Naveed Dogar presented a paper at the 2026 eSociety conference in Zagreb, entitled Elfin – An Ontology-Based Health Record For The Fracture Liaison Service.
This paper describes the implementation of an ontology-based Electronic Health Record for clinical management and reporting in a Fracture Liaison Service. The system, called Elfin, was first implemented in live practice at the Nuffield Orthopaedic Centre, Oxford, in 2014.
Elfin uses the model-driven cityEHR open source health record system and was originally developed using an agile methodology (iterative and user-centered). It was then iteratively refined in response to user feedback on the live implementation.
In 2021, a second version of the system was developed (Elfin2) using a new specification of the underlying clinical information model and incorporating feedback and lessons learned from the first implementation. Elfin2 has never been introduced into live operation but the original Elfin has continued in live use and was more formally evaluated in 2025, in preparation for the development of Elfin3 which includes the additional design goal of creating a system that can be used in any international setting.
