Applying representational state transfer (REST) architecture to archetype-based electronic health record systems

Area of Science:

• Computer Science
• Health Informatics

Background:

• The openEHR project and ISO 13606 standard provide structures for Electronic Health Records (EHRs).
• A finalized openEHR service interface specification for application developers is currently lacking.
• This paper explores using Representational State Transfer (REST) for a platform-independent, HTTP-based openEHR service interface.

Purpose of the Study:

• To formalize openEHR storage, retrieval, and version-handling semantics into an implementable service interface.
• To explore the benefits and tradeoffs of a RESTful architectural style for openEHR services.
• To develop an open-source educational EHR environment for learning and rapid prototyping.

Main Methods:

• Utilized Representational State Transfer (REST) architectural style for designing the service interface.
• Formalized EHR content semantics, storage, retrieval, and version handling.
• Developed an open-source implementation (LiU EEE) for educational purposes.

Main Results:

• An implementable HTTP-based service interface for openEHR was formalized.
• The modular design facilitates prototyping, testing, replication, distribution, caching, and load balancing using standard web technologies.
• Approaches for querying and retrieving EHR content considering caching, logging, and distribution were developed.
• An open-source educational EHR environment, LiU EEE, was created.

Conclusions:

• REST effectively addressed many architectural concerns for openEHR service interfaces.
• An additional messaging component was identified as necessary for certain architectural aspects.
• The developed approaches are valuable for other archetype-based EHR implementations and service model specifications.