Case studies on the openEHR website

Hi all,

I need to source some case studies for the openEHR website. They don’t have to be too lengthy - really just the basics. I’ve come up with the following sections - open to suggestions for others of course:

:black_small_square: Lead Researcher
:black_small_square: Timeline
:black_small_square: Background
:black_small_square: Objectives
:black_small_square: Challenges
:black_small_square: Project Scope
:black_small_square: Stakeholders and Collaborators
:black_small_square: Methodology - including which parts of openEHR used.
𝘢𝘯𝘥 𝘱𝘦𝘳𝘩𝘢𝘱𝘴
:black_small_square: Benefits openEHR brings to this project.

If you have a deployment you’d like to shout about, please get in touch and I’ll see it gets featured. Thanks. Pete -

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Hi Pete, here it goes; please note that I added a few more props like URL, publications etc.

Project Name: GastrOS – Gastrointestinal Endoscopy Reporting Application
URL: GitHub - atalagk/GastrOS: GastrOS is an endoscopic reporting software based on open standards: openEHR and MST. Built upon stable reference model & driven in runtime by Archetypes. It was built as part of my research at the University of Auckland to study maintainability & interoperability.
Lead Researcher: Dr Koray Atalag
Timeline: 2009 - present
Key publication(s): Atalag K, Yang HY, Tempero E, Warren JR. Evaluation of software maintain ability with openEHR - a comparison of architectures. Int J Med Inform. 2014 Nov;83(11):849-59. doi: 10.1016/j.ijmedinf.2014.07.006. Epub 2014 Aug 6. PMID: 25153769.

Background: Continuation of Koray’s PhD research to validate whether it is easier and less costly to maintain health information systems using openEHR multi-level modelling.

The project consists of developing an openEHR based endoscopic reporting application using C# and MS .Net platform. The main goal is to deliver the first working prototype by March 2010 based on the very same requirements of an earlier application which has been developed, tested and validated as part of Koray Atalag’s Ph.D. research. This application is a ‘typical’ example of how most health information systems have been built so far: Object/Procedural (VB6) programming and a RDMS with hundreds of fields; a big ball of mud! Within the context of the wider research being undertaken by Dr. Atalag at the University of Auckland, Department of Computer Science, this project aims to help answer the following research question: are we better off in terms of software maintainability using openEHR? (hence a way of looking at the future-proof aspect).


  • lack of available real-world openEHR implementations (huge thanks to Ocean Informations for providing their implementation of openEHR RM as open source)
  • unclear modelling best-practices
  • no available .NET openEHR reference implementations
  • almost no API capabilities at the start of the project
  • building AQL by hand was difficult!
  • various bugs in modelling tools
  • almost no available best practices and tooling support for creating meaningful UI from openEHR models - so we had to invent our own! (GUI Directives)

Project Scope:
GastrOS is an endoscopic reporting application based on open standards: openEHR and MST. GUI is driven by Archetypes/Templates. It is part of our research at the University of Auckland to investigate software maintainability and interoperability.

First .NET open source implementation
Uses openEHR Archetypes and Templates
Based on the incredibly structured and quality international standard terminology - MST
Dynamic GUI creation (using our own GUI Directives) and data binding
Can create endoscopy reports
Can be extended by modifying the model - no coding

Stakeholders and Collaborators: Ocean Informatics, Dr Louis Korman (author of MST) and University of Auckland

Methodology: full stack openEHR development

Benefits openEHR brings to this project: this is one of the first real-world clinical information system development using full-stack of openEHR methodology and the first ever like-for-like comparison (not just in health informatics but the entire corpus of software engineering!) of complex software compared to each other using objective data and metrics (ISO/IEC 9216 and 25000 suite of Software Quality standards).

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Perfect! Thanks Koray. That’s the first one in the bag. :metal:

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Hi Peter,

On the openEHR website I saw your call for reports of case studies openEHR.

In 2021 I have completed my PhD on the pattern of Conceptual independence, as it is applied in openEHR.

In my thesis there are two papers that describe a multiple casestudy in healthcare in the Netherlands, in the case studies I have compared the flexibilty and operation of the implementation of openEHR in 10 organisations in mental healthcare in the Netherlands, 5 organisations that have implemented openEHR in their IT infrastructure and 5 organisations that had not. (At the time) These were organisations that were/are representative of the mental healthcare organisations in the Netherlands.

The respondents were IT experts, and IT management in these organisations.

Here I add the papers:

Tarenskeen, D., van de Wetering, R., Bakker, R., & Brinkkemper, S. (2020). The contribution of conceptual independence to IT infrastructure flexibility: the case of openEHR. Health Policy and Technology, 9(2), 235-246.

(open access)

Tarenskeen, D., Van de Wetering, R., Bakker, R., & Brinkkemper, S. (2022). Investigating the Impact of Outsourcing on IT Flexibility: The Conceptual Independence Perspective. International Journal of Healthcare Information Systems and Informatics (IJHISI), 17(2), 1-26.

(open access)

And my complete thesis:

In the library of the Utrecht University, The Netherlands. In the document you can also find an analysis of hard coded terms in (open source) patient record systems compared with the flexibility of terms in openEHR patients records.

Tarenskeen, D., Van de Wetering, R., & Bakker, R. (2018). Unintended effects of dependencies in source code on the flexibility of IT in organizations. FedCSIS (Communication Papers), 17, 87-94.

(open access)

If you have any questions I will be happy to answer those,

Kind regards,

Deborah Tarenskeen (Debbie),

Arnhem, the Netherlands


Update on this one - I’ve had four case studies so far (hat-tip to @Koray_Atalag & @d.tarenskeen ). All being well, they’ll be up on the website next week. If you’d like to include a case study, please get in touch. Ta!

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