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By comparison, OMOP and open EHR have profited less from external incentives to spur the adoption and thereby grow the ecosystem beyond a certain critical mass.
J Med Internet Res 2025;27:e66616
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Standardizing Corneal Transplantation Records Using openEHR: Case Study
One promising approach for standardizing EHRs is the use of open EHR structures [16,17]. open EHR is an open-source standard that provides a set of specifications and tools to support the creation of interoperable data structures and the long-term management of health data [18]. A foundational paradigm on which the open EHR framework is based is the 2-level modeling, separating domain semantics from software.
JMIR Med Inform 2024;12:e48407
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The most relevant DCM-based standards in the current state of the art are the following:
Open EHR: It aims to create a standard EHR specification based on the dual-model methodology [6]. The reference model offers the components EHR, folder, composition, section, and entry and categorizes entries into observations, evaluations, instructions, and actions [22]. Open EHR offers a platform model with services related to data entry, querying, persistence, and versioning.
J Med Internet Res 2023;25:e48702
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In addition, it provides open EHR open EHR Expression Language (EL) [27] to specify archetype rules and decision expressions. Open EHR EL can be used to represent high-level query expressions combined with coding concepts. Domain-specific languages have shown promise in many use cases. So, open EHR EL makes it possible for clinical researchers to query on EHRs compared to SQL.
However, it is still an open question how open EHR can be applied in patient screening for clinical research.
JMIR Med Inform 2021;9(10):e33192
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ISO13606 is based on the open EHR 2-level modeling method, which involves a simplified reference model, and is regarded as a subset of the open EHR specifications [15].
The open EHR Foundation provides a comprehensive information architecture for representing the entirety of EHR content in a structured and interoperable form. This architecture includes a modeling framework that uses domain-specific languages and intuitive modeling tools.
JMIR Med Inform 2021;9(10):e31288
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openEHR Archetype Use and Reuse Within Multilingual Clinical Data Sets: Case Study
In response to the COVID-19 pandemic, between February and July 2020, 7 open EHR templates were independently created to represent COVID-19–related data sets for symptom screening, confirmed infection reporting, clinical decision support, and research. Each of the templates prioritized reuse of existing use-case agnostic archetypes found in open EHR International's online Clinical Knowledge Manager [10] (CKM) tool as much as possible.
J Med Internet Res 2020;22(11):e23361
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A Computer-Interpretable Guideline for COVID-19: Rapid Development and Dissemination
The open EHR standard is a potential solution. From the technology point of view, open EHR aims to facilitate interoperability between information systems [27]. The open EHR archetype provides a standard information model that can be shared among organizations to avoid the “curly braces problem” [24]. From the domain knowledge perspective, open EHR aims to bring informaticists and medical specialists together.
JMIR Med Inform 2020;8(10):e21628
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Development of an openEHR Template for COVID-19 Based on Clinical Guidelines
To develop an open EHR template for COVID-19, our method consists of six steps. These steps include collecting data items, organizing domain concepts, searching corresponding archetypes, developing an open EHR template, and reviewing and releasing the template (see Figure 1).
The method of developing an open EHR template about COVID-19. CKM: Clinical Knowledge Manager; COVID-19: coronavirus disease.
J Med Internet Res 2020;22(6):e20239
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For open EHR and ISO/CEN EN13606, CIMs are defined in the form of archetypes, whereas those of HL7 are in the form of HL7 templates. According to the systematic review done by Moreno-Conde et al [13], archetypes are the preferred type of technical artifacts, and open EHR is most frequently mentioned. Therefore, CIMs in our study specifically refer to open EHR archetypes.
Open EHR is an open-source EHR standard ensuring universal interoperability among all forms of electronic data [14-21].
J Med Internet Res 2019;21(5):e13504
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OpenEHR and General Data Protection Regulation: Evaluation of Principles and Requirements
One of the main goals of open EHR is to enable the development of EHR systems to be able to communicate with each other, without loss of meaning, thus achieving semantic interoperability.
Modeling in open EHR relies on a 2-level scheme that separates the content from the form in which it is defined.
JMIR Med Inform 2019;7(1):e9845
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