Can OpenEHR, ISO 13606 and HL7 FHIR work together? An agnostic perspective for the selection and application of EHR standards from Spain

Due to the heterogeneity of Electronic Health Record (EHR) standards, the decision-making teams, who are not experts in health information, express confusion for selecting and applying these resources in their data platforms. For this reason, a group of experts has analyzed strengths and weaknesses about design, modeling capabilities, flexibility and resources implemented of three relevant standards based on Detailed Clinical Models: OpenEHR, ISO 13606 and HL7 FHIR. Thus, it was concluded that: (1) they are useful for the purposes for which they have been designed and show shortcomings in those for which they have not; (2) they are functionally compatible in health data platforms and methodologies developed in a standards-agnostic perspective; and (3) they are conceptually and technically compatible with each other, so the choice of one or the other does not have a high impact as long as one starts from the one richer in modeling capabilities and flexibility.