The openEHR Foundation is an international non-profit foundation founded in 2000, with the ambition to make interoperable and lifelong electronic health records (EHR) a reality and improve medical care in the information society through the open standard specification openEHR.See e-Health standardization map http://www.talkstandards.com/wp-content/uploads/2009/05/map-ehealth-sso.jpg
The foundation is dedicated to the development of specifications, open source software and tools for the creation of adaptable health computing systems and patient-centric electronic health records. The focus in openEHR is not on how different systems exchange data with each other, but on architecture, reference models and especially archetype models for standardization of data, irrespective of the application of such data. The term openEHR is used both for the foundation and its published work. The first version, openEHR 1.0, was released in February 2006, and the latest version, openEHR 1.0.2 was published in December 2008. Being rather new, the openEHR open standard has not yet been widely implemented. Various evaluations of openEHR are however ongoing in regions within about ten countries.
OpenEHR was founded by University College London and Ocean Informatics Pty ltd from Australia and the board of the foundation is composed of four members from these two organizations. Membership in the foundation is open to anyone, and by now, openEHR has more than 700 members from more than 70 countries. Membership is free of charge although the foundation is actively searching for sponsors.
Standardization is considered necessary by openEHR, however the openEHR view is that traditional standards setting processes with committees doing the development work does not have a future. Instead, a development process aligned to the open source model is considered to be needed, with continual and open review where anyone can request changes. OpenEHR seeks to standardize through openness and accessibility; the tree key activities fof openEHR are said to be “implementation, implementation, implementation”. Therefore, the published work is released in official versions which the users continually review, but with defined rules for how changes in the specifications are to be made. OpenEHR can be considered to consist of three types of content: specification documents, archetypes and software. The latter two builds on the specifications. Thus a new version of openEHR implies revision of the set of specifications. All the specifications are developed and managed by a project group within the foundation. However, each specification typically is the work of a specific working group. Anyone in the foundation may suggest changes to a specification, and when such a proposal is made it is discussed and developed until a consensus has been reached among the members of the foundation. Any such changes are then reviewed and documented by the Architecture Review Board consisting of seven members before the revision of the specification is implemented by the project group.
All intellectual property rights (IPR) of the contributions to openEHR is owned by the foundation and all material is made publicly available for free under licenses where the only terms are that users may not use the material out of context or modify it in such a way that it may damage the openEHR foundation. The stance of the foundation on IPR is that all components and specifications have to be in open source format; otherwise complete interoperability among all the complex systems in the healthcare area will never be achieved.
OpenEHR continually cooperate with other organizations such as CEN and ISO. The openEHR specifications build upon various definitions and specifications in standards from CEN and ISO – while CEN in turn have adopted standards based on openEHR. A large international project of harmonization is also underway within ISO to develop specifications for how data following the openEHR standard should be exchanged in messages following the HL7 version 3 Standard. Other examples is the development of terminology within the International Health Terminology Standards Development Organization (IHTSDO) and the definition of technical binding approaches for SNOMED-CT and openEHR archetypes and templates within UK NHS Connecting for Health.
Key success factors
The free membership of openEHR creates incentives for wide participation, especially from motivated individuals.
The set leadership of the foundation, although somewhat undemocratic, provides a coherent leadership vision.
The open development of standards and specifications provides swift reactions to technological progress and ensures that standards will meet the market demands.
The focus on interoperability enhances the ability of openEHR to respond and adapt to technological developments.
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