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The openEHR architecture is different from other architectures in the health domain, and in most domains. The main difference is that it doesn't only have an object model from which to create software, database schemas etc, it also has also a layer of domain models called archetype FAQs. As a consequence, the part of the architecture that is defined as object models (known as the "reference model" or RM) is smaller and more generic than many models. The RM can be considered for most purposes as a typical object model. To get a feel for the architecture, the Architecture Overview (PDF) is a good place to start.

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How versioning is implemented will have a major impact on the storage approach. Logically, every top-level object in openEHR is versioned, meaning that separate versions from each commit are always available. Further, the Contribution concept means that any particular commit causes a set of versions (often called a "change-set") to be committed in one go. Rolling back to previous states of the data means retrieving the state of the data at each Contribution commit point, not just at arbitrary previous points in time. See the change_control package in the Common IM|svn/specification/TRUNK/publishing/architecture/rm/common_im.pdf|\.

We also have to be mindful of the requirements of versioned openEHR data - any solution should take account of the following features of openEHR data:

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An object database on the other hand is a proper scalable and secure database management system management system that supports querying as well as persistence - in other words, like a relational databases system, except that it deals directly with objects rather than tables. Usually some object-flavoured SQL will be supported. Example products include Matisse (a language-neutral database with SQL querying). There are also clinical information systems based on object databases such as InterSystems Caché and Jade. Zope is a Python-based object database that is quite widely used behind active websites and has been used in health information systems, e.g. FreePM, OIO.

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An object/relational (O/R) product  is is one that ultimately relies on an underlying relational database to store the data but does all the hard work of turning objects into relational form to write into the database. From the programmer's point of view, it may look just like an object database. The advantage of this approach is that it allows you to use an existing relational database in your environment that is already required for some other purpose. O/R products solve the problem of performing the object/relational mapping in a generic way, but they don't a priori know anything about your data. In particular, they don't know about what the patterns of querying are, where the business object boundaries are, or anything else. Some products may allow such things to be specified. 

The default situation will be that using an O/R product on a typical object model over a relational database will result in numerous tables and extremely fine-grained object storage and retrieval, with the consequent performance penalty. Most likely, an O/R product will not know about business object boundaries and will do the same thing as an object database with a naively designed object model: store and retrieve everything reachable by reference-following. Avoiding these problems means at a minimum reducing the granularity of the objects being stored; see below.

Examples of object/relational products include: Apache ObJectRelationalBridge (OJB) for Java and  and DataObjects.NET.

Relational databases

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