openEHR & HL7 FHIRClinical Data Architecture
Vård's database schema, clinical data models, and system archetypes are built from the ground up using openEHR principles—ensuring semantic interoperability with hospital EHRs and national health records through HL7 FHIR APIs.
Vård Interoperability Architecture
A three-layer architecture ensuring semantic accuracy, data integrity, and clean integration with Ireland's NSCR.
User Experience Layer
Modern, intuitive interface for consultants and staff
Data Semantics Layer
openEHR-aligned archetypes for consistent clinical data
Transport Layer
HL7 FHIR APIs for standards-based integration
What is openEHR?
openEHR is an open, vendor-neutral standard for storing and exchanging structured clinical data.
It is not an app, not a messaging protocol, and not a database product. It is a clinical data model and architecture designed so that health data:
Is stored once
Is structured consistently
Remains usable for decades
Can be safely shared across systems
Global openEHR Adoption
openEHR is the foundation for national and regional electronic health records worldwide, chosen by governments for its vendor-neutral architecture, semantic interoperability, and ability to support longitudinal, lifelong patient data. From Slovenia's nationwide system covering 98% of its population (2.1M people, 250M+ records) to the UK's "One London" project serving 10 million residents, openEHR enables future-proof health data infrastructures that separate clinical knowledge from application software.
In Ireland, the National Shared Care Record (NSCR) uses openEHR internally for clinical data modeling, with access and integration increasingly FHIR-based. Similarly, Norway has 80% of hospitals using openEHR via suppliers like DIPS, Brazil has adopted it as the national standard to unify public health data, Spain's Catalan Health Service covers 8M residents, and Greece is implementing a national shared care record for 10M+ citizens and 130+ hospitals. The Nordic countries (Finland's "UNA" project), Australia (ADHA's AI-enabled records), Germany (HiGHmed consortium), and emerging projects in the Netherlands, Portugal, South Africa, and South America demonstrate openEHR's global momentum as the standard for interoperable, research-ready healthcare data.
Separation of Concerns
openEHR's architectural approach ensures clinical meaning and technical implementation evolve independently.
Reference Model (RM)
Technical backbone: data types, versioning, audit trails
Archetypes
Clinical definitions: blood pressure, diagnosis, medication order
Templates
Context-specific combinations: 'Outpatient Cardiology Note'
Why This Matters
Clinicians define
what data means
Developers define
how it is stored and accessed
Systems can evolve
without breaking historical data
openEHR + HL7 FHIRComplementary, Not Competing
KarePilot uses both standards strategically for optimal interoperability.
openEHR
Source of Truth
Canonical clinical data model — how data is stored long-term
- Preserves semantic meaning indefinitely
- Vendor-neutral and future-proof
- Used by Ireland's NSCR
HL7 FHIR
Transport Layer
Transport & interoperability — how data moves between systems
- Modern RESTful APIs
- Industry-standard integration protocol
- Expected by hospital IT teams
KarePilot Template Definition
{
"template_id": "KarePilot.Consultation.v1",
"concept": "Consultant Outpatient Record",
"definition": {
"rm_type": "COMPOSITION",
"archetype_id": "openEHR-EHR-COMPOSITION.encounter",
"items": [
{
"rm_type": "OBSERVATION",
"archetype_id": "openEHR-EHR-OBSERVATION.blood_pressure",
"path": "/content[at0001]",
"min": 0,
"max": 1
},
{
"rm_type": "OBSERVATION",
"archetype_id": "openEHR-EHR-OBSERVATION.body_weight",
"path": "/content[at0002]"
},
{
"rm_type": "EVALUATION",
"archetype_id": "openEHR-EHR-EVALUATION.clinical_synopsis",
"path": "/content[at0003]"
}
]
}
}Templates compose multiple archetypes into clinical workflows specific to KarePilot use cases, ensuring consistent data capture.
KarePilot openEHR ↔ FHIR Mapping
// KarePilot transforms openEHR to FHIR for external systems
async function exportToNSCR(consultation) {
const openEHRData = await karePilot.getConsultation(
consultation.id,
format: 'openEHR'
);
const fhirBundle = karePilot.openEHR.toFHIR({
composition: openEHRData,
target: 'NSCR',
mappings: {
'OBSERVATION.blood_pressure': 'Observation',
'INSTRUCTION.medication': 'MedicationRequest',
'EVALUATION.problem_diagnosis': 'Condition'
}
});
return await nscr.upload(fhirBundle);
}Dual-standard architecture: KarePilot stores data in openEHR format internally, then transforms to HL7 FHIR for NSCR integration.
Standards-Based Data Exchange
Vård's FHIR APIs enable seamless interoperability with hospital systems, NSCR, laboratories, and imaging services—transforming openEHR data into industry-standard resources for real-time clinical collaboration.
Patient
Observation
MedicationRequest
Condition
Encounter
Appointment
FHIR Patient Resource
{
"resourceType": "Patient",
"id": "karepilot-patient-12345",
"identifier": [{
"system": "urn:oid:2.16.372.1000.1.2",
"value": "1234567890"
}],
"name": [{
"use": "official",
"family": "Murphy",
"given": ["Sarah", "Jane"]
}],
"gender": "female",
"birthDate": "1985-03-14",
"address": [{
"use": "home",
"line": ["12 Main Street"],
"city": "Dublin",
"postalCode": "D02 XY45",
"country": "IE"
}]
}Vård: Patient demographics synced to NSCR
FHIR Observation Resource
{
"resourceType": "Observation",
"id": "karepilot-obs-bp-789",
"status": "final",
"category": [{
"coding": [{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "vital-signs"
}]
}],
"code": {
"coding": [{
"system": "http://loinc.org",
"code": "85354-9",
"display": "Blood pressure panel"
}]
},
"subject": {
"reference": "Patient/karepilot-patient-12345"
},
"effectiveDateTime": "2026-01-23T14:30:00Z",
"component": [{
"code": {
"coding": [{"system": "http://loinc.org", "code": "8480-6"}]
},
"valueQuantity": {"value": 120, "unit": "mmHg"}
}]
}Vård: Vital signs from openEHR archetypes
FHIR MedicationRequest Resource
{
"resourceType": "MedicationRequest",
"id": "karepilot-rx-456",
"status": "active",
"intent": "order",
"medicationCodeableConcept": {
"coding": [{
"system": "http://www.whocc.no/atc",
"code": "N02BE01",
"display": "Paracetamol"
}]
},
"subject": {
"reference": "Patient/karepilot-patient-12345"
},
"authoredOn": "2026-01-23T15:00:00Z",
"dosageInstruction": [{
"text": "Take 500mg every 6 hours as needed",
"timing": {
"repeat": {"frequency": 1, "period": 6, "periodUnit": "h"}
},
"doseAndRate": [{
"doseQuantity": {"value": 500, "unit": "mg"}
}]
}]
}Vård: Prescriptions mapped from openEHR INSTRUCTION archetypes
How Vård Maps Data
Internal Storage: Clinical data stored using openEHR archetypes (e.g., OBSERVATION.blood_pressure) for long-term semantic integrity.
External Integration: Real-time transformation to HL7 FHIR resources (e.g., Observation, Patient, MedicationRequest) when syncing with NSCR, hospital EHRs, and third-party systems.
Result: Clinicians work in a modern interface, data remains vendor-neutral internally, and external systems receive standards-compliant FHIR payloads.
Long-Term AI Advantage
openEHR's structured, semantic data model provides the foundation for advanced AI and analytics.
Longitudinal Records
Complete patient histories over decades
Clean Data
Queryable clinical data without re-mapping chaos
AI Training
Models trained on consistent semantics
Outcomes Tracking
Population-level insights without re-engineering