Report from joint #openEHR / #FHIR meeting

Last month, the openEHR and FHIR communities met for a day in Norway. From the openEHR community, Ian McNicoll and Silje Ljosland Bakke were present, and from the FHIR community, Ewout Kramer and myself were present, along with a group of Norwegians who are involved in FHIR and/or openEHR. My thanks to HL7 Norway, DIPS (en) and the Direktoratet for e-helse for collaborating to bring the meeting together.

The overall agenda for the day:

  • Welcome, introductions / complaints about the weather (de rigueur, but Norway was lovely, there was even some sun one day)
  • Opening presentations from Ian and myself
  • Discussion on specific model mapping HL7 FHIR – openEHR
  • Discussion on a general form solutions
  • Some general questions on HL7 FHIR – openEHR: Mapping, query, Workflow, Pub/Sub, Terminologies, Modeling

And then drinks afterwards, where we solved all the worlds problems (except for a few big ones).

I enjoyed the day greatly – there was a real positive spirit, based on a recognition that both communities are vibrant productive communities that have much to offer each other. Technically, the FHIR and openEHR communities have different scopes, with some overlap, and there’s plenty of real world problems that FHIR is not attempting to solve that openEHR has invested in – and vice versa. Given good will, and a focus on pragmatic outcomes, we can work well together and both derive benefit from that collaboration.

Given that, most of the day focused on immediate challenges faced by Norwegian implementers today. The most obvious question is ‘I have content described by an archetype, and I want to exchange that using FHIR. How do I go about that?’  Right now, there’s no clean simple answer. There’s several different paths, which work variably well. We discussed some of the issues with a focus on mapping between openEHR and HL7 FHIR of observations like body temperature. The outcome of the discussion is that the place to focus is mapping openEHR templates to/from FHIR Profiles. We’ve created a joint workspace in the openEHR Github repository so we can work together on that (as of today, it’s empty. It’s work in progress and will gradually start to fill up, and hopefully with useful stuff).

The plan is that we’ll automatically convert openEHR archetypes and templates to FHIR Logical models, and then map to FHIR resources using the FHIR Mapping language, and generate profiles and implementation guides from that. If that works well (not yet known), this would establish a single demonstrated path to interoperability. Note that I didn’t say a simple path – to make it simple will require further content reconciliation between the communities – perhaps this will provide the impetus for more investment in that (we’ve done some, but it’s hard work).

Then we discussed the different and similarities of the FHIR and openEHR approaches to forms/questionnaires, and what would be involved to interconvert between the different formats. We agreed to work on this further, including a set of activities on Form Mapping at the FHIR DevDays meeting in Amsterdam in November.

One idea that has been floating around recently is for openEHR to use the FHIR binding syntax and terminology services – we discussed this a little, and hopefully we can work towards a concrete proposal for this in the next few months to see how it flies in the wider openEHR community.

Overall, the meeting created a lot of prospects about what we can do together, but now we actually have to follow up and do them.

p.s. Thanks to Sigurd From from DIPS for keeping notes from the meeting which I used for this report

p.s. Also, thanks to the Norwegians for being great hosts. In addition to Norwegian national day, I enjoyed the fjords greatly. Now I just have to find the right supplier of Fjord Cider here in Australia, and all will be good.


  1. Thomas Lukasik says:

    RE “Thanks to Sigurd From from DIPS for keeping notes from the meeting.”

    Will those notes be shared with the community at some point.. perhaps on the GitHub joint workspace?

    If they’re even half as interesting as your post, I’d really like to review them.


    • Grahame Grieve says:

      Sigurd’s notes don’t say much more than my summary, but they include some good photos. I’ll ask him 😉

  2. Bjørn Næss says:

    Thanks for your great post. It is a good summary of what we discussed that day.

    For me personally it was so good to recon that we share the same challenges and that we have different scopes. Those statements tells that we have so much to learn and give each other to make eHealth better.

    I find it urgent to

    a) share the information modelling initiatives – there are simpy not enough resources to make this two times.

    b) share the same terminology bindings and services

    c) follow up on the topics you have described.

    Look forward to see you again.

    Bjørn Næss
    DIPS AS / Product owner openEHR platform

  3. Ian McNicoll says:

    Thanks Grahame,

    Indeed an excellent summary of a very interesting and enjoyable day.

    My main take is that although there are clearly overlaps, openEHR and FHIR each have a rather different goal. There a number of places already where there is naturally close alignment, examples of actual joint working, and opportunities, particularly in the area of profiled FHIR Observations, where the library of openEHR Observation archetypes can help inform, and indeed auto-generate content.

    There are other places like FHIR terminology services where a gap is filled for openEHR systems, and some potentially very interesting future collaboration around Questionnaires and form generation.

    It would be great if we could explore further joint modelling, as we did with Allergies but it is quite hard work to corral the various communities, given all of the other pressures.

    Thanks too to our hosts, Dips for organising the event.

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