Inaugural joint archetype review by HL7 & openEHR!

We have movement. We have willingness to try. We have a draft FHIR archetype for Adverse Reaction uploaded onto the openEHR CKM that is undergoing some final preparation before being sent out for joint review by the international openEHR and HL7 communities, hopefully as early as next week.

After calling for some collaboration on modelling between HL7’s FHIR and openEHR archetypes (Stop the #healthIT ‘religious’ wars and Technical/Wire…Human/Content) we have taken some preliminary steps towards exploring if agreement about the clinical content across these two modelling paradigms is possible.

The intended outcome of this will be agreed content that will inform the FHIR Resource/s and a published openEHR archetype. Even if the information models are represented differently there should be a clear mapping possible between the two approaches. This will be a first.

The self-appointed (mainly because we all volunteered or were conscripted) Editorial team consists of:

  • Grahame Grieve (Australia), one of the primary authors of the FHIR specifications;
  • Russ Leftwich (USA), an internist and immunologist who is a co-chair of the HL7 Patient Care Working Group;
  • Ian McNicoll (UK), a clinician and informatician who is a board member of openEHR and co-leading the international CKM Editorial work; and
  • myself (again from Australia).

Our preparation has required consolidating components from the openEHR archetype, the existing FHIR allergy/intolerance models and the HL7 DAM. The archetype you see now on CKM is the immediate result of that process, and over the next few months we intend to conduct a number of public review rounds that will enable anyone/all to provide feedback on the proposed model.

Grahame will inform and invite the HL7 community formally via lists, explaining the process and mappings between the HL7 models and the current archetype. Similarly when the review is ready to be released, there will be similar communications on the openEHR website.

In the meantime, if you are interested in participating there are two ways of registering your interest:

  1. If you have NEVER registered on the openEHR CKM before:
    Please register in the Adverse Reaction Project on CKM. This link will walk you through the Registration wizard and automatically add you as a member of the Project.As soon as the archetype is released for review, you will receive an email invitation that will take you connect you directly to the review process.
  2. If you are ALREADY A REGISTERED USER on the openEHR CKM:
    Please log in to the openEHR CKM and open the Adverse Reaction (FHIR/openEHR) archetype. We need you to clinical on the ‘Adopt Archetype’ button as shown in Step #2 in the diagram below. This will register you as willing to review the archetype and as soon as the archetype is released for review, you will receive an email invitation that will take you connect you directly to the review process.
    Adopt an archetype

None of us are quite sure how this will play out but I’m hopeful that we might look back on this review as a watershed moment in clinical content specification development. It will possibly inform how future harmonisation across a number of clinical modelling approaches might proceed, including broader HL7 efforts and CIMI.

Anyone who is interested to participate is welcome. If you have any problems with registering please email me directly on

Let the harmonisation begin!





In a comment on one of my most recent posts, Lloyd McKenzie, one of the main authors of the new HL7 FHIR standard made a comment which I think is important in the discourse about whether openEHR archetypes could be utilised within FHIR resources. To ensure it does not remain buried in the rather lengthy comments, I’ve posted my reply here, with my emphasis added.

Hi Lloyd,

This is where we fundamentally differ:
You said: “And we don’t care if the data being shared reflects best practice, worst practice or anything in between.

I do. I care a lot.

High quality EHR data content is a key component of interoperability that has NEVER been solved. It is predominantly a human issue, not a technical one – success will only be achieved with heaps of human interaction and collaboration. With the openEHR methodology we are making some inroads into solving it. But even if archetypes are not the final solution, the models that are publicly available are freely available for others to leverage towards ‘the ultimate solution’.

Conversely, I don’t particularly care what wire format is used to exchange the data. FHIR is the latest of a number of health data exchange mechanisms that have been developed. Hopefully it will be one that is easier to use, more widely implemented and will contribute significantly to improve health data exchange. But ultimately data exchange is a largely technical issue, needs a technical solution and is relatively easy to solve by comparison.

I’m not trying to solve the same problem you are. I have different focus. But I do think that FHIR (and including HL7 more broadly) working together with the openEHR approach to clinical modelling/EHRs could be a pretty powerful combo, if we choose to.


We need both – quality EHR content AND an excellent technical exchange format. And EHR platforms, CDRs, registries etc. With common clinical archetypes defining the patterns in all of these uses, data can potentially start to flow… and not be blocked and potentially degraded by the current need for transforms, mappings, etc.