Table 2.

The comparison between the Fast Healthcare Interoperability Resources (FHIR) and openEHR approaches.

Comparison aspects	FHIR approach	OpenEHR approach
Scope and purpose	FHIR is a new Health Level Seven specification for defining the structure and semantics of health care information that is involved in health information exchange. It is not engineered for persistence and the modeling of all electronic health record data.	OpenEHR defines the structure and semantics of all health information in electronic health records and is engineered for persistence and health information exchange.
Reference model	The model does not have a separate layer and uses a mix of data types and structural resources.	The model has a discrete and stable layer that comprises building blocks, upon which archetypes are built.
Information model	FHIR	OpenEHR archetypes
Composition and constraints	FHIR profile	OpenEHR template
Extensibility	FHIR extensions that are discoverable via Uniform Resource Identifiers	New archetypes or archetype specializations for adding new data items, value sets, and tighter constraints
Localization	Localization is not well defined. Localization is possible with extensions, but this is under review.	Localization is a well-defined section in archetypes for data elements and value sets.
Terminology support	Supports terminology bindings	Supports terminology bindings
Reference relationship	The resources may refer to those outside of FHIR.	The archetypes allow for the linking of other archetypes via an archetype slotting mechanism.