modelinghl7-fhiropenehr

relationship between FHIR and openEHR


How do HL7 FHIR and openEHR relate? I understand that HL7 v2 etc is basic messaging for interoperability. But FHIR seems to add some Clinical Data Modeling to this in the form of resources - A Visit with a Patient with an Observation is to my mind a Clinical Model no? And when you add in a FHIR server concept are we not verging on the CDR ?

So then openEHR models the same Clinical concept through Archetypes, aggregated within a Template. - fantastic ( this I think I get and see where it fits in openEHR )

Next - where is the cross over in interoperability?

Is openEHR designed to - provide Archetypes as direct map to the model on the screen? My understanding is yes.( Datasource and UI interoperbility if you will )... i.e. (In its simplest form) - Client calls Server - Server runs AQL on the data and returns XML result, client runs XSL over that to generate HTML -

But isnt FHIR more about interoperability and openEHR about data modelling? - so now are we suggesting an openEHR server serves the result as an openEHR standard - and we try Map it to FHIR resources and serve it to the front end or any interoperable system.

Should we be looking at picking one and forgetting the other?


Solution

  • FHIR models resources with the intent of data interchange.

    openEHR defines a complete EHR platform architecture to manage clinical data structure definitions (archetypes, templates), including constraints and terminology/translations, manage clinical information (canonical information model), access clinical information (standard query language AQL), define rules for clinical decision support (standard rule language GDL), and defines a service model (REST API is close to be approved).

    So, openEHR is all the internal stuff needed to allow interoperability (not just data exchange), FHIR is a service layer, that can be on top of an openEHR system, as other service layers can be like HL7 v2.x, IHE profiles, or even DICOM services.

    In terms of FHIR over openEHR, mappings between openEHR archetypes and FHIR resources are needed to have a technical implementation. So you can have an openEHR CDR and access it via FHIR.

    In terms of having a GUI over the openEHR system, from archetypes GUI can be automatically generated, and input data automatically validated using those archetypes used to generate the GUI. There are many implementations of this, some open source (I have many examples on my github repos).

    Bottom line: you can create your EHR using openEHR, and provide an API or many APIs (custom, openEHR, FHIR, HL7 v2.x, XDS, ...).