Table 1. Descriptive summary of published experiences gathering interoperability among e-health systems with information exchange.

Authors	Origin	Aims	Setting	Standard	Information technology	Outcomes
Muñoz et al 40	Spain	The authors present an electronic healthcare record (EHR) server, designed and developed as a proof of concept of the revised prEN13606:2005 European standard concerning EHR communications.	AD HOC and real (patients with chronic diseases)	ISO 13606	CORBA (communication), Eiffel (OO language), Java, Web service, XML	Tests sending and receiving extracts were successful, being installed in a real scenario later
Rinner et al 41	Austria	The goal of this article is to examine whether W3C XML schema provides a practicable solution for the semantic validation of standard based electronic health record (EHR) documents. With semantic validation, we mean that the EHR documents are checked for conformance with the underlying archetypes and reference model		ISO 13606 and openEHR	XML schema	EHR extracts based on ISO 13606 archetypes and CDA implementation guides were semantically validated with XML schema. Internal constraints have been transformed into XML object nodes
Duftschmid et al 42	Austria	Practical implementations of the ISO/EN 13606 standard have been scarcely reported on, and none of the publications describe in detail an efficient technique of archetype compliant data extraction from an electronic health record system. We address this research issue in the present report and focus on a specific class of largely research oriented electronic health record system, which is internally based on the EntityAttribute-Value Model	Medical University of Vienna	ISO 13606	XML, XML Schema e XSLT	Three archetypes were chosen for testing A form in its system was developed to contemplate the obligatory data of the archetypes. XML schema of origin (system data) and destination XML schema (archetype) were generated, resulting in an EHR extract archetyped through XSLT
Sachdeva and Bhalla 43	Japan	This study aims to provide different approaches in understanding some current and challenging concepts in health informatics. Successful handling of these challenges will lead to improved quality in healthcare by reducing medical errors, decreasing costs, and enhancing patient care		openEHR and ISO 13606	Various	Primary concepts of health information exchange of openEHR standard around the world. Analysis of the current needs to promote interoperability
Maldonado et al 44	Spain	This study presents the mapping and data transformation capabilities of LinkEHR-Ed, a visual tool to construct formal definitions of medical concepts in the form of archetypes, which can be defined on the basis on multiple electronic health record architecture such as ISO 13606	General Hospital	ISO 13606	XQuery	The process of transforming the data by LinkEHR and XQuery was validated at the General University Hospital of Valencia. Payment report data was modeled on archetype
Muñoz et al 45	Spain	This article provides (a) an introduction to the different standardization efforts related to the interoperable exchange of EHR around the world, and (b) a description of how the ISO/EN 13606 standard provides interoperable sharing of clinical information		ISO 13606		This study makes a comparative analysis between the different standards for electronic health record systems from requirements, such as quality, safety, and infrastructure. It expands on the ISO 13606 standard and suggests improvements, such as the governance of archetypes
Pahl et al 46	Germany/Malaysia/Brazil	This work investigates whether openEHR, with its reference model, archetypes, and templates, is suitable for the digital representation of demographic as well as clinical data. Moreover, it elaborates openEHR as a tool for modeling Hospital Information Systems on a regional level based on a national logical infrastructure	Obstetrics	openEHR		Demographics and clinical data related to obstetrics tested for existence and adequacy in the openEHR (CKM) archetype repositories, and concluded that it is a viable alternative to represent the data required by the Ministry of Health in Brazil, although these are not fully contemplated

Abbreviation: EHR, electronic health record.