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openEHR / IHTSDO Update from the Board

November 30, 2010  |  from: openEHR Board

At the end of August, the Foundation Board posted an announcement about progress of discussions with IHTSDO concerning governance of archetypes and SNOMED terminology, expecting to be in a position to report back by mid-October. We have been working along the lines set out in previous announcements, here, and the wiki consultation process with openEHR users, earlier this year. Although a detailed set of options has been drafted by IHTSDO and openEHR representatives and presented to the IHTSDO General Assembly, there has as yet been no feedback and thus we have not been able to provide any more information. We are assured, however, that there will be a formal response soon, and at that stage we will be able to discuss the outcome more widely.

As is clear from the several threads of discussion on the openEHR lists, there is understandable frustration about slow progress in defining next steps for openEHR, and we share that frustration. The Foundation currently has no formal status in the wider governmental and intergovernmental discussions but the work done and communicated, by members on the lists, UCL and Ocean over many years, and taken up and developed within the wider EHR community and in ISO-13606, is seen as an important contribution, on which many are building or wish to do so. It is certainly very widely studied by very many visitors who download and use materials from the openEHR web site and observe the discussion lists.

The participants in the recent openEHR list debates have reflected widely different perspectives and interests, but a broadly shared goal. Caricaturing the dialogue a bit, it's all about:

  • standards, standards, standards;
  • and/or open-source, open-source, open source;
  • and/or governance, governance, governance.

Whereas, as far as openEHR is concerned, it's all about implementation, implementation, implementation!

Of course, the underlying drivers cannot be wholly detached from considerations of power and influence, reputation, resource and personal freedom.

A community like ours has many highly motivated people seeking to take forward personal, organisational and wider community missions. We readily acknowledge our own failings and constraints in not pursuing various lines of approach which others powerfully advocate for us. We have adopted a low profile, to avoid being drawn into the multiple vortices afflicting the field. We have thereby retained flexibility to focus on requirements and implementation issues, making no pretence of democratic process. It has brought some advantages and some, no doubt justified, disappointments and criticisms. Effectively, all openEHR Foundation efforts are focused through the ARB and CRB, sustained and supported by Ocean and UCL. Observation of the times of posting of announcements, code and documents shows how much people active in openEHR are doing it in the spare 20 hours of their sixty plus hour weeks. In our work, we all have companies or departments to run, services to provide, products to develop and market and professions to keep up-to-date.

To summarise previous statements of our approach, we are working as follows - the governance and support of openEHR IP must change as soon as possible, as previously announced. We have set a deadline of September 30th, 2011 for this.

We are seeking the best possible combination of:

  • Continued, open access to the resources owned by and protected by the Foundation.
  • Alignment with governments, through IHTSDO, to contribute towards their desire for joined up archetype and terminology governance, and related models, specifications, software methods, repositories and open-source tooling.
  • Creation of an openEHR Users' Association to pursue wider collaboration on open-source tool chain developments, that support EHR systems developers.

When we have transferred the Foundation IP to the best form of sustainable long term development and governance achievable, we will consider the formative work and role of the openEHR Foundation to have been completed and, as promised from the outset of openEHR, we will close the Foundation.

So, we see our sole current role as a Foundation Board as joining together the continuing work of the ARB and CRB looking after the IP in openEHR until such time as it can be contributed towards creating a sustainable model of future governance. The core team is committed to working closely with whatever new organisational structure is adopted, to help make the transition effective.

Finally, the only reason for doing any of this is to help healthcare to improve. openEHR was created to support a 'learning by doing' agenda for the EHR with a focus on what clinicians really need. This remains an important concern.


David Ingram, Sam Heard and Dipak Kalra,
for the openEHR Foundation Board


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