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GEHR, the electronic healthcare record architecture for Europe will offer, in the public domain: an architecture description formal object model exchange format; a multi-lingual dictionary of health record items; a library of anatomical drawings; specifications for data access and integration tools; a follow-on initiative to support future development.
The processes of synthesis and abstraction leading to a definition of functional requirements was the primary clinical and technical work of the first year of the project. In the second year work focused on developing the clinical end-user specification for a structural architecture, the building of further prototypes and planning for their implementation and testing in practical clinical settings. In the final year the major effort has been applied to the formal architecture description. This has been a very complex task involving successive modelling exercises, with refinements and modifications being studied and tested by informatics and clinical experts within and beyond the project. This architecture definition has been published and starts from a description of the record in clinical terms. From this emerges a set of concepts with which a generic model of the content and structure of the record, in all its diverse instances, meeting ethical and legal requirements, is defined. A set of terms in all community languages is proposed in support of this model architecture. The model is then used to define an exchange format, one particular view of any possible GEHR compliant system data structure, for interoperation among systems. Finally, an object view is taken of the architecture using a set of object classes to embody the GEHR concepts.
It has been important to make the architecture open to progressive refinement and to the incorporation of new requirements and advances, such as the systematisation of medical knowledge and the utilisation of new technologies. The final phase of the project has seen the incorporation of the formal architecture into the next generation of prototypes, which will also conform to the ethical and legal guidelines. Evaluation across clinical specialities and professional disciplines is proposed in test sites which will also incorporate a wide range of data types.
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