When planning information sharing between healthcare systems there is a plethora of published standards from which to choose. The most widely used are published by IHE (e.g. XDS), HL7 (e.g. FHIR) and openEHR. However, it is not always clear how these standards relate to one another – are they mutually exclusive or complementary?

These standards emerged to address different concerns:

  • IHE profiles define common architectural patterns for interactions between components in a healthcare system. Historically, these used XML web-services to describe the API and messages.
  • HL7 FHIR describes the API and message level interaction between components in a healthcare system, localised through use of profiles.
  • openEHR describes a portable persistence and query platform for a healthcare system, based on shared clinical components known as archetypes and localised through use of templates.

The good news is that these standards are converging. IHE profiles are being updated to allow the use of FHIR for data interchange and many openEHR vendors are offering FHIR interfaces onto underlying data. This consistency means that there is no longer a need to choose between these standards. 

Whilst openEHR remains one of many options for clinical data, the openEHR archetype creation methodology has a long pedigree of use for creating clinical data models. This methodology can be used to inform FHIR profiling activity.

FAQs

Do FHIR and openEHR address the same problem?

No.

Whilst FHIR and openEHR create open Clinical Information Models, openEHR creates a model that is vendor independent across openEHR Platforms.  Systems built using openEHR are portable across openEHR Platforms.  FHIR creates a common model that can be used across any application to then be the basis of defining interoperability between applications whatever open or proprietary models they have been built on. 

openEHR is available through the Apperta Foundation and is open source, is HL7 FHIR proprietary to HL7?

No.

HL7 FHIR is open source and is as freely available to any systems or organisation that wants to use it.

IHE, HL7 FHIR & openEHR – a smörgåsbord of standards?

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