Principles of Health Interoperability HL7 and SNOMED

1. Chapter 2
Why Interoperability is Hard
Presented by:
Dr.Fahad Alsheref

2. Outlines
• What is Interoperability?
• Benefits
• Need for a Lingua Franca
• Electronic Health Records
• System Analysis

3. What is Interoperability?
• Interoperability is ability of two or more
systems or components to exchange
information and to use the information that has
been exchanged.
• The HL7 EHR Interoperability Work Group has
developed a framework, which covers three
different points of view:
– Technical interoperability
– Semantic interoperability
– Process interoperability

4. Technical interoperability
• Technical interoperability moves data from
system A to system B, neutralizing the effects of
distance.
• It is domain-independent.
• It does not know or care about the meaning of
what is exchanged.
• One of the foundations of technical
interoperability is Claude Shannon’s information
theory, which proved that it is possible to
achieve 100% reliable communication over a
noisy channel.

5. Semantic interoperability
• Semantic interoperability ensures that system A
and system B understand the data in the same
way.
• It allows computers to understand, interpret,
and use data without ambiguity.
• This is specific to domain and context and
usually involves the use of codes and identifiers.
• Semantic interoperability is at the core of what
we usually mean by healthcare interoperability.

6. Process interoperability
• Process interoperability coordinates work
processes, enabling the business processes at
the organizations that house system A and
system B to work together.
• Process interoperability is achieved when
human beings share a common understanding,
so that business systems interoperate and work
processes are coordinated.
• The importance of reengineering work
processes to take full advantage of electronic
systems has long been recognized.

7. Benefits
• The benefits of joined-up health care, to
provide the right information at the right time
and place, are predicated on deploying and
using standards that enable computer systems
to exchange information in a way that is safe,
secure, and reliable.

8. Number of interfaces needed to connect
N systems increases using the formula
(N²–N)/2.

9. Benefits
• Examples of functions needing interoperability
cover a wide range:
– Requests for investigations such as
laboratory tests and radiology
– Prescriptions for medication and other
therapy in hospitals and in the community
– Orders for nursing care, equipment, meals,
and patient transport
– Investigation reports from laboratories,
radiology, and other diagnostic departments

10. Need for a Lingua Franca
• lingua franca:any language that is widely used
as a means of communication among speakers
of other languages.
• There are two translations in any interchange;
first from the native language of System A to
the lingua franca; second, from the lingua
franca to the native language of System B.
• lingua franca (such as a version of HL7)

11. Need for a Lingua Franca
• When we talk about a language we mean both
the syntax, grammar or information structure of
the language and its semantics, vocabulary, or
terminology.
• Rosetta stone from ancient Egypt.
• The Rosetta stone contains the same
proclamation in three languages, used by the
priests (Hieroglyphic), the court (Greek), and
the people (Demotic).

12. Electronic Health Records
• The EHR is not a collection of facts, but a set of
observations about a particular patient, which
have been made by clinicians, each at a specific
time and place for some purpose.

13. System Analysis
• One person may have several names and
several addresses, which they can change at
will. For example, a woman may use both her
maiden and married names in different
contexts. One person may use several addresses
(home, work, previous, holiday, etc.) and each
address may also be associated with different
people, such as family members, friends, or
colleagues.

14. System Analysis
• One way to simplify the problem is to distinguish
clearly between information that needs to be
processed by computer and that which needs to be
read and understood by human users.
• Computer processing is essential when data
elements need to be identified, matched, retrieved,
or counted. This type of information must be
structured, complete, unambiguous, and validated.
These are relatively few but important.

15. Thank for your listening