title: Applying representational state transfer (REST) architecture to archetype-based electronic health record systems.
abstract: BACKGROUND
  The openEHR project and the closely related ISO 13606 standard have defined structures supporting the content of Electronic Health Records (EHRs). However, there is not yet any finalized openEHR specification of a service interface to aid application developers in creating, accessing, and storing the EHR content.The aim of this paper is to explore how the Representational State Transfer (REST) architectural style can be used as a basis for a platform-independent, HTTP-based openEHR service interface. Associated benefits and tradeoffs of such a design are also explored.
  
  
  RESULTS
  The main contribution is the formalization of the openEHR storage, retrieval, and version-handling semantics and related services into an implementable HTTP-based service interface. The modular design makes it possible to prototype, test, replicate, distribute, cache, and load-balance the system using ordinary web technology. Other contributions are approaches to query and retrieval of the EHR content that takes caching, logging, and distribution into account. Triggering on EHR change events is also explored.A final contribution is an open source openEHR implementation using the above-mentioned approaches to create LiU EEE, an educational EHR environment intended to help newcomers and developers experiment with and learn about the archetype-based EHR approach and enable rapid prototyping.
  
  
  CONCLUSIONS
  Using REST addressed many architectural concerns in a successful way, but an additional messaging component was needed to address some architectural aspects. Many of our approaches are likely of value to other archetype-based EHR implementations and may contribute to associated service model specifications.
authors: Department of Biomedical Engineering, Linköping University, Linköping 581 85, Sweden. erik.sundvall@liu.se
authors: Erik
authors: E
authors: Sundvall
authors: Mikael
authors: M
authors: Nyström
authors: Daniel
authors: D
authors: Karlsson
authors: Martin
authors: M
authors: Eneling
authors: Rong
authors: R
authors: Chen
authors: Håkan
authors: H
authors: Örman
mesh_terms: D003198:Computer Simulation; D057286:Electronic Health Records; D006801:Humans; D012984:Software; D018511:Systems Integration
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