What is Interoperability in Healthcare?

Physician discussing test results with patient

Interoperability in the Healthcare Ecosystem

Interoperability is the ability of different information systems, devices and applications (‘systems’) to access, exchange, integrate and cooperatively use data in a coordinated manner, within and across organizational, regional and national boundaries, to provide timely and seamless portability of information and optimize the health of individuals and populations globally. Health data exchange architectures, application interfaces and standards enable data to be accessed and shared appropriately and securely across the complete spectrum of care, within all applicable settings and with relevant stakeholders, including by the individual.

Four Levels of Interoperability:

  • Foundational (Level 1) – establishes the inter-connectivity requirements needed for one system or application to securely communicate data to and receive data from another

  • Structural (Level 2) – defines the format, syntax, and organization of data exchange including at the data field level for interpretation

  • Semantic (Level 3) – provides for common underlying models and codification of the data including the use of data elements with standardized definitions from publicly available value sets and coding vocabularies, providing shared understanding and meaning to the user

  • “New” Organizational (Level 4) – includes governance, policy, social, legal and organizational considerations to facilitate the secure, seamless and timely communication and use of data both within and between organizations, entities and individuals. These components enable shared consent, trust and integrated end-user processes and workflows

Access previous versions of the HIMSS definition

Interoperability Adoption and Implementation

We know what interoperability is, but what does interoperability look like in the real world? How are systems and stakeholders working to achieve it? This section of our resource library will provide examples of the technology and workflows that lend to the electronic exchange of health information, and national interoperability approaches and organizations that currently are driving efforts to a more interoperable health ecosystem.

For up to date information on where the United States stands on their progress to achieve health IT interoperability, please check out the ONC Health IT Dashboard for current metrics on adoption and use.

HIMSS Interoperability Call to Action

In this Call to Action, HIMSS asserts that we must achieve secure, appropriate, and ubiquitous data access and electronic exchange of health information, and provides guiding principles to inform health policy and spur our nation’s health sector to action.

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Where do you fit in?

The health interoperability ecosystem comprises individuals, systems and processes that want to share, exchange and access all forms of health information, including discrete, narrative and multimedia. Individuals, patients, providers, hospitals/health systems, researchers, payors, suppliers and systems are potential stakeholders within this ecosystem. Each is involved in the creation, exchange and use of health information and/or data.

An efficient health interoperability ecosystem provides an information infrastructure that uses technical standards, policies and protocols to enable seamless and secure capture, discovery, exchange and utilization of health information.

This definition was created by members of the HIMSS Interoperability & HIE Committee.

To learn more about this group and ways to get involved, visit the HIMSS Interoperability & HIE Community page.

Get Involved

Join the Interoperability and Health Information Exchange Committee.


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1 HIMSS Dictionary of Healthcare Information Technology Terms, Acronyms and Organizations, 4th Edition, 2017.
2 American Academy of Family Physicians (AAFP), Center for Health IT, 2013.
3 National Committee on Vital and Health Statistics (NCVHS) Report on Uniform Data Standards for Patient Medical Record Information, July 6, 2000, pp. 21-22.
4 Institute of Electrical and Electronics Engineers, IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries, New York, NY: 1990.
5 National Academy of Medicine (NAM), Procuring Interoperability: Achieving High-Quality, Connected and Person-Centered Care, Washington, DC: 2018.
6 Health Level 7 (HL7) Interoperability Project Team, Interoperability Definition: 2007.
7 Office of the National Coordinator for Health Information Technology, 21st Century Cures Act Interoperability Definition: 2016.
8 European Commission, New European Interoperability Framework: 2017.