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Why is Interoperability hard?
Tim Benson
About me - Interoperability
• Author “Principles of health interoperability HL7 and SNOMED” 2nd Edition Springer 2012– text book for health
informatics
About me - Apps
• howRU – health tracker –
PROM – free on App store
• howRwe – patient experience
monitor
Definition
• Interoperability is ability of two or more systems or components to exchange information and to use the information that has been exchanged (IEEE 1990).
Types
• Technical– now a commodity
• Semantic– the hard one
• Process– where you get the benefits
The nub of the matter – size matters
No of links = (n2-n)/n
Easy as one, two, three
Web of Care – Alzheimer’s
Web of Care – Breast Cancer
Logical Components of Apps
• Many to many relationships between each component type• Apps may leverage existing components
Language
• Syntax– V2.3, V2.3A, V2.4, V2.5, V2.6, V2.7– CDA R2 L3, NHS CDA, greenCDA,
Consolidated CDA, CCD– EDIFACT, XML, RDF etc
• Semantics– Local codes, LOINC, SNOMED CT, Read
V2, V3 etc
It is a problem of human communication
• Source staff
• Source IT
• Interchange specialists
• App IT
• App users
What are the barriers?
• Culture of closed systems
• Receiving is much harder than sending
• No business case to upgrade an interface that works
• Interoperability has become a dirty word
Standards
• Standards are there to help
• Most standards are over-specified– Long– Complex– Arcane jargon
• You need agreed “profiles”– the minimum viable product to do your use
case
Metadata Standards
• Metadata is used for information discovery and retrieval
• Metadata conveys contextual information– Who about, from, to– What sort of information – When created, relates to– Where from, to.
