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openEHR EHR Conformance Guide

Issuer: openEHR Specification Program

Release: CNF latest


Revision: [latest_issue]

Date: [latest_issue_date]

Keywords: conformance

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The openEHR Foundation is an independent, non-profit foundation, facilitating the sharing of health records by consumers and clinicians via open specifications, clinical models and open platform implementations.


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Issues: Problem Reports

Amendment Record

Issue Details Raiser Completed

CNF Release 1.0.?


SPECCNF-6: Initial Writing.

P Pazos

22 Oct 2021


This specification was developed and is maintained by the openEHR Specifications Editorial Committee (SEC).


  • 'openEHR' is a trademark of openEHR Foundation

1. Preface

1.1. Purpose

This document describes the openEHR EHR System Conformance Definition, which states a test schedule and content of tests to be used to determine the conformance of EHR solutions to openEHR EHR specifications. The audience of this document includes:

  • Software development organisations developing EHR systems;

  • Customer organisations.

Useful references for reading this document include:

1.3. Status

This specification is in the DEVELOPMENT state. The development version of this document can be found at

Known omissions or questions are indicated in the text with a 'to be determined' paragraph, as follows:

TBD: (example To Be Determined paragraph)

1.4. Feedback

Feedback may be provided on the openEHR Conformance forum.

Issues may be raised on the specifications Problem Report tracker.

To see changes made due to previously reported issues, see the CNF component Change Request tracker.

2. Glossary of Terms and Acronyms

The following terms and acronyms are used in this document.

Term Meaning


Application Programmer Interface.


Clinical Decision Support.


Representational state transfer, a type of web service. REST-compliant Web services allow requesting systems to access and manipulate textual representations of Web resources using a uniform and predefined set of stateless operations.


System under test.

3. Overview

Conformance testing is used as the basis of product certification, and has the following goals:

  • Tendering: enable tendering authorities to state formal criteria for compliance in tenders

  • Protection for solution developers: enables bona fide vendors and other developers to prove the quality of their solutions compared to other offerings claiming conformance

  • Protection for procurement: provides a way of ensuring that purchased solutions can be contractually guaranteed to perform in certain ways

The following use cases…​.

conformance framework use cases
Figure 1. Use Cases

4. Artifacts


conformance framework artifacts
Figure 2. Conformance-related artifacts

5. Product Categories


conformance framework product cats
Figure 3. Product categories

6. Test Items

What could be tested are the operations per interface of the SM. In the Conformance Specification there should be a criteria that tests at least one success case, one case for each possible error, and if there are border cases, one test for each border case. This is abstract, is what to test but doesn’t specify how to test. In the Testing Technical Framework it is specified how to test and which specific data sets to use.

conformance framework test items
Figure 4. Test items

Each product category should offer a subset of the interfaces specified in the SM. Then those 'contracts' are used to verify conformance on each category. Each product category is associated with one or more 'components' of the SM which means they provide the interfaces defined by those components.

conformance framework test items per cat
Figure 5. Test items associated with products