David Ingram, co-founder and President of openEHR, on our 20th anniversary

In what have been described as the best opening lines of a history book, ever, Gregory of Tours writing in the sixth century, threw up his hands to express a minimalist overview: ‘A great many things keep happening – some of them good, some of them bad!’. That seems to characterize the vehicles and landscape of health care IT that we are travelling in and travelling through, pretty well! Sadly, on the IT front we have got rather too used to paying first class fare for third class journey!

openEHR has seen its share of good and bad times in its quest to create and share common ground underpinning the design and operation of effective and sustainable digital care records. It has survived as much as anything because of the way it has set about tackling this domain. It focused from the start on the requirements of users, and worked incrementally and iteratively, informed by and learning from experience of putting ideas into practice. It has been lucky beyond measure in the inspirational, now international and multisectoral, community that has joined in along the way, and is now leading the way forward.

It is good to celebrate the traction that the openEHR mission has begun to achieve at this twentieth birthday. We should as well recognise that the job is still only half done. New balance, continuity and governance, will characterise health care services and the communities they serve, over the next twenty years. This will be synergistic with new methods that deliver care and manage and analyse data. We must stay true to the founding mission and enable it to grow into new mission at the heart of this new care community.

Thirty years ago we started from clinical requirement in formulating the architecture of GEHR, which ten years later was consolidated in the mission of openEHR. Five years ago, openEHRInternational took on the mantle of further developing this mission in context of everyday use of openEHR at the heart of care services, supporting products, and patient communities.

Looking forward twenty years from today, the next half of the journey must place the citizen at the heart of care services, and shared knowledge at the heart of care practice. It must place standardised information systems at the centre of coherent supporting record and data, and all this under community governance. openCare sounds a good name to capture this second-half mission!