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The openEHR Java Reference Implementation Project
Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
2007 (English)In: Proceedings of the 12th World Congress onHealth (Medical) Informatics / [ed] K.A. Kuhn, J.R. Warren and T.-Y. Leong, IOS Press , 2007, 58-62 p.Conference paper (Refereed)
Abstract [en]

The openEHR foundation has developed an innovative design for interoperable and future-proof Electronic Health Record (EHR) systems based on a dual model approach with a stable reference information model complemented by archetypes for specific clinical purposes.

A team from Sweden has implemented all the stable specifications in the Java programming language and donated the source code to the openEHR foundation. It was adopted as the openEHR Java Reference Implementation in March 2005 and released under open source licenses. This encourages early EHR implementation projects around the world and a number of groups have already started to use this code.

The early Java implementation experience has also led to the publication of the openEHR Java Implementation Technology Specification. A number of design changes to the specifications and important minor corrections have been directly initiated by the implementation project over the last two years. The Java Implementation has been important for the validation and improvement of the openEHR design specifications and provides building blocks for future EHR systems.

Place, publisher, year, edition, pages
IOS Press , 2007. 58-62 p.
Keyword [en]
Electronic Health Records, Health Information Systems, openEHR, Java, open source
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-38638Local ID: 45134ISBN: 978-1-58603-774-1OAI: diva2:259487
12th World Congress on Health (Medical) Informatics Brisbane Convention Centre, 20–24 August, Brisbane, Australia
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2010-04-14Bibliographically approved
In thesis
1. Towards interoperable and knowledge-based electronic health records using archetype methodology
Open this publication in new window or tab >>Towards interoperable and knowledge-based electronic health records using archetype methodology
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The use of Electronic Health Records (EHR) is wide spread in healthcare today. EHRs are not only used to support daily care but also used to support important secondary uses, e.g. clinical research, quality assurance and education. Although considered advantageous compared to paper-based records, EHRs still have a long way to go in realizing its full potential as an integral part of a safe, effective and efficient health care system.

Making EHRs interoperable is a prerequisite to support increasingly distributed and diverse healthcare. Bringing up-to-date knowledge into EHRs for decision support is a critical step to foster evidence based care. EHR data from different sources need to be analyzed in research in order to find new evidence for improvement of the current practice. Knowledge in the form of guidelines needs to be disseminated and applied in practice through continuous education. This cyclic flow of information and knowledge between care, research and education must be facilitated in order to achieve a safer and more efficient healthcare. An interoperable EHR framework can facilitate the sharing of information and knowledge between not only human users but also participating software systems. This is the aim of this thesis, which is built upon the research in the field of semantic interoperability, in particular the pioneering work by the openEHR Foundation.

The journey of this thesis started with a template-based supplementary EHR system - Julius, which allows clinicians to define and share record structures for care and research. The formalism behind Julius is comparable to the openEHR archetype formalism but less expressive and without the backing of international standards. This finding led to an open source implementation of the openEHR design, which in turn initiated the validation and further improvements of the archetype formalism. The software components made the archetype formalism more accessible to academic and commercial projects around the world.

The investigation of the convertibility between a legacy EHR content model and the archetype model showed that the archetype format is more expressive and thus can be used to preserve legacy EHR content definitions. A general strategy for migration from legacy EHRs to archetype-based EHRs was formulated. A novel way of representing clinical practice guidelines using archetype formalism was proposed and tested on a lymphoma chemotherapy guideline. The implication of this study is improved interoperability between guidelines and EHRs that could facilitate both clinical decision support and guideline-compliance checking. Maintainability of guidelines could be increased through reuse of EHR content models as building blocks of guidelines. In the last part of the research, a way of expressing fully structured care plans using openEHR and CONTsys has been explored based on the requirements for elderly home care. A sharable and semantically well-defined care plan could contribute to the coordination of shared care.

The key contribution of the thesis can be summarized as the validation and further improvement of the openEHR archetype formalism through software implementation and the explorations on clinical guidelines, shared care plans and legacy EHR content models in relation to archetypebased EHR framework.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2009. 44 p.
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 1280
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-54822 (URN)978-91-7393-504-3 (ISBN)
Public defence
2009-11-05, Eken, Campus US, Linköpings universitet, Linköping, 09:00 (English)
Available from: 2010-04-14 Created: 2010-04-14 Last updated: 2012-11-15Bibliographically approved

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