The story of openEHR

How a European research project that began in 1992 became a global, community-run open standard for health records, and the people who made it happen.

Chapter 1

1988–2002

Origins: from GEHR to openEHR

openEHR grew out of a decade of research into what an electronic health record should be. It was exploratory and research-driven work, carried out by teams in London and Australia who became convinced that record standards had to be tested in real, working systems.

  1. 1988

    The European Union launches Advanced Informatics in Medicine (AIM), a research programme led by Dr Niels Rossing. A shared architecture for electronic health records becomes one of its main goals.

  2. 1991

    Dr Alain Maskens, a Belgian oncologist, and Dr Sam Heard, an Australian GP lecturing at St Bartholomew’s in London, form a seven-partner consortium to bid for the work. Led by Professor David Ingram at St Bartholomew’s Medical College, with support from Lesley Southgate, they call it the Good European Health Record: GEHR.

  3. 1992

    GEHR begins in January. Dr Dipak Kalra leads the clinical work and David Lloyd joins the technical team. Tom Beale joins in 1993 and helps produce the first GEHR object model. The results are published openly and feed into the European pre-standard for health records, ENV 12265.

  4. 1994–1995

    GEHR ends and the work continues in Synapses, a European project on federated health records that separates the structure of the record from its clinical content. In 1995 David Ingram becomes Professor of Health Informatics at UCL and founds CHIME, the Centre for Health Informatics and Multiprofessional Education, where Dipak Kalra and David Lloyd join him. CHIME becomes the home that incubates and anchors openEHR’s early core team, methods and mission.

  5. 1996

    In Australia, Sam Heard and Tom Beale develop the GEHR model into a two-level approach: a stable record architecture, plus clinical “archetypes” that define the content. This becomes the core idea of openEHR. Its roots go back further, to ideas Jo Milan developed through his design and implementation work at the Royal Marsden Hospital in London.

  6. Late 1990s

    “Implementation, implementation, implementation.” At CHIME, Dipak Kalra’s team tests the ideas in working prototypes across the European projects Synapses, Synex and Medicate, while the Australian team builds an archetype-based GEHR server.

  7. 1998

    The idea of an openEHR Foundation takes shape, as the UCL and Australian teams set out to bring their two approaches together under one open, non-profit name.

  8. 2001

    A week-long meeting in London brings together Sam Heard, Tom Beale, Peter Schloeffel, Dipak Kalra and others. Their systems prove largely compatible, and the teams commit to a single two-level architecture with clinical archetypes.

Hear it from David Ingram

In his keynote at Medinfo 2007 in Australia, David Ingram tells the story of GEHR, Synapses and the early days of openEHR.

Read the transcript (PDF)

The transcript is one of the Additional Resources for David’s book, alongside other documents about the birth of openEHR that were written at the time. The first three chapters of this page draw on those contemporary accounts, which tell the story in much fuller detail.

Read the original origins account or see the Additional Resources

Chapter 2

2003–2013

The Foundation years

With a shared architecture agreed, openEHR needed a home. For its first decade it was run from CHIME at UCL, sustained by the commitment of a small group of founders and by the time their employers gave to the work.

  1. 2003

    The openEHR Foundation is formally established at UCL as a not-for-profit, asset-locked company, with UCL and Ocean Informatics as its guarantors. Its job: take the mission forward and work with industry, national health IT programmes and international standards bodies.

  2. By 2008

    An Architecture Review Board governs the specifications. The Clinical Knowledge Manager, provided by Ocean Informatics, gives the clinical models their own review process, starting with a Clinical Review Board.

  3. 2008–2013

    openEHR’s archetype model becomes central to the CEN and ISO 13606 standard for exchanging health records, and a growing international community of clinical modellers adopts the openEHR tools. Efforts to align, and possibly merge, with the IHTSDO (now SNOMED International) don’t succeed.

  4. 2013

    With more industry partners building on openEHR and no funding beyond contributions in kind, it’s clear the Foundation can’t continue as it is. The next step has to be self-governance by the worldwide community that now uses it.

Chapter 3

2014–2018

Handing openEHR to its community

A wide-ranging review led openEHR to be run by the people who use it: members who pay a subscription, vote, and elect the board.

  1. 2014

    openEHR agrees a new model: a subscribing membership, an elected management board, and funding from industry partners. Ocean Informatics steps down as a guarantor of the Foundation.

  2. 2015

    The first management board is elected. It works well for three years.

  3. 2018

    After consulting members, openEHR decides to go further and become a self-governing, asset-locked UK Community Interest Company. The openEHR Foundation keeps ownership of the intellectual property but stops trading.

  4. October 2018

    At the Foundation’s final AGM with UCL as guarantor, UCL steps down and the new articles and membership structure come into effect.

Chapter 4

2019–today

openEHR International

Today openEHR is run by and for its global community, with the specifications, clinical models, software and education developed openly through its programs.

  1. 2019

    The new Community Interest Company, trading as openEHR International, takes over the day-to-day running of openEHR. The openEHR Foundation continues to hold the intellectual property.

  2. Programs

    The community’s work is organised into programs for specifications, clinical modelling, software and education, joined by the openEHR Fellowship.

  3. 2023

    David Ingram publishes Health Care in the Information Society, a two-volume, open-access history of health informatics that includes the story of openEHR and the CHIME community.

  4. November 2024

    EHRCON24, the first openEHR International Conference, brings the community together near Reading, UK.

  5. October 2025

    EHRCON25 in Barcelona adds a peer-reviewed scientific track. Its abstracts are published in BMC Proceedings.

  6. September 2026

    EHRCON26 in Amsterdam.

Health Care in the Information Society

David Ingram’s history of information technology in health care, from its pioneers to the present day, including the ideas and people behind openEHR. It’s peer-reviewed, published in two volumes by Open Book Publishers, and free to read online.

Read Volume 1 Read Volume 2

The people behind openEHR

openEHR was built by many people across many countries. These are some of those who shaped it. Many of them were staff, honorary members or regular visitors at CHIME at UCL, the community that incubated openEHR.

Founders and early years

  • Professor David IngramLed the GEHR consortium and project, and founded CHIME at UCL.
  • Dr Sam HeardCo-led the GEHR bid and co-developed the archetype approach in Australia.
  • Tom BealeCame into the field through Jo Milan’s team. Produced the first GEHR object model and co-developed archetypes.
  • Professor Dipak KalraA GP and David Ingram’s PhD student, he led GEHR’s clinical work, then CHIME’s implementation projects in the NHS, EU research and CEN/ISO 13606, becoming a professor at UCL.
  • David LloydPart of GEHR’s technical team who moved to CHIME; coordinated openEHR’s first web presence.
  • Dr Peter SchloeffelWorked with David Ingram on GEHR and established openEHR in Australia.
  • Dr Alain MaskensCo-led the original GEHR bid.
  • Dr Jo MilanHis decades of design and implementation work at the Royal Marsden Hospital brought the earliest ideas of two-level modelling to the community. Worked on GEHR and Synapses.
  • Lesley SouthgateSupported the GEHR proposal at St Bartholomew’s.
  • Dr Martin SeversClinician and long-standing member of the CHIME community, and a leading figure in NHS and international health informatics.
  • Dr Ian McNicollClinician from the CHIME community who became one of openEHR’s leading clinical modellers and educators.
  • Dr Heather LeslieLed openEHR’s clinical knowledge governance and built the community that reviews archetypes in the Clinical Knowledge Manager.
  • Dr Tony ShannonClinician from the CHIME community who championed openEHR in the NHS and later founded the Ripple Foundation.

Carrying it forward

  • Tomaž GornikFounder of Better (formerly Marand), whose platform helped take openEHR into large-scale use.
  • Rachel DunscombeNHS digital leader who championed openEHR at scale and helped lead openEHR International.

Further reading

openehr.org