available: https:
//www.iso.org/standard/52823.html
“Iso - iso 13940:2015 - health informatics — system of concepts to
support continuity of care.” [Online]. Available: https://www.iso.org/
standard/58102.html
“Reference information model (rim) downloads — hl7 international.”
[Online]. Available: https://www.hl7.org/implement/standards/rim.cfm
“Dicom.” [Online]. Available: https://www.dicomstandard.org/
“Home – loinc.” [Online]. Available: https://loinc.org/
“Snomed - home — snomed international.” [Online]. Available:
“Icd-10 version:2019.” [Online]. Available: https://icd.who.int/browse10/
/en
“Hl7 standards product brief - hl7 version 2 product suite —
hl7 international.” [Online]. Available: https://www.hl7.org/implement/
standards/product brief.cfm?product id=185
“Hl7 standards - section 1e: Version 3 (v3) — hl7 international.”
[Online]. Available: https://www.hl7.org/implement/standards/product
section.cfm?section=14
“Hl7 standards product brief - cda® (hl7 clinical document
architecture) — hl7 international.” [Online]. Available: https://www.
hl7.org/implement/standards/product brief.cfm?product id=496
“Iso - iso/hl7 10781:2015 - health informatics — hl7 electronic
health records-system functional model, release 2 (ehr fm).” [Online].
Available: https://www.iso.org/standard/57757.html
“Iso - iso 13606-1:2019 - health informatics — electronic health record
communication — part 1: Reference model.” [Online]. Available:
https://www.iso.org/standard/67868.html
“openehr home.” [Online]. Available: https://www.openehr.org/
“Fhir v4.3.0.” [Online]. Available: https://hl7.org/fhir/
E. Sundvall, M. Nystr ̈om, D. Karlsson, M. Eneling, R. Chen,
and H. ̈Orman, “Applying representational state transfer (rest)
architecture to archetype-based electronic health record systems,” BMC
Medical Informatics and Decision Making, vol. 13, pp. 1–25, 5 2013.
[Online]. Available: https://bmcmedinformdecismak.biomedcentral.com/
articles/10.1186/1472-6947-13-57
L. Min, Q. Tian, X. Lu, and H. Duan, “Modeling ehr with the
openehr approach: An exploratory study in china philip payne,” BMC
Medical Informatics and Decision Making, vol. 18, pp. 1–15, 8 2018.
[Online]. Available: https://bmcmedinformdecismak.biomedcentral.com/
articles/10.1186/s12911-018-0650-6
C. Pahl, M. Zare, M. Nilashi, M. A. de Faria Borges, D. Weingaertner,
V. Detschew, E. Supriyanto, and O. Ibrahim, “Role of openehr as an open
source solution for the regional modelling of patient data in obstetrics,”
Journal of Biomedical Informatics, vol. 55, pp. 174–187, 6 2015.
L. Wang, L. Min, R. Wang, X. Lu, and H. Duan, “Archetype relational
mapping - a practical openehr persistence solution,” BMC medical
informatics and decision making, vol. 15, 11 2015. [Online]. Available:
https://pubmed.ncbi.nlm.nih.gov/26541142/
E. Rinaldi and S. Thun, “From openehr to fhir and omop data
model for microbiology findings,” Public Health and Informatics:
Proceedings of MIE 2021, pp. 402–406, 7 2021. [Online]. Available:
https://ebooks.iospress.nl/doi/10.3233/SHTI210189
C. B ̈onisch, D. Keszty ̈us, and T. Keszty ̈us, “Harvesting metadata in
clinical care: a crosswalk between fhir, omop, cdisc and openehr
metadata,” Scientific Data 2022 9:1, vol. 9, pp. 1–7, 10 2022. [Online].
Available: https://www.nature.com/articles/s41597-022-01792-7
G. Fette, M. Ertl, and S. St ̈ork, “Translating openehr models to fhir,”
Studies in health technology and informatics, vol. 270, pp. 1415–1416,
2020. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/32570686/
“eprescription (fhir) - clinical knowledge manager.” [Online]. Available:
https://ckm.openehr.org/ckm/templates/1013.26.80
“Open source implementations - fhir - confluence.” [Online]. Available:
https://confluence.hl7.org/display/FHIR/Open+Source+Implementations
“hapifhir/hapi-fhir: Hapi fhir - java api for hl7 fhir clients and servers.”
[Online]. Available: https://github.com/hapifhir/hapi-fhir
“Firelyteam/firely-net-sdk: The official firely .net sdk for hl7 fhir.”
[Online]. Available: https://github.com/FirelyTeam/firely-net-sdk
“Firelyteam/spark: Firely and incendi’s open source fhir server.”
[Online]. Available: https://github.com/FirelyTeam/spark
“Linuxforhealth/fhir: The linuxforhealth fhir server and related
projects.”
[Online]. Available: https://github.com/LinuxForHealth/FHIR
“Healthcare data, technology and analytics — merative.” [Online].
Available: https://www.merative.com/?ref=ibm
“microsoft/fhir-server: A service that implements the fhir standard.”
[Online]. Available: https://github.com/microsoft/fhir-server
“openehr/java-libs: Standard java libraries for java implementations of
openehr.” [Online]. Available: https://github.com/openEHR/java-libs
R. Chen and G. Klein, “The openehr java reference implementation
project,” Studies in Health Technology and Informatics, vol. 129, pp.
–62, 2007. [Online]. Available: http://svn.openehr.og/ref impl java.
“openehr/archie: Openehr library implementing adl 2, aom 2, bmm,
rm 1.0.4 and many tools.” [Online]. Available: https://github.com/
openEHR/archie
“ehrbase/ehrbase: An open source openehr server.” [Online]. Available:
https://github.com/ehrbase/ehrbase
H. Demski, S. Garde, and C. Hildebrand, “Open data models for
smart health interconnected applications: The example of openehr
standards, technology, machine learning, and modeling,” BMC
Medical Informatics and Decision Making, vol. 16, pp. 1–9, 10 2016.
[Online]. Available: https://bmcmedinformdecismak.biomedcentral.com/
articles/10.1186/s12911-016-0376-2
“crs4/pyehr: Python modules for managing openehr projects.” [Online].
Available: https://github.com/crs4/pyEHR
“skoba/openehr-ruby: Ruby implementation of the openehr specifica-
tion.” [Online]. Available: https://github.com/skoba/openehr-ruby
J. Kryszyn, K. Cywoniuk, W. T. Smolik, D. Wanta, P. Wr ́oblewski,
and M. Midura, “Performance of an openehr based hospital information
system,” International Journal of Medical Informatics, vol. 162, p.
, 6 2022.
D. Teodoro, E. Sundvall, M. J. Junior, P. Ruch, and S. M. Freire, “Orbda:
An openehr benchmark dataset for performance assessment of electronic
health record servers.” PloS one, vol. 13, p. e0190028, 2018. [Online].
Available: http://www.ncbi.nlm.nih.gov/pubmed/29293556http://www.
pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC5749730
“Microsoft join openehr international as diamond industry partners.”
[Online]. Available: https://www.openehr.org/news events/openehr
news/380
“Latest integration/hl7 fhir topics - openehr.” [Online]. Available:
Downloads
Published
Issue
Section
License
Copyright (c) 2023 International Journal of Electronics and Telecommunications
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
1. License
The non-commercial use of the article will be governed by the Creative Commons Attribution license as currently displayed on https://creativecommons.org/licenses/by/4.0/.
2. Author’s Warranties
The author warrants that the article is original, written by stated author/s, has not been published before, contains no unlawful statements, does not infringe the rights of others, is subject to copyright that is vested exclusively in the author and free of any third party rights, and that any necessary written permissions to quote from other sources have been obtained by the author/s. The undersigned also warrants that the manuscript (or its essential substance) has not been published other than as an abstract or doctorate thesis and has not been submitted for consideration elsewhere, for print, electronic or digital publication.
3. User Rights
Under the Creative Commons Attribution license, the author(s) and users are free to share (copy, distribute and transmit the contribution) under the following conditions: 1. they must attribute the contribution in the manner specified by the author or licensor, 2. they may alter, transform, or build upon this work, 3. they may use this contribution for commercial purposes.
4. Rights of Authors
Authors retain the following rights:
- copyright, and other proprietary rights relating to the article, such as patent rights,
- the right to use the substance of the article in own future works, including lectures and books,
- the right to reproduce the article for own purposes, provided the copies are not offered for sale,
- the right to self-archive the article
- the right to supervision over the integrity of the content of the work and its fair use.
5. Co-Authorship
If the article was prepared jointly with other authors, the signatory of this form warrants that he/she has been authorized by all co-authors to sign this agreement on their behalf, and agrees to inform his/her co-authors of the terms of this agreement.
6. Termination
This agreement can be terminated by the author or the Journal Owner upon two months’ notice where the other party has materially breached this agreement and failed to remedy such breach within a month of being given the terminating party’s notice requesting such breach to be remedied. No breach or violation of this agreement will cause this agreement or any license granted in it to terminate automatically or affect the definition of the Journal Owner. The author and the Journal Owner may agree to terminate this agreement at any time. This agreement or any license granted in it cannot be terminated otherwise than in accordance with this section 6. This License shall remain in effect throughout the term of copyright in the Work and may not be revoked without the express written consent of both parties.
7. Royalties
This agreement entitles the author to no royalties or other fees. To such extent as legally permissible, the author waives his or her right to collect royalties relative to the article in respect of any use of the article by the Journal Owner or its sublicensee.
8. Miscellaneous
The Journal Owner will publish the article (or have it published) in the Journal if the article’s editorial process is successfully completed and the Journal Owner or its sublicensee has become obligated to have the article published. Where such obligation depends on the payment of a fee, it shall not be deemed to exist until such time as that fee is paid. The Journal Owner may conform the article to a style of punctuation, spelling, capitalization and usage that it deems appropriate. The Journal Owner will be allowed to sublicense the rights that are licensed to it under this agreement. This agreement will be governed by the laws of Poland.
By signing this License, Author(s) warrant(s) that they have the full power to enter into this agreement. This License shall remain in effect throughout the term of copyright in the Work and may not be revoked without the express written consent of both parties.