Summary
Objectives
This paper seeks to provide an overview of the initiatives that are proceeding internationally
to develop standards for the exchange of electronic health record (EHR) information
between EHR systems.
Methods
The paper reviews the clinical and ethico-legal requirements and research background
on the representation and communication of EHR data, which primarily originates from
Europe through a series of EU funded Health Telematics projects over the past thirteen
years. The major concepts that underpin the information models and knowledge models
are summarised. These provide the requirements and the best evidential basis from
which HER communications standards should be developed.
Results
The main focus of EHR communications standardisation is presently occurring at a European
level, through the Committee for European Normalisation (CEN). The major constructs
of the CEN 13606 model are outlined. Complementary activity is taking place in ISO
and in HL7, and some of these efforts are also summarised.
Conclusion
There is a strong prospect that a generic EHR interoperability standard can be agreed
at a European (and hopefully international) level. Parts of the challenge of EHR interoperability
cannot yet be standardised, because good solutions to the preservation of clinical
meaning across heterogeneous systems remain to be explored. Further research and empirical
projects are therefore also needed.
Keywords
Electronic health records - interoperability - standardisation - information model
