EN 13606 - Technical Approach

Technical Approach

This European Standard has drawn on the practical experience that has been gained in implementing its European predecessor, ENV 13606, other EHR-related standards and specifications, commercial systems and demonstrator pilots in the communication of whole or part of patients’ EHRs, and on fifteen years of research findings in the field. This European Standard builds on ENV 13606, updating it in order to make it more rigorous and complete, to accommodate new requirements identified, to incorporate a robust means of applying the generic models to individual clinical domains, and to enable communication using HL7 version 3 messages. A mapping from the existing prestandard is also provided to support implementers of existing conformant systems. The technical approach to producing this European Standard has taken into account several contemporary areas of requirement.

a. In addition to a traditional message-based communication between isolated clinical systems, the Electronic Health Record will in some cases be implemented as a middleware component (a record server) using distributed object technology and/or web services.

b. “Customers” of such record services will be not only other electronic health record systems but also other middleware services such as security components, workflow systems, alerting and decision support services and other medical knowledge agents.

c. There is wide international interest in this work, and this European Standard has been drafted jointly through CEN and ISO with significant input from many member countries.

d. Mapping to HL7 version 3 has been considered an important goal, to enable conformance to this European Standard within an HL7 version 3 environment.

e. The R&D inputs on which ENV 13606 was based have moved forward since 1999 and important new contributions to the field have been taken into account. The openEHR foundation, integrating threads of R&D in Europe and Australia, is one such example.

Given the diversity of deployed EHR systems, this European Standard has made most features of EHR communication optional rather than mandatory. However, some degree of prescription is required to make EHR Extracts safely processable by an EHR recipient system. This European Standard will, in practice, usually be adopted alongside other health informatics standards that define particular aspects of health data representation. This European Standard can be used alongside key complementary standards, including the Health Level 7 Version 3 Reference Information Model (RIM), EN 14822-1, EN 14822-2, EN 14822-3, CEN/TS 14822-4 (GPIC), prEN 12967 (HISA) and EN13940-1 (CONTSYS).