A reaction form a person active in the early days when history was written.
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In the beginning there was the ORCA European project (I have many of its deliverables in my archive) that was about the EHR. It provided the beginnings of the Two-Level modelling method: basic Reference Model and Archetypes. The Reference Model was extremely generic. It resulted in the first Standard for the EUropean EHR.
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Because of co-operation in the project with persons from Australia (Thomas Beale, and more) the next development took place in Australia. They produced the first version of a more detailed Reference Model.
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In Europe CEN started to work on the second version of its EHR standard EN 13606 payed for by the EU. David Markwell became the projectleader to create this second version. I (Gerard Freriks) was an extended member of this group. The EN13606 v2 was clearly a messaging standard, Around 1995 these developments took place.
At the same time HL7 v2 in the USA proved to be successful in the market but its Reference Model became so complex that only sheet of paper roughly two meters wide allowed the model to be represented in a readable way. It was much too complex. Around 1996 a German anaesthesiologist (Günther Schadow) proposed the HL7 v3 method. It allowed to created standardised sentences, aka messages. -
Around 2000 I became the chairman of CEN/tc251 Wg1 and started the proces to produce EN13606 v3. That was to be based on important work done by the Australians on the OpenEHR Reference Model and Archetype model. The CEN Archetype model was and is an exact copy of an OpenEHR version. For political reasons it was positioned as EHR messaging solution, but hidden in the Scope statement there was an idea to extend it to EHR-systems, as was the clear scope of OpenEHR.
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As chairman I initiated a co-operation between CEN and HL7. Soon it became clear that the Europeans were supposed to assimilate with HL7. Many Europeans became active within HL7 to influence them from within. e.g. David Markwell that left CEN for HL7. In the end Europeans and Australians wrote a manifesto explaining why HL7v3 was failing. It had to many design errors in models and methods.
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Around 2010 I started the renewal process of the CEN ISO EN13606 v4. This time with a scope that included the use of the standard to define EHR-systems. Also two other standards were harmonised with: System of Concepts for Continuity of Care (CEN ISO 19340 ) and Health Information Services Architecture (CEN ISO 12967) Observe that by then these EHR related and harmonised standards were developed jointly by CEN and ISO.
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Because of the implementation problems with HL7v3 the HL7 organisation started what became FHIR as implementable alternative for HL7 v3. Technical implementation engineers designed a method to (explicitly) allowed fast development of messages; allowing that 80% of the data in existing systems could be exchanged using FHIR (Fast Healthcare Interoperable Resource)