2024 openEHR conference series
Interview at EHRCON24 5th November 2024, Reading, UK
Sam Heard
Empowering Aboriginal Health through OpenEHR: Sam's Vision for Community-Controlled Lifelong Records
Dr Sam Heard MD, FRACGP, MRCGP, FACHI has served as Chair of the OpenEHR Foundation Board since June 2023 and is a practising clinician in inner London and Australia's Northern Territory.
He initiated the Good European Health Record project in the early 1990s, co-founded Ocean Informatics in 2002, served as OpenEHR CEO until 2012 and co-chaired the HL7 EHR Technical Committee, driving EHR standardisation across UK and Australian programmes.
Interview summary
Sam Heard is a GP working in a large Aboriginal community-controlled health service in Central Australia, and one of the original architects of openEHR. His involvement began through a European project to build a shared electronic health record, which did not fully succeed but laid the groundwork for what eventually became openEHR - a process he describes as requiring a massive amount of pain and energy across roughly a decade of work from the late 1990s.
His current context gives the interview an unusual grounding. Working across 16 clinics with a shared pharmacy record, Sam is directly confronting what happens when system barriers meet communities where healthcare access is already precarious. If a patient drives 500 kilometres to see a doctor and finds no appointments available, they stop getting care. The openEHR vision he describes - where a patient's blood pressure readings from a home device satisfy the monitoring requirement for prescription renewal, removing the need for a clinic visit - is not an abstract future state for him but an immediate practical necessity. Every unnecessary barrier has a measurable human cost.
Beyond the clinical, Sam raises a dimension absent from the other interviews: the significance of health records to Aboriginal communities as a means of reconnecting families separated by the stolen generations. Records going back 20 years carry value far beyond clinical history. That this data remains locked in proprietary systems is, for him, a specific and serious governance failure. His broader vision is of data sovereignty for Aboriginal health services built on an openEHR platform - one where patients control which parts of their record sit where and for what purpose, and where the record can follow the person rather than the institution. The architecture, he notes, is already designed for this. The gap is political will and procurement practice, not technical capability.