specifications program

The openEHR Specification Program develops, manages and maintains specifications and their computable expressions, in support of the openEHR goal of enabling the development and deployment of open, interoperable and computable patient-centric health information systems.

The openEHR Specifications Program is managed by its Program Board, the Specifications Editorial Committee (SEC), and is formally governed according to the rules and guidelines in its Terms of Reference (ToR).

The goals of the Specification Program include:

▪️ quality in health information: to enable data quality, validity, reliability, consistency and currency of clinical data across the data lifecycle from creation to archival, and across enterprises and sectors;
▪️ support industry technologies: to actively support the use of widely used ICT technologies e.g. major programming languages and frameworks;
▪️ de jure standards integration: to provide means for the specifications to be useful to users of related de jure standards, e.g. by providing additional transformation or mapping specifications and/or implementation guides;
▪️ manage impact of change: to ensure the preservation of validity of clinical data created according to previous releases of the openEHR specifications.

The responsibilities of the Program are:

▪️ to build and maintain quality of the specifications library;
▪️ to ensure the utility and relevance of the specifications to the larger e-health community;
▪️ to work with de jure standards development organisations (SDOs) to improve the coherence and robustness and reduce the cost of use of formal standards

The Program achieves its goals in the following way:

▪️ by developing new technical specifications where required by the community;
▪️ by accepting and adapting donated specifications;
▪️ by managing and maintaining the openEHR specifications in a coherent way, so that they satisfy the needs of production systems/solutions developers, application and data users (including patients), and user organisations;
▪️ by making all specifications openly available and free to use, under liberal open source / content licenses.

The specifications under management by the Program are defined in terms of Specifications Components, each consisting of one or more concrete Specifications relating to a topic area. A Component is defined as being something that is separately releasable. In openEHR, Components include the Reference Model, the Archetype Model, Querying, Conformance and CDS.

The definitive list of Components at any time is shown in the ‘Component’ column of the specifications home page.

At any point in time, a Specification is in one of the lifecycle states: Planned, Development, Trial, Stable, or Retired as shown on the change process page.

Users of specifications may raise Problem Reports (PRs). Changes made to the specifications as a result are documented in Change Requests (CRs), which are found on the dedicated change tracker for each component. Links to the PR and CR trackers may be found on the specifications home page.

In order to realise the mission, the Specification Program adopts the following quality criteria for its work.

Clear scope: the scope of any specification or computable artefact should be clearly described, indicating which use cases, situations etc, for which the artefact is appropriate.

Modularity: the specifications should be organised into a set of components, following basic principles of low coupling and uni-directional dependence, enabling a) incremental deployability and b) limited impact of any given change to a particular specification.

Design: the specifications are not created by committees, but designed in an appropriate technical way for the given artefact, based on the following precepts:
▪️ requirements-based: the development process includes a requirements capture phase in which requirements are either documented de novo, or obtained by research and communication with the community. This ensures that it is stated what requirements a specification tries to satisfy and provides the specification user an idea of its valid scope.
▪️ theory-based: a clear design philosophy should be evident and stated in all specifications. References to published works should be included where relevant.
▪️ evidence-based: the models and specifications must be based on evidence: knowledge of how well current implementations have functioned; knowledge of clinical data and workflow; knowledge of real use cases.

Coherence: the specifications are all mutually compatible, forming a coherent whole. No specifications are added or changes made that cause inconsistencies within the specification library.

Comprehensibility: the specifications must be easily understandable to a person with the appropriate general competencies; complexity of models and documentation must be consciously managed.

Clarity: particular effort should be made to eliminate the possibility of misinterpretation, misuse, and inconsistency in use.

Computability: all specifications describing formal models and languages should have an associated computable expression available for tool use. The computable expression should have the same semantics as the documentary form (ideally it would be used to generate some / all of the documentary form, but this is not always practically possible). Specifications which are essentially guides or overviews do not need formal expressions, although concrete examples in the form of code etc are always encouraged.

Implementability: all formal specifications have expressions in implementation technologies. In any given technology, usually only a partial view of a specification can be expressed, and there may be semantic differences. For example in XML Schema, behaviour, some constraints and inheritance are not available, or are substantially different to these things in the core specifications. Nevertheless, XML schema is widely used, hence the need for a normative expression of the relevant specifications.

Change-management: the specifications are managed over time in a known way, i.e. following industry norms for versioning, releases and so on. The versioning rules at semver.org are applied to all specifications (although they may not have been in the past, i.e. prior to current governance rules). Issue trackers are used to record problem reports and change requests. Breaking or major changes are assigned to major releases, and impact carefully assessed before proceeding.

The openEHR Specifications Program is formally governed according to the rules and guidelines in its Terms of Reference (ToR).

The specifications under management by the Program are defined in terms of Specifications Components, each consisting of one or more concrete Specifications relating to a topic area. A Component is defined as being something that is separately releasable. In openEHR, Components include the Reference Model, the Archetype Model, Querying, Conformance and CDS.

The definitive list of Components at any time is shown in the ‘Component’ column of the specifications home page.

At any point in time, a Specification is in one of the lifecycle states: Planned, Development, Trial, Stable, or Retired as shown on the Change Process page.

Users of specifications may raise Problem Reports (PRs). Changes made to the specifications as a result are documented in Change Requests (CRs), which are found on the dedicated change tracker for each component. Links to the PR and CR trackers may be found on the specifications home page.

The following diagram illustrates the Specifications Program structure.

specifications program board

Rong Chen MD, PhD

Co-Chair

Rong Chen MD, PhD

Co-Chair

Rong Chen, MD PhD, is the Chief Medical Informatics Officer and the head of Medical Informatics Group at Cambio Healthcare Systems, Sweden, where he is responsible for the research and development in clinical decision support and knowledge management. Rong holds a PhD degree in health informatics on the subject of EHR semantic interoperability from Linköping University, Sweden. He is an associated researcher at the Health Informatics Centre at Karolinska Institutet, where he lectures and supervises PhD and master students. Rong has contributed to several core openEHR design specifications, and has for many years led the Java Reference Implementation of openEHR. Rong is the lead author of Guideline Definition Language (GDL), which is designed to express clinical logic for scalable decision support with openEHR underpinning. Since May 2023 he is also a co-chair on the Specifications Editorial Committee (SEC).

Sebastian Iancu

Co-Chair

Sebastian Iancu

Co-Chair

In his early professional years, Sebastian developed complex web-based applications for the healthcare sector in Romania and later on in The Netherlands. His main interests were data interoperability, telemedicine and knowledge-based systems. After receiving an Engineering degree in Automation and Computer Science, Sebastian focused on developing a completely new PHP-based implementation of openEHR specifications. In 2010, he became one of the three founders of Code24 BV, and has since been the lead software engineer within this company. Currently, Code24 BV provides openEHR based IT solutions (Base24, mConsole) for more than 100,000 patients and their care providers in the mental healthcare sector in The Netherlands. Since May 2020 he is also a co-chair on the Specifications Editorial Committee (SEC).

Bostjan Lah

Co-Chair

Bostjan Lah

Co-Chair

Since joining Marand, Bostjan has been involved as lead developer in the design, development and implementation of Think!EHR Platform as health data platform based on openEHR standards designed for real-time, transactional health data storage, query, retrieve and exchange. He leads a team of developers that deliver high quality, cost effective solutions with the focus of adding value for developers, participants and other end users by making the most of new and established technologies.

Prof Seref Arikan

Prof Seref Arikan

Seref Arikan is a software architect who has been working at Ocean Informatics UK since 2010. He started his professional career in 1997 as a freelance developer working on B2B and B2C solutions and has worked in various health IT companies since 2001, mostly in various R&D and product development roles.<br>His work on openEHR started around 2002, while he was working for a hospital information system vendor. He has released various openEHR related software components and tools as open source in 2009, which were develop in relation to his PhD in medical informatics. Seref’s PhD, which he completed at UCL, CHIME, under the supervision of Professor David Ingram, is on the integration of openEHR specifications with Bayesian Networks for clinical decision support. He is currently in charge of development of various platform components at Ocean Informatics, with a focus on analytics, scalability and API development. His particular interest and most active research is on the implementation of openEHR persistence and relevant specifications such as AQL.<br>

Thomas Beale

Thomas Beale

Thomas is one of the founders of openEHR International and is the chief technical architect and editor of the openEHR specifications, and was the co-chair on the Specifications Editorial Committee (SEC) up to 2023. He is also a openEHR CIC Board member.<br>He has participated in international standards work (OMG HDTF, HL7, CEN TC/251) for many years. He designed the archetype formalism (ADL), object model (AOM) (an ISO standard), the Basic Meta-Model (BMM), and much of the Task Planning and Decision Language specifications. He has consulted for Intermountain Healthcare, the US Department of Veterans Affairs (VA), and various ministries, departments of health and other public agencies in places including Australia, UK, Brazil, Jamaica, Denmark, Sweden, and Catalonia. Thomas’s academic background is in Electrical Engineering (communications) and Computer Science. His earlier professional work was in real-time distributed control (SCADA) systems for power, gas and mining; investment management and finance, and document and software configuration management systems. He has published a number of papers in health informatics and has presented widely on the patient-centric EHR, the model-based platform eco-system, and e-Health strategy. Thomas is VP Informatics at GraphiteHealth.

Diego Boscá Tomás

Diego Boscá Tomás

Diego Boscá received his M. Sc. in Computer Science from Universitat Politècnica de Valencia (UPV) and is currently a predoctoral research fellow at the Biomedical Informatics Group (IBIME) at the ITACA Institute of UPV. He has been involved in the implementation and deployment of health information systems and use of health standards in the real world for over eight years.<br>His experience covers the analysis, design, implementation and deployment of semantically interoperable health information systems using standards such as openEHR, ISO 13606, HL7 CDA. He is a certified HL7 CDA Specialist. He has participated as external advisor at the European epSOS project and as an external expert in the SemanticHealthNet European project. He has worked in the development and governance of the archetypes for the Spanish national shared EHR project. He has participated in several research projects and co-authored more than 30 papers about data integration and standardization of the EHR. Diego is one of the authors of LinkEHR software for archetype-based data integration.

Sebastian Garde

Sebastian Garde

Sebastian Garde is a Health Informatician, holding a doctorate from the University of Heidelberg, Germany. He is also a Foundation Fellow of the Australasian Institute of Digital Health. Currently serving as Product Lead at Ocean Health Systems, Sebastian is responsible for the Clinical Knowledge Manager (CKM). At Ocean, he has built on his research on the governance of clinical content models at CQUniversity Australia, culminating in the creation of the Clinical Knowledge Manager. He has been involved with openEHR since 2004. Before joining Ocean, Sebastian held various positions in academia. He worked as a Research Fellow in Health Informatics at CQUniversity Australia and as a Research Associate at Austin Health, Melbourne, one of Australia’s largest hospitals. Earlier in his career, Sebastian was a scientific employee in the field of Medical Informatics at the Heidelberg University Medical Centre, Germany.

Birger Haarbrandt

Birger Haarbrandt

Birger Haarbrandt holds a B.A. in Medical Information Management and an M.Sc. in Computer Science. Between 2013 and 2017, Birger has established the Hannover Medical School Translational Research Framework (HaMSTR), investigating the enhancement of traditional data warehousing approaches (including i2b2/tranSMART) with openEHR. He previously worked on the establishment of a regional health network in the state of Lower-Saxony based on IHE XDS and as a software developer for CGM MEDISTAR. Since 2015, he has substantially contributed to the concept of the HiGHmed consortium to apply for the Medical Informatics Initiative, a national research project to enable secondary use of health data across institutions. Since the start of the project in January 2018, he is working in HiGHmed as a software architect for the Peter L. Reichertz Institute for Medical Informatics, aiming at the establishment of an open platform based on IHE, openEHR and FHIR between eight German university hospitals.

Shinji Kobayashi

Shinji Kobayashi

Shinji Kobayashi is an associate professor in the EHR research unit, Kyoto University. He has worked as a clinical hematology/oncologist and researched clinical informatics. He launched the Japanese openEHR affilate and leads openEHR localisation in Japan as well as the Ruby implementation of openEHR. This localisation work is now propagating to Asia.

Severin Kohler

Severin Kohler

I’m Severin Kohler, a health informatician shaping industry standards. Currently, I serve as a Member of the Specification Board at openEHR International, where I play a key role in driving advancements in healthcare informatics. My work involves actively participating in various medical informatics projects, including significant contributions to initiatives like HiGHmed and the NUM project. 

Mattijs Kuhlmann

Mattijs Kuhlmann

Software Developer at Nedap Healthcare. He is the technical lead of this team.

Dr Ian McNicoll

Dr Ian McNicoll

Ian is a former Scottish GP, and has been involved in healthcare informatics for nearly 30 years, working with and promoting openEHR technologies for the last 8 years, initially with Ocean Informatics and latterly as an independent consultant. His current focus is on the promotion of the Apperta open e-health platform ecosystem, with openEHR at its core, and the development of a related Development Platform, adopted by NHS England as a key part of their Code4Health initiative. A Director of the openEHR Foundation Board. Previous Chair of the openEHR Management Board, and Director of the International Board from March 2019 until November 2022.

Bjørn Næss

Bjørn Næss

Bjørn has implemented openEHR systems since 2010 and has been a member of the specification editorial committee since 2015. Bjorn believes in an open platform approach and that the openEHR community is the best approach to make a global approach to better health data, which is needed to be able to provide better healthcare services and for the research for new treatments. He received his M. Sc. in Telecommunications from the Norwegian university of science and technology, NTNU. Before this he worked some years as a physiotherapist. He has been working in e-health in various areas, starting as a developer of a national booking solution for medical services in Norway. Later he worked on integration and interop between systems and organizations. More recently he has focused on implementation of openEHR in DIPS Arena, the next generation of the DIPS EHR solution. His contributions to this work has included both openEHR evangelism and on the specification and implementation of the DIPS openEHR server.

Prof Matija Polajnar

Prof Matija Polajnar

After defending a PhD in the field of data mining at University of Ljubljana and briefly working for an insurance company software division, Matija Polajnar joined Better in 2014 (called Marand at that time). Beginning in the team developing Better’s end-user products built atop their openEHR platform, in 2017 he was transferred to the openEHR platform development unit as a software architect and developer. Since 2020 he is the technical lead of this team.

Pablo Pazos Gutierrez

Pablo Pazos Gutierrez

Pablo Pazos Gutierrez has a Computer Engineering degree from UdelaR (University of the Republic), Uruguay. He has worked with health information systems, standards and interoperability since 2006. His first project in eHealth was an EHR based on openEHR, and he is part of the openEHR community since 2006. His interests include software architecture of distributed and integrated systems, information models, clinical data repositories, open platforms and open source. In 2011 Pablo created the first online full length course about openEHR in Spanish, since then he coordinates the openEHR community in Spanish. In 2012 Pablo founded CaboLabs, a company that provides consultancy and training in health information systems, standards and interoperability. Since then he has developed several courses and workshops. Pablo is a member of openEHR SEC heavily involved in openEHR software development, and appointed to the openEHR Education Program Board in 2022, as well as in disseminating the openEHR standard in Latin America, in association with the Chilean Association of Health Informatics (ACHISA).

Prof Erik Sundvall

Prof Erik Sundvall

Erik Sundvall has an MSc in Information Technology, and PhD in Medical informatics from Linköping University, Sweden. Recent activities focus on trying to tie things together via implementation of an openEHR based educational EHR system (LiU EEE) enabling reusable patient overview system at the same time as it is a test platform for a scalable REST based openEHR component/service design that aims to make it easier to deploy openEHR based systems by putting together components from different projects/vendors/platforms. Erik has also supervised several student projects and MSc theses, e.g. one leading to the first openEHR Archetype editor in Java.

SEC expert panel

Pieter Bos

Pieter Bos

Pieter has an MSc in computer science at the University of Twente (2007). He started working at Nedap Healthcare in 2007. During this time, He led the development from the small time registration application to a fully featured suite for use in the elderly care, including an EHR implementation with medical and administrative records and financial/invoicing features. After a short break working on smart grid systems involving home battery systems for Nedap Energy Systems, He returned to the Healthcare group, becoming responsible for the teams that develop and maintain the administrative and financial parts of the Nedap EHR. He presently remains in that position. In 2015 he introduced openEHR at Nedap Healthcare. After building a prototype we concluded openEHR was the way forward for Nedap, solving the need for a much more flexible and standards based EHR solution. As Nedap started implementing a CDR, it found that ADL 2 had clear advantages over the currently used version, but tooling was lacking. Nedap decided to build its own tooling, which we then released as the open source library Archie. Archie is now a library upon which archetype authoring tools, CDRs and client applications can be built, with an international community of users and contributors. Pieter is the primary maintainer of this library. He also led the development of an ADL 2 Archetype Editor based on Archie. Within Nedap Healthcare Pieter also helped to build a CDR plus a number of client applications, and to integrate it into our suite of products. It is now an actively used part of our software suite for clients, with a generic application that works on all archetypes and data, plus specific custom made applications for specific purposes. openEHR enabled Nedap to flexibly model EHR data, and build its EHR upon international standards.

Christian Chevalley

Christian Chevalley

Christian Chevalley is R&D manager at ADOC Software Development. He has over 30 years of experience in software design, development, data center architecture and IT security. He has led several developments of multimillion dollar commercial projects in the international finance, manufacturing, Telco and health care industries. He is specialized in building distributed networked systems on UNIX/Linux and mainframes, integrating a large spectrum of IT resources including micro-controllers, databases, real-time unified communications, location systems, identity management and private data protection. For the past twelve years, Christian has been focusing on producing systems for the Healthcare arena; point of care management for aged care and acute care, telemedicine and careflow. He has been developing the EtherCIS platform based on openEHR since 2010 and has delivered a first release, which includes an open source openEHR server. Christian studied Computer Science and Physics at Geneva University and speaks fluent English and French.

Heath Frankel

Heath Frankel

Heath is a Health Information and Systems Integration Consultant with 20 years’ experience in solution architecture, development and integration of health information systems. My interest is in shared health records, electronic transfer of care and health information exchange. I specialise in the architecture and integration of digital health solutions using openEHR data repositories, clinical archetypes, HL7 messaging and FHIR APIs.

Dr Joost Holslag

Dr Joost Holslag

I trained as a medical doctor at the University of Groningen Netherlands and have clinical experience in (neuro) surgery and elderly care. I currently work at Nedap as a clinical informatician focused on elderly care. I’ve been seeing patients on and off for the last view years, and intend to keep my focus on IT and keep practicing to keep my license and experience up to date, to keep providing clinical input that is recent enough to be of value.<br>My goal is to support doctors in their difficult job with excellent EHR software. My interests are in information modelling, multidisciplinary collaboration, interoperability and the clinician experience with our software/company.

Kjetil Jørgensen

Kjetil Jørgensen

Product owner, DIPS asa, Norway.

Borut Jures

Borut Jures

Borut Jures spent many years as a software architect and implementer of ERP systems before “accidentally” finding openEHR. Since then he has implemented openEHR code generators, ADL converter, OPT data synthesizer and FHIR-openEHR data mapping tool. For some time, he researched the use of BPMN for clinical pathways. His first openEHR tool was generating UML diagrams from openEHR specifications. More recently he has focused on SNOMED CT as a basis for semantic interoperability of clinical data repositories.

Dr Chunlan Ma

Dr Chunlan Ma

Chunlan is a gynaecologist and obstetrician who has been developing openEHR based software APIs and applications for more than 15 years. Her personal interest area is openEHR data reporting. She was the lead author of the openEHR AQL specification, and has worked in many other areas: openEHR RM implementation in C#, openEHR RM Schema, openEHR template to OPT transform, HL7 message to openEHR composition transform openEHR Platform, including EHR APIs, Demographic APIs, AQL query engine etc., openEHR data reporting. Her PhD (U South Australia) was in Computer-based Patient Education, knowledge engineering in patient profile.

Luis Marco-Ruiz

Luis Marco-Ruiz

Luis Marco-Ruiz, PhD, is a data engineer at HIGHmed Consortium, who focuses his work on the adoption of information standards and terminologies for clinical data reuse and clinical decision support. He holds a MSc in Applied Statistics and a PhD in Health Science. Since 2007 Dr. Marco-Ruiz has participated as a developer, advisor, and researcher in private- and public-funded projects in Norway, Germany, the UK, and Spain. In 2013 he joined the Norwegian Centre for E-health Research where he works in the development of national data reuse infrastructures and advises the Norwegian health authorities on the adoption of clinical information standards and biomedical ontologies. In addition, he works as a semantic interoperability specialist at the Peter L. Reichertz Institute for Medical Informatics (Hannover Medical School) developing a cross-institutional data reuse network for the HiGHmed consortium, which involves the Hannover Medical School, Heidelberg University Hospital, and University Medical Center Göttingen, among others. Luis is a member of openEHR SEC Expert Panel and Education Program Board.

Dr Sidharth Ramesh

Dr Sidharth Ramesh

A doctor by training, but a developer at heart. Founded Medblocks in 2015, and currently serving customers all around the world to deliver better healthcare. Believes that providing data-driven clinical decisions can save more lives than doctors can, by themselves. Medblocks provides an open-source library for building openEHR interfaces – Medblocks UI. Also providing opinionated open-source backend services for building your openEHR + FHIR-based applications quickly – Medblocks Stack. Providing consulting services for: Setting up openEHR server – Cloud/on-premise, openEHR Clinical Modelling and Template Designing, Building openEHR based applications and forms from openEHR templates, Integrating and helping with Medblocks UI into your existing frontend application, Dashboards and analytics using AQL on openEHR repositories, Setting up SNOMED CT server – Cloud/on-premise, SNOMED CT mapping and Reference set creation, Setting up an FHIR server – Cloud/on-premise, Building and deploying SMART on FHIR applications, FHIR Profiling and clinical modelling.

Jake Smolka

Jake Smolka

Product owner, DIPS asa, Norway.

Renaud Subiger

Renaud Subiger

Renaud Subiger is a solutions architect with a passion for digital health and interoperability. He has been working on designing and implementing various systems within the Java ecosystem for over 17 years now. Since 2016, Renaud has been involved in significant healthcare projects such as MyHealth@EU, NUM-CODEX, SiNCP, and has also participated in several IHE Connectathon events. Through these experiences, he has gained an extensive knowledge of standards like FHIR, openEHR, the IHE profiles, and DICOM. Renaud believes in open standards and platforms. He is a member of the openEHR SEC Expert Panel and contributes to HAPI FHIR and EHRbase projects.

Alexandru Vidrean

Alexandru Vidrean

I’m a developer at heart, working in the health tech sector for almost a decade, building proprietary solutions. Working from Romania, I joined the EHRbase project in 2022 as the Product Owner. In my role, I am supporting the team in enhancing EHRbase’s capabilities across both open-source and enterprise domains. Since May 2023 I’m also part of the SEC Expert Panel. I’m dedicated to shaping a more open, accessible future for health data, driven by my belief in the transformative power of open standards in healthcare.

want to know more?

For detailed guidance on managing changes within the openEHR Specification Program, you can refer to the Change Process. It outlines the procedures governed by the SEC for handling updates to the major specification components, ensuring transparency and accountability. Additionally, the Release Strategy provides an overview of the structured release management system designed to minimize disruptions for developers and users.