Abstract
This chapter explores some of the reasons why healthcare interoperability is hard and why standards are needed. Interoperability can be looked at as layers (technology, data, human and institutional) involving different types of interoperability, technical, semantic, process and clinical. Standards are needed to tame the combinatorial explosion of the number of links required to join up systems, but usually require translation to and from an interchange language. Users and vendors are not always incentivised to interoperate. Apparently simple things such as addresses are more complex than they seem. Clinical information in EHRs is inherently complex, but complexity and ambiguity in specifications creates errors. Any interoperability project involves change management.
References
Palfrey J, Gasser U. Interop: the promise and perils of highly interconnected systems. New York: Basic Books; 2012.
HIMSS. HIMSS dictionary of healthcare information technology terms acronyms and organizations. Chicago: HIMSS; 2006.
IEEE. IEEE standard computer dictionary: a compilation of IEEE standard computer glossaries. New York: Institute of Electrical and Electronics Engineers; 1990.
Gibbons P et al. Coming to terms: scoping interoperability in healthcare. Final. HL7 EHR Interoperability Work Group, February 2007.
Shannon C. A mathematical theory of communication. The Bell Syst Technical J 1946; 27: 379–423 and 623–56.
Dolin R, Alschuler L. Approaching semantic interoperability in health level seven. JAMIA. 2011;18:99–103.
Grieve G. Dynamic health IT. Blog 2 Dec 2015 http://dynamichealthit.blogspot.co.uk/2015_12_01_archive.html
Hardin G. The tragedy of the commons. Science. 1968;162(3859):1243–8.
Anthony J. Personal communication 2008.
Rector A, Nowlan W, Kay S. Foundations for an electronic medical record. Methods Inf Med. 1991;30:179–86.
Health Informatics – Electronic health record communication – Part 1: Reference Model ISO 13606–1:2008.
Kalra D. Electronic health record standards. Year Book Med Inform, IMIA 2006; 45:136–44.
Weed L. Medical records that guide and teach. NEJM. 1968; 278: 593–9 and 652–7.
Schultz J. A history of the PROMIS technology: an effective human interface. In: Goldberg A, editor. A history of personal workstations. Reading: Addison Wesley; 1988.
Weed LL. Knowledge coupling: new premises and new tools for medical care and education. New York: Springer; 1991.
Weed LL, Weed L. Medicine in denial. Charleston: Createspace; 2011.
Purves I, Fogarty L, Markwell D. The Holy Grail or poisoned chalice: the GP-GP record transfer project. Newcastle: HIRI; 2001.
Walker R. A general approach to addressing. ISO Workshop on address standards: considering the issues related to an international address standard. Copenhagen. 2008: 23–7.
Benson T. Why industry is not embracing standards. Int J Med Inform. 1998;48:133–6.
Benson T. Prevention of errors and user alienation in healthcare IT integration programmes. Inform Prim Care. 2007;15(1):1–7.
Alderwick H, Robertson R, Appleby J, Dunn P, Maguire D. Better value in the NHS: the role of changes in clinical practice. London: The Kings Fund; 2015.
Kotter J. Leading change. Boston: Harvard Business School Press; 1996.
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Benson, T., Grieve, G. (2016). Why Interoperability Is Hard. In: Principles of Health Interoperability. Health Information Technology Standards. Springer, Cham. https://doi.org/10.1007/978-3-319-30370-3_2
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