openEHR and ISO/CEN 13606 - what is the relationship?

The relationship between openEHR and ISO/CEN 13606 is a common question for newcomers, and sometimes a source of confusion.

As an overview…

  1. openEHR and 13606 share a common heritage and make use of two-level domain modelling, based on the Archetype Object Model, which though developed by openEHR, is itself part of the ISO13606 specification. Both use archetypes to define their clinical content but openEHR and 13606 archetypes are quite different and are not compatible.

  2. Their Reference models are quite different, and while sharing a similar high-level conceptual structure (Compositions, Sections, Entries, Elements) the details of these structures are very different, as are their datatypes.

  3. These differences in part reflect the different scope and purpose of each - openEHR is primarily a persistence/query standard, whilst 13606 is primarily designed for data communication/exchange similar to the HL7v3, CDA and FHIR standards.

In summary, although ISO 13606 and openEHR have a common heritage, and share the Archetype Object Model, they each have quite different Reference models and therefore archetypes, based on the different requirements of a Communication standard (13606) and a persistence standard (openEHR).


I would also add that, even if they have different refence models, archetypes (and data instances) are directly transformable/compatible between both: ISO13606 part 3 includes codes to identify which kind of Entry is being used in openEHR and openEHR contains a generic Entry class that can be used to easily accommodate 13606 archetypes and data


I do not think the reference models of openEHR and ISO/CEN 13606 are so “quite” different. Yes, they are different like “British English” and “American English”, not so far as “Japanese(日本語)” and “English”. While ISO 13606 is emphasized on the conformance to other ISO standards, openEHR is based on the discussion for implementation of EHR platform. ISO 13606 series have been updated in this 2019 with the long-time discussion and openEHR specification.

Anyway, the difference of openEHR and ISO13606 is too emphasized on negative contexts of FUD for openEHR and ISO 13606. Both are our standards, specifications, and implementations.


The openEHR approach can improve the interoperability of electronic health record (EHR) through two-level modeling. Developing archetypes for the complete EHR dataset is essential for implementing a large-scale interoperable EHR system with the openEHR approach.

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I would like to add a 4 bullet point:
4. Both OpenEHR and ISo 13606 use the same modelas described in part 2 of the ISO standard. This allows transformations between the Archetypes, but also resukts in the same archtype editoe/tooling for both specifications.

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