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Customizable shared Electronic Health Care Records require new mechanisms to dynamically generate user defined objects. An object model based on a semantic network of concepts has been implemented (pragmatic database model). This model offers an easier way to represent “archetypes” of user objects including the concepts, their relationships and the specific organization and representation of the associated knowledge that are necessary to model the context of production of record elements. The aim of this paper is the presentation of this framework and its implementation in an online electronic health record system using Java Web Services technologies. A web-based registry on tobacco was implemented according to this framework and is today daily used in 150 tobacco addiction centers.
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