Interoperability

The nomenclature of interoperability is growing and confusing. The openEHR specifications aim to provide a robust basis for semantic interoperability: when machines as well as people can process the information. Here, to help with the issues around interoperability is a post on the list from Ian McNicoll:

The initial argument really hinges on whether the most minimum communication of an email with attached clinical pdf, by being human interpretible meets the definition of 'functional interoperabillity'. I would say no, simply because it then makes no distinction between simple communication (which can be extremely helpful) and 'functional interoperability' which I believe carries some notion of computability, helping place the document or information therein, more precisely within the recipient system, but falling short of the precise computability suggested by 'semantic interoperability'.

Semantic interoperability is hard to achieve because it requires both technical consensus and human, clinical agreement. I am starting to think that one of the values of archetypes is that they provide a natural levle of granualarity within the record that immediately supports funtional interoperability, whilst allowing for the organic development of semantic interoperability. As an example, within the NHS, there is a workstream devoted to
interoperability between the heath and social care services. Because of the lack of consensus around the data items to be included, it has been decided initially to use a CDA wrapper with some broad 'functional' headings e.g Past Medical History, Mobility Assessment, Continence Assessment.

These accord very nicely to probable or actual archetypes which immediately support a level of functional interoperability.The maximal dataset approach allows each archetype to contain mutliple varieties of e.g. mobility assessment and backed by the reference model, enables minimal 'functional' representations of these in non-native systems. Semantic interoperability will only come about when 2 or more agencies agree to share a particular variety of mobility assessment, via further template level constraint, adjusting their internal processes to match but this is a social/organisational commitment, requiring no change in the technical representation on the  archetype.