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HL7 and openEHR are cooperating (finally)

Publication date: Jan 21, 2011

During the HL7 Working group Meeting in Sydney a couple of initiatives were made to create a closer cooperation between HL7 and openEHR. A closer cooperation will be of benefit to us all - there are surely a lot of things where we can learn from each other.

An HL7 Work Group Meeting (WGM) recently took place in Sydney, Australia. Ocean informatics, a key player in the development of the openEHR standard is based in Australia. Whether that is part of the reason I don't know, but somehow there was a change in atmosphere and closer cooperation is now being envisioned when it comes to certain areas.

Grahame Grieve, who has been involved both in HL7 as well as in openEHR, presented a plan to create a whitepaper about the differences and similarities between the standards. In the past there have been a fair number of heated arguments that were probably caused by the different context in which the standards are to be used, or by the different goals that they have. If one doesn't understand the different aims any comparision between the two will lead to significant misunderstandings.

In the upcoming whitepaper Grahame will elaborate on these and other issues. HL7 defines interoperability standards for use between loosely coupled systems. This leads to fairly rich and self-describing information models in HL7, for one can't really make any assumptions about a receiving application. openEHR doesn't specify interoperability, it specifies the behaviour of an EHR system - in such an environment one is entirely aware of the system capabilities, it is the tightest form of tight coupling. The difference in goals leads to a different vision as how one should model healthcare data.

There are however considerable areas of overlap: both approaches are based on the use of a Reference Model (an high level information model) as well as a layer of constrained models.

In both standard envionments there is a need to capture the details of clinical models (an analysis model, using end-user terms, with references to literature). Clinical models (also known in ISO terms as a DCM, Detailed Clinical Model) contains a combination of medical knowledge, data specifications and terminology, making it suitable for various technical applications. During the week it was decided to create a feasability project to see whether one can express clinical models in openEhr archetypes, with transformation to HL7 v3 templates. openEHR has the tools that allow persons with a clinical background to define archetypes - hopefully those definitions can be reused in the HL7 context.

The HL7 RIMBAA Work Group> (the group that covers software development aspects of HL7 standards) hosted a joint meeting with openEHR software developers. We may have differences as to what is the 'best' reference model - for an implementer that doesn't actually matter that much. There are significant areas of overlap, e.g. in both standards one will have to deal with a 2-layer validation process (RIM, constrained models). Persistence, GUIs, querying techniques, model driven techniques etc. will be very similar. It was a very constructive meeting, we'll again have a joint meeting during the upcoming WGM in Orlando.

A closer cooperation will be of benefit to us all - there are surely a lot of things where we can learn from each other. The process of innovation includes looking at ones own product through different eyes now and then, if only to prevent group think in a closely knit standards development community.


Related posts: Adventures of a clinician in HL7! (Heather Leslie) and Healthcare standards: Convergence (Keith Boone).

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Ringholm bv is a group of European experts in the field of messaging standards and systems integration in healthcare IT. We provide the industry's most advanced training courses and consulting on healthcare information exchange standards.
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