Global Adoption of openEHR Clinical Data Repositories: A Vendor and Community Survey
- 1Digital Health Center, Berlin Institute of Health at Charite - Universitaetsmedizin Berlin, Berlin, Germany
Abstract
The openEHR standard provides an open, vendor-neutral architecture for clinical data repositories (CDRs), yet its real-world deployment has not been systematically documented. We conducted a dual-perspective survey combining a vendor survey of openEHR CDR providers with a community survey of openEHR practitioners. Eleven vendor organisations reported deployments across 22 countries and over 100 institutions and health regions. A complementary community survey (n=29, 17 countries) provided context on regulatory environments, adoption drivers, and barriers. Combined, the surveys cover 28 countries, 26 of them with a reported openEHR CDR deployment. Three findings emerge: openEHR has achieved national-scale presence through two distinct channels. Through vendor-market convergence, openEHR-based systems cover the majority of regional health authorities without a national mandate, including 19 of 21 Swedish regions, 3 of 4 Norwegian health regions, and 16 of 21 Finnish wellbeing services counties. Through national health record adoption, governments have built or procured national systems on openEHR as their technical foundation, including Ireland, Malta, Greece, Jamaica and Slovenia. Across Europe, this constitutes an openEHR-based interoperability infrastructure already in place across multiple EU member states. We identified no country in which openEHR is named in binding national regulation, creating structural fragility and an unrealised opportunity for alignment with the European Health Data Space (EHDS). Second, 61% of deployments serve primary use only, and 12% support both primary and secondary use. Third, lack of openEHR-specific knowledge is the most consistent adoption barrier across all geographies and deployment tiers. Adoption is driven by practitioner need and innovation, not by regulatory mandate.
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BibTeX
@misc{kohler2026global,
title = {{Global Adoption of openEHR Clinical Data Repositories: A Vendor and Community Survey}},
author = {S. Kohler and F. Meyer-Eschenbach and X. Michelena and M. Marschollek and R. Eils},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.27.26361529},
url = {https://www.medrxiv.org/content/10.64898/2026.08.27.26361529v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Global Adoption of openEHR Clinical Data Repositories: A Vendor and Community Survey
AU - S. Kohler
AU - F. Meyer-Eschenbach
AU - X. Michelena
AU - M. Marschollek
AU - R. Eils
PY - 2026
DA - 2026/08/27
PB - medRxiv
DO - 10.64898/2026.08.27.26361529
UR - https://www.medrxiv.org/content/10.64898/2026.08.27.26361529v1
AB - The openEHR standard provides an open, vendor-neutral architecture for clinical data repositories (CDRs), yet its real-world deployment has not been systematically documented. We conducted a dual-perspective survey combining a vendor survey of openEHR CDR providers with a community survey of openEHR practitioners. Eleven vendor organisations reported deployments across 22 countries and over 100 institutions and health regions. A complementary community survey (n=29, 17 countries) provided context on regulatory environments, adoption drivers, and barriers. Combined, the surveys cover 28 countries, 26 of them with a reported openEHR CDR deployment. Three findings emerge: openEHR has achieved national-scale presence through two distinct channels. Through vendor-market convergence, openEHR-based systems cover the majority of regional health authorities without a national mandate, including 19 of 21 Swedish regions, 3 of 4 Norwegian health regions, and 16 of 21 Finnish wellbeing services counties. Through national health record adoption, governments have built or procured national systems on openEHR as their technical foundation, including Ireland, Malta, Greece, Jamaica and Slovenia. Across Europe, this constitutes an openEHR-based interoperability infrastructure already in place across multiple EU member states. We identified no country in which openEHR is named in binding national regulation, creating structural fragility and an unrealised opportunity for alignment with the European Health Data Space (EHDS). Second, 61% of deployments serve primary use only, and 12% support both primary and secondary use. Third, lack of openEHR-specific knowledge is the most consistent adoption barrier across all geographies and deployment tiers. Adoption is driven by practitioner need and innovation, not by regulatory mandate.
ER -