On March 13, 2023, we celebrated 20 years since the birth of openEHR. In the world of technology, 20 years is a lifetime, enough time to even reach obsolescence. And yet, it is now when openEHR is entering its era of maturity, increasingly considered as a fundamental tool for innovation in the management and exploitation of health information. What has made openEHR resilient to changes in trends and healthcare technologies over the past 20 years, and what can it offer us for the future?

What is openEHR?

Let's first define what openEHR is and, above all, what it is not. openEHR is a set of specifications maintained by openEHR International for building durable electronic health record (EHR) systems, robust to changes, and flexible to new information recording needs. openEHR is not an application or a system aimed at end-users. What openEHR will facilitate is the ability to build healthcare applications on top of clinical data repositories, ensuring that the underlying information follows standard and quality information models.

Clinical information models are at the core of health information systems

The main goal of any healthcare information system, particularly an EHR system, should be to help improve healthcare processes. Improvements in research and management activities will be equally welcomed benefits. An EHR should assist in the faithful documentary record of people's health status, their monitoring, and their treatment. All that recorded information should be well-structured and have precise meaning. This is achieved through the use of clinical information models.

This is the great differential fact of openEHR, promoting that clinical information models guide the operation of the systems developed based on them. And who better than healthcare professionals to define these models in the first place? In openEHR, we call them archetypes if they are universally usable models and templates if they are models adapted to specific use scenarios. Hundreds of professionals from around the world have been dedicated for many years to defining these models in such a way that they are reusable and validated by a wide community of users. They are also public and accessible models through the openEHR Clinical Knowledge Manager. openEHR has been based from its origin on this idea, starting the path towards collaboration in the standardization of healthcare knowledge.

One for all and all for one

We cannot fail to mention the relationship between openEHR and other health information or terminological standards, such as HL7 FHIR, OMOP CDM, or SNOMED CT. Sometimes, and due to a misunderstood competitiveness, it is assumed that standards are at war with each other, that one must bet everything on one, and that only one will prevail. Nothing could be further from the truth. Each standard has its raison d'être, its advantages, and its limitations. It's not a war. It's about choosing which standard or combination of standards is most suitable for each use case. An example is the INFOBANCO project, where we collaborate with the Hospital 12 de Octubre and the Primary Care Area of the Community of Madrid, to implement a unified platform of clinical data for research based on openEHR. From that core, partial views of the data can be generated in other standards, such as HL7 FHIR or OMOP CDM, to interoperate with other research systems. 

We face a profound strategic change

The EHR is the fundamental core of the rest of healthcare information systems, as it stores and manages the health data of individuals who come into contact with the healthcare system. It is not a piece that can be changed lightly. Any modification requires careful planning and a detailed study of its impact. 

This is the case of the new Digital Health Strategy of Catalonia, where a new repository of clinical data in openEHR format will be the core from which a longitudinal platform centered on the patient will be built.

These changes are not simple; they require careful planning and can even be painful, but they are necessary to ensure the future sustainability of the healthcare system, to allow greater interoperability between organizations, and to incorporate new technologies based on data utilization more efficiently, such as the development of solutions using Artificial Intelligence. For 20 years, the professionals at Veratech for Health have been working to help cope with this change, putting our knowledge at the service of organizations and healthcare professionals, and promoting the adoption of these innovative technologies, whether it be openEHR, HL7 FHIR, OMOP CDM, or SNOMED CT. We offer a strategy based on training, consultancy, and support during this period of transition. Also collaborating with openEHR International, participating both in the specification editorial committee and its education board. All with one goal, to put the most innovative technology, such as openEHR, at the service of improving healthcare.

And you, when do you join the change?

Author:

David Moner Cano, PhD. Production Manager at Veratech for Health, openEHR Recognized Educator, and member of the Education Program Board of openEHR International

This article can be found on pages 44 and 45 of Revista SEIS Nº 157