Interoperability: what it is and how it is applicable to health
1 – What is interoperability?
In the context of Information and Communications Technology (ICT), interoperability is the capability of two or more applications to exchange data and information securely and automatically. It is of paramount importance for ensuring that systems, applications, or devices, often from different manufacturers and technologies, can communicate.
In other words, interoperability allows systems and technologies to effectively integrate to meet the users’ and organizations’ needs.
How does interoperability apply to health?
This capacity to share information is especially relevant in industries such as healthcare, where electronic logs need to be shared between different institutions, and in technologies such as the Internet of Things (IoT), where multiple devices need to work together to provide advanced functionality to users.
Thus, interoperability between healthcare systems enables healthcare organizations to share, exchange, and use information quickly and accurately, to improve healthcare coordination, quality of patient healthcare, and operational efficiency.
In this segment, listing some of the main applications, benefits, and challenges in interoperability between systems is possible. Please see below:
- Standardization of data and communication: in the healthcare area, it is common to find some standards for structure and formatting of healthcare data, as well as for communication between systems. Examples include the HL7, FHIR, and DICOM standards.
- Exchange of clinical information: health systems can share relevant clinical information such as patient records, test results, medical histories, and treatment plans. Thus, it is possible for healthcare professionals to have a broad view of actual patient’s health status, evaluating the entire clinical history of visits to other health institutions.
- Integration between systems: healthcare organizations use a variety of applications and devices. Interoperability ensures integration of these systems to work harmoniously and efficiently, generating greater quality information and, consequently, better decision-making in clinical treatments.
- Security and privacy: data protection is crucial. Systems must ensure strong security measures and compliance with privacy regulations, such as HIPAA in the United States, GDPR in the European Union, and LGPD in Brazil.
- Improved decision-making: Interoperability enables healthcare professionals to access information in real time, positively influencing clinical decision-making and leading to more accurate diagnoses and more effective treatments.
- Reduction of errors and costs: The exchange of information through interoperability reduces duplication of exams/tests, medical errors, and operational costs, improving the efficiency of the healthcare system.
- Patient engagement: Interoperability can also involve share of health information with patients, allowing them to take a more active role in their own care.
- Technological and cultural challenges: The achievement of interoperability can be complex due to systems diversity, resistance to change, as well as data ownership and access issues.
- Regulation and incentives: governments and health authorities play an important role in promoting interoperability by establishing regulations and offering financial incentives for their implementation.
- The future of digital health: Interoperability is a key part of the evolution of digital health, enabling advances such as shared electronic health logs, telehealth, and personalized medicine.
In short, interoperability in healthcare systems is essential to improve quality of care, reduce costs, and provide a more integrated and patient-centered experience. This is an ever-evolving field as technology and regulations continue to develop.
2 – Existing formats and interoperability standards
In healthcare, there are several standards and data formats commonly used to facilitate interoperability. Some of the most important formats and standards include:
- HL7 (Health Level Seven): set of international standards for exchange of electronic health information. HL7 uses messages and documents to represent clinical, administrative, and financial data. HL7 v2.x and HL7 FHIR (Fast Healthcare Interoperability Resources) are remarkable examples.
- DICOM (Digital Imaging and Communications in Medicine): widely used standard for exchanging medical images such as X-rays, MRIs, and CT scans. It defines file formats and communication methods for digital medical images.
- CDA (Clinical Document Architecture): Clinical document standard developed by HL7 that provides an XML structure for representing medical documents such as hospital discharge reports and health summaries.
- SNOMED CT (Systematized Nomenclature of Medicine – Clinical Terms): Terminology that provides a comprehensive set of clinical terms, composed of concepts, descriptions, correlations, and categories, used to represent clinical concepts in electronic health logs. This is used to code diagnoses and procedures that can be used to record information about patients’ health.
- LOINC (Logical Observation Identifiers Names and Codes)**: medical observation coding system that produces standardized codes for laboratory test results and clinical observations.
- ICD (International Classification of Diseases): international classification of diseases used to code clinical diagnoses and health statistics. ICD-10 is widely used, but ICD-11 is already under development.
These are just some examples of the standards and formats used and their respective applications in the health industry to ensure interoperability of information systems. The choice of format or standard depends on the specific requirements of the healthcare system and local and national regulations.
Effective interoperability involves adopting and complying with these standards to ensure the secure and accurate exchange of health information among systems and organizations. Each of these standards serves a specific purpose, facilitating the exchange of information between different healthcare systems and professionals.
Thus, interoperability in healthcare is essential to provide safer, more effective, and patient-centered care, as well as to facilitate medical research and improve the efficiency of healthcare systems.
