Jul 26, 2021

Happy 12 Year Anniversary ART-DECOR®





ART-DECOR® is an open source tool suite that aims at interoperability solutions in the healthcare sector. This year October 1st, it’s ART-DECOR’s 12th birthday. Reason enough to take a short look back in history.

The Early Years

Back in 2008 was the beginning of the tool – in those times still known as “DECOR” only and without a User Interface – and it started for some Dutch projects, including Perinatology, General Practice Information Exchange, Diabetes Care. Later in 2009, also a Laboratory project eLab with IHE Netherlands in the lead and some other projects without Nictiz followed.


All these projects had in common, that healthcare IT specifications were documented on huge spreadsheets, that vary even from project to project. In three large areas, the sheets collected the functional healthcare provider view, scenarios to the very left and finally the technical specifications. Some of our readers may vividly remember this “methodology”.

The DECOR method

The DECOR method is used since then as a consistent replacement for the spreadsheets and to overcome varieties, inconsistencies and errors when going through the life cycle of health IT specifications, from requirement documentation, scenarios, profiles and support implementation as well as the testing and production phase.


In the beginning, the so-called called DECOR specifications were a collection of XML-based definition files and a set of transformation scripts, mainly used by batch processing to create documentation and particularly test and validation methods for data instances using ISO schematron.

Making it ART

In 2009, Gerrit Boers added the User Interface and a database to DECOR. Since then, the tool has the name ART-DECOR (Advanced Requirements Tooling – Data Elements, Codes, OIDs and Rules). Next to the introduction of an XML database, a comprehensive Query language and an Xforms framework was introduced for further development.

ART-DECOR Expert Group

At almost the same time the ART-DECOR® Expert Group was formed initially comprised of specialists from Netherlands and Germany, to coordinate and drive the development. 


The tool quickly became a home for other foreign projects such as the Dutch Infrastructure Specifications for the so-called AORTA, the CDA specifications of the Deutsche Rentenversicherung DRV in 2009, HL7 Germany in 2010, and some European projects in 2011 such as the Information Exchange Dialysis Treatment and for the European Renal Association and regional e-health projects in Norway and Lithuania. 

ART-DECOR is used since then also for various integration projects in Europe. For example, after the epSOS (Smart Open Services for European Patients) project finalized its first phase in 2014, subsequent project phases use the tool for development and maintenance of the specifications. The eHealth Digital Service Infrastructure (eHDSI for cross-border health data exchange under the Connecting Europe Facility (CEF) set up and started deploying specifications for Patient Summary and e-prescription. Since the first official release in 2014 many other publications followed.

2015 and ongoing

ART-DECOR and IHE Europe signed a Memorandum of Understanding in 2015 aiming on synergistic tooling: The ART-DECOR tools suite and IHE Gazelle Objects Checker facilitate the creation and consistent standardized documentation of CDA based specifications and support rigorous compliance validation and testing.

The collaboration was also subject on the ART-DECOR Specification Developer Days at the International HL7 Interoperability Conference (IHIC) in Prague February 2015. Along with tutorials and speakers about special topics from Nictiz in the Netherlands, and IHE Europe, also the collaboration with IHE Gazelle Object Checker for an efficient specification, maintenance, testing and validation tool suite was explained.

ART-DECOR Release 2.0 was published in 2017 and a lot of features were added, also through the feedback of the growing community. The tool is subject of several Bachelor and Master theses in the area of medical informatics.

ART-DECOR® Open Tools

In 2017, ART-DECOR® Open Tools has been established as a Company to handle all commercial aspects of the ART-DECOR® tool suite, offers commercial support for customers working with the tool and strategically complements the ART-DECOR® Expert Group that drives the development.


Around the start of a new decade

Meanwhile specifications for National Infrastructures in the Netherlands, Austria (ELGA), Switzerland (e-health Suisse) and Poland are hosted by ART-DECOR, as well as support for large national and international organizations including clients of IHE Europe, the Deutsche Gesetzliche Unfallversicherung DGUV or projects such as the Medical Informatics Initiative in Germany, the Ministry of Health of British Columbia, Canada, the Sequoia project in the US and regional specifications in Italy and Denmark (and others not listed here).

The New Story Begins

In January 2020, right before the Corona crisis, the ART-DECOR Experts met in Berlin for their strategy and planning meeting and decided to move on with a new Frontend Development Framework and a complete rewrite of the User Interface. A New Story began: ART-DECOR® Release 3.


After months of inspiring development, ART-DECOR® Release 3 will be published step by step starting now and brings along many new features and improvements. We will continue to inform you here with subsequent Blogs around the Release 3 series.

Title Photo: © sarawut795 – stock.abobe.com 

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