Complete interoperability in health care institutions faces significant challenges in enabling meaningful use and incentives, as well as, maintaining a competitive edge. The key role of interoperability is to ensure high efficiency in various functions including research, finance and clinical operations, which enhance both profitability and the organization’s ability to collaborate with the necessary business partners (Oracle, 2010).
The greatest impediments to achieving system interoperability within and between health care organizations involve communication barriers. These barriers include both functionality and semantic hurdles that result in misunderstandings between senders and recipients. While the systems are tailored to ensure secure and precise transfer of information, they do not address the challenges arising from differences in language between the entities. For instance, a sender may convey a message in a standards-based file format using a set of lab codes to a recipient using proprietary files and codes, which poses challenges to the logical interpretation of the health information. To solve the problem, various devices are used to complement multiple functions between different entity systems. These devices demand a standard format to make the information relayed meaningful (Oracle, 2010).
The development of standards that involves the inclusion of vocabulary in new interoperability systems has enhanced the value of both clinical and administrative systems. Some of the new standards provide structures on the right format to represent a patient’s summary record. Such structures allow the users to input various elements of a patient’s medical history including personal information, medication history and lab results. Consequently, interoperability enhances the performance of various clinical systems including the laboratory information systems (LIS), Clinical Decision Support Systems (CDSS) and the Pharmacy Information Systems (PIS), as well as, administrative systems like Electronic Medical Records (EMR) and Patient Administration Systems (PAS). The evolvement of interoperability will enhance the physicians’ access to more complete patient information from any caregiver, which will ensure better diagnosis and administration of treatment (Oracle, 2010).
Technical standards for health information systems are necessary to allow physicians to share health data at local, regional, national and international levels. These standards help to define the required elements in the identification of participants, sharing of prescription knowledge and interchange of information, as well as, the definition of clinical standards and protocols. These standards also define various elements including names, data types, units and terminologies, in order to ensure interoperability between multiple e-health applications (Hammond, 2004).
An example of an identifier standard is the Omaha System, which is registered under Health Level Seven (HL7®) to support nursing practice. The Omaha System is a standardized research-based, comprehensive practice that documents patient care from admission to discharge (HIMSS, 2011).
An example of a general communications standard is the TC 215/WG 2 Data interchange, which is an ISO standard governed by the ISO Technical Committee 215 Health Informatics. Its functions include standardization in the field of information for health and health–information-and-communications technology (ICT) to achieve compatibility and interoperability between independent systems (HIMSS, 2011).
An example of a specific communications standard is the Unified Code for Units of Measure (UCUM), which facilitates clear electronic communication of entities within units, as a way to eliminate direct communication between humans. Support information is contained in the Logical Observation Identifiers Names and Codes (LOINC), which is supported by the Regenstrief Institute (HIMSS, 2011).
Information and communications technology (ICT) and technical standards provide support in the handling of hardware and software that support health information. These standards look into the storage and transmission of voice data, written data and picture data that are used in planning and management operations in the health sector (Hammond, 2004).
Hammond, W. E. (2004). The Role Of Standards In Electronic Prescribing. Perspective: Electronic Prescribing, 325-322.
HIMSS. (2011). Healthcare Informatics Organizations Participating in Standards Activities. Healthcare Informatics Organizations.
Oracle. (2010). Interoperability: A Key to Meaningful Use. An Oracle Technical White Paper.