Combining openEHR and FHIR® in practice: A practical approach to bridging two standards
How do you connect openEHR and FHIR® in a way that's practical and maintains data quality? A step-by-step explanation with a blood pressure example.
By Marc van Aalten, Interoperability Expert at Interoplab
More and more healthcare organizations want to combine openEHR and HL7 FHIR®: openEHR for semantically rich data storage, FHIR® for system-to-system exchange. But how do you link those two standards in a way that’s practically viable and guarantees data quality?
The problem
Healthcare data is scattered across systems with incompatible structures. When you convert data via mappings to FHIR, you run into persistent problems:
- Complex translations. Each source system needs its own mapping to the right FHIR® profiles. Small interpretation differences lead to errors or data loss.
- Maintenance burden. FHIR® profiles and systems are updated regularly. Each update requires adjustments to the mappings.
- Data loss. Clinical nuances sometimes disappear during translation, especially when source systems contain more detail than the FHIR® profile can hold.
The solution: FHIRconnect
FHIRconnect specifications describe how to link openEHR composites and FHIR® profiles. They’re bidirectional, vendor-neutral (YAML format), and executed by the openFHIR engine — either in real-time or via database synchronization.
Step-by-step: Blood pressure as an example
Step 1: Context mapping Define the basic connection: which FHIR® version, which profile, which openEHR template, and which archetypes are involved.
Step 2: Model mapping Build the mapping with three components:
- Header — links the FHIR® profile to the openEHR archetype
- Preprocessor — determines when the mapping applies (conditional rules)
- Body — the actual field-by-field mapping, using FHIRPath and openEHR paths
Step 3: Upload to the openFHIR engine Configuration files are loaded into the engine via the API.
Step 4: Execute The engine generates conformant FHIR® output based on the openEHR data — automatically and repeatably.
Governance and community support
Platforms like Clinical Knowledge Manager (CKM) and Simplifier.net make it possible to store and share mappings centrally. Nictiz maintains national mappings for reuse. The approach has broad support among healthcare professionals and technical experts who work daily with these standards.
Conclusion
With FHIRconnect specifications, you link openEHR and FHIR® without reinventing the wheel each time. Scalable, reliable, and reusable — that’s how it should be.
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