JMIR Publications

ABSTRACT

Current Electronic Health Records (EHR) information systems have limitations that prevent genuine use of health data. To address this issue, numerous initiatives in Spain have developed advanced data infrastructures for primary and secondary use at regional, national, and international levels. These proposals have incorporated different health information standards into their design to make health data compliant with the FAIR Principles. However, the selection and application of standards has not been homogeneous across the different initiatives, leading to questions about which standard is most suitable for specific requirements. In this study, a team of experts in EHR standards analyzed the strengths and weaknesses of three relevant standards based on Detailed Clinical Models: OpenEHR, ISO 13606, and HL7 FHIR, with respect to their design, modeling capabilities, flexibility, and implementation resources offered. Thus, this study agreed on an approach for the concurrent use of these standards in different applications, including knowledge modeling and formalization, data persistence, data querying, and data exchange. The study concluded that (1) these standards are useful for the purposes for which they were designed, but have shortcomings for those for which they were not; (2) they are functionally compatible in health data platforms, tools and methodologies designed to be standards-agnostic; and (3) they are technically compatible with each other, hence the selection of one or the other does not have a high impact as long as one starts with the one richer in modeling capabilities and flexibility. Therefore, data recorded and persisted in information systems, whose concepts have been modeled in a meaning-rich way through clinical archetypes, can be exchanged and exploited through the different EHR standards analyzed in this study, according to the purpose and characteristics of the use case.