Defining Interoperability in the Health Ecosystem
Interoperability is the ability of different information systems, devices or applications to connect, in a coordinated manner, within and across organizational boundaries to access, exchange and cooperatively use data amongst stakeholders, with the goal of optimizing the health of individuals and populations.
Health data exchange architectures and standards allow relevant data to be shared effectively and securely across the complete spectrum of care, within all applicable settings and with relevant stakeholders (including with the person whose information is being shared). Optimally, interoperability facilitates connections and integrations across these systems to occur regardless of the data’s origin or destination or the applications employed, and ensures the data are usable and readily available to share without additional intervention by the end user.
In the health ecosystem, interoperability furthers the goal of optimizing health by providing seamless access to the right information needed to more comprehensively understand and address the health of individuals and populations.
Systems participating in information exchange do so with varying degrees of interoperability. Each component, described below, demonstrates the types of exchange organizations may engage in and such exchanges may occur simultaneously within a single healthcare setting:
- “Foundational” interoperability develops the building blocks of information exchange between disparate systems by establishing the inter-connectivity requirements needed for one system or application to share data with and receive data from another. It does not outline the ability for the receiving information technology system to interpret the data without interventions from the end user or other technologies.
- “Structural” interoperability defines the structure or format of data exchange (i.e., the message format standards) where there is uniform movement of healthcare data from one system to another such that the clinical or operational purpose and meaning of the data is preserved and unaltered. Structural interoperability defines the syntax of the data exchange. It ensures that data exchanges between information technology systems can be interpreted at the data field level.
- “Semantic” interoperability is the ability of two or more systems to exchange information and to interpret and use that information.Semantic interoperability takes advantage of both the structuring of the data exchange and the codification of the data, including standard, publicly available vocabulary, so that the receiving information management systems can interpret the data. Semantic interoperability supports the electronic exchange of patient data and information among authorized parties via potentially disparate health information and technology systems and products to improve quality, costs, safety, efficiency, experience and efficacy of healthcare delivery.
- “Organizational” interoperability encompasses the technical components as well as clear policy, social and organizational components. These components facilitate the secure, seamless and timely communication and use of data within and between organizations and individuals. Inclusion of these non-technical considerations enables interoperability that is integrated into end-user processes and workflows in a manner that supports efficiencies, relationships and overall health and wellness through cooperative use of shared data both across and within organizational boundaries.
1 HIMSS Dictionary of Healthcare Information Technology Terms, Acronyms and Organizations, 2nd Edition, 2010, Appendix B, p190, original source: Wikipedia.
2 American Academy of Family Physicians (AAFP), Center for Health IT, 2013.
3 HIMSS Dictionary of Healthcare Information Technology Terms, Acronyms and Organizations, 3rd Edition, 2013, p. 75.
4 National Committee on Vital and Health Statistics (NCVHS) Report on Uniform Data Standards for Patient Medical Record Information, July 6, 2000, pp. 21-22.
5 Institute of Electrical and Electronics Engineers, IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries, New York, NY: 1990.
6 HIMSS Dictionary of Healthcare Information Technology Terms, Acronyms and Organizations, 2nd Edition, 2010, Appendix B, p190, original source: HIMSS Electronic Health Record Association.
7 National Academy of Medicine (NAM) Procuring Interoperability: Achieving High-Quality, Connected and Person-Centered Care, Washington, DC: 2018.