Tim Benson, HANDIHealth, Lee

1. Why is Interoperability hard?
Tim Benson

2. About me - Interoperability
• Author “Principles of
health
interoperability HL7
and SNOMED” 2nd
Edition Springer
2012
– text book for health
informatics

3. About me - Apps
• howRU
– health tracker –
PROM – free on App
store
• howRwe
– patient experience
monitor

4. 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).

5. Types
• Technical
– now a commodity
• Semantic
– the hard one
• Process
– where you get the benefits

6. The nub of the matter – size
matters
No of links = (n2-n)/n

7. Easy as one, two, three

8. Web of Care – Alzheimer’s

9. Web of Care – Breast Cancer

10. Logical Components of Apps
• Many to many relationships between each component type
• Apps may leverage existing components

11. 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

12. It is a problem of human
communication
• Source staff
• Source IT
• Interchange specialists
• App IT
• App users

13. 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

14. 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

15. 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.

16. Finally
“Keep it simple stupid”
Tim Benson
www.abies.co.uk
tim.benson@abies.co.uk