Interoperability in Healthcare


Interoperability in Healthcare

Seamless communication in healthcare is one of the medical organizations’ top priorities. The COVID-19 pandemic has shown us some of the shortcomings of technology in healthcare. We have reached a seemingly disconnected IT buzzwords threshold with data standards, electronic health records, patient portals, etc. What is necessary is to create a way of uniting different data centers to ensure the best possible healthcare delivery. In other words: we require healthcare interoperability.

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What is Interoperability

Healthcare Information and Management Systems Society defines interoperability as:

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.”

It allows for uninterrupted data sharing for the benefit of organizations and individuals.

What is Interoperability in Healthcare

The healthcare industry is in a peculiar position. Because of the sensitive nature of health data, it must be kept securely. Yet, regulations that might prevent data sharing could impede emergency interventions necessary to save lives. The solution? The development of standards that regulate how protected health information is stored and shared between organizations.
Interoperability in healthcare thus refers to a medical organization’s ability to quickly and securely access and share health data. Usually, it consists of the communication between an EHR, hospital management system, and anything in between.

Levels of Interoperability

As per HIMSS, we can differentiate between four different interoperability levels:

  • Foundational Interoperability: inter-connectivity which allows one system to share data with another.
  • Structural Interoperability: defines the format, syntax, and organization of data exchange.
  • Semantic Interoperability: defines the models and codification of data based on the publicly available value sets, providing the shared meaning.
  • Organizational Interoperability: encompasses governance, policies, social and legal frameworks involved in the sharing of data to ensure the development of trust and shared consent.

Healthcare Standards

Seamless connectivity can only be achieved by developing standards defining how health information can be preserved and shared. There are over 40 Standards Development Organizations (SDOs), and each may develop one or multiple standards, depending on its own goals and mission.

To achieve full healthcare interoperability, the Office of the National Coordinator for Health Information Technology (ONC) published the interoperability roadmap to guide the process of connected healthcare. It outlined that, by 2024, the goal is to:

Achieve nationwide interoperability to enable a learning health system, with the person at the center of a system that can continuously improve care, public health, and science through real-time data access.”

That further suggests that the goal is to achieve perfect, nationwide synchronization of interoperability in healthcare. HealthIT has already assembled a list of health IT standards, with a section on those we should pay close attention to. One of those arguably most widely implemented in the world is the standard of HL7.


Health Level Seven International is a non-profit, ANSI-accredited organization with a goal of standards development in order to maximize and empower the global exchange of healthcare data. FHIR (Fast Healthcare Interoperability Resource, pronounced “fire”) is a standard for healthcare data exchange.
Here at Vicert, we already have experience with EHR interoperability. Based on decades of experience, you can take a look at some of our FHIR solutions already.

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What is SMART

SMART Health IT was launched, proposing a universal API (application programming interface) in order to transform EHRs into platforms working on iPhone-like apps. Because FHIR spread first and became more implemented, SMART now works on top of FHIR. Take a look at how SMART on FHIR works, and check out our guide on utilizing a HAPI-FHIR library.

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Interoperability Challenges

While significant steps are being taken in order to make healthcare systems more interoperable, there are still significant challenges along the way. Although most organizations agree that interoperability is an essential component of the future, most still face similar challenges:

  • Lack of strategy: while there are numerous standards developing organizations, there still needs to be an active effort from healthcare organizations to create and implement a long-term strategy.
  • Disjointed data centers: the development of interoperability in healthcare is slowed down since organizations keep
  • their data in disconnected and disparate places. It is, therefore, necessary to adopt a unified center holding all of the organization’s information.
  • Legacy systems: many organizations still rely on outdated software/hardware. While we can still appreciate their usability in certain situations, their outdated methodologies can slow down today’s game-changing evolutions.
  • Cost: not everyone knows to achieve systems interoperability. That is why hiring experts is an excellent solution for your business needs, although smaller organizations might have limited resources to invest in implementing new technologies.

The Future of Interoperability in Healthcare

With Obama signing the 21st Century Cures Act, the future of interoperability in the healthcare industry seems bright. As a result, a significant step against information blocking was taken, and it is only reasonable to expect that the goals outlined by the ONC will be fully achieved by 2024. It remains to be seen whether interoperability in healthcare will be as valuable as the projections suggest.