The nomenclature of interoperability is growing and confusing. The openEHR specifications aim to provide a robust basis for sematic 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
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communication of an email with attached clinical pdf, by being human
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interpretible meets the definition of 'functional interoperabillity'.
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I would say no, simply because it then makes no distinction between
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simple communication (which can be extremely helpful) and 'functional
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interoperability' which I believe carries some notion of
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computability, helping place the document or information therein, more
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precisely within the recipient system, but falling short of the
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precise computability suggested by 'semantic interoperability'.
Semantic interoperability is hard to achieve because it requires both
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technical consensus and human, clinical agreement. I am starting to
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think that one of the values of archetypes is that they provide a
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natural levle of granualarity within the record that
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immediately supports funtional interoperability, whilst allowing for the organic
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development of semantic interoperability.
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As an example, within the NHS, there is a workstream devoted to
interoperability between the heath and social care services. Because
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of the lack of consensus around the data items to be included, it has
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been decided initially to use a CDA wrapper with some broad
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'functional' headings e.g Past Medical History, Mobility Assessment,
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Continence Assessment.
These accord very nicely to probable or actual archetypes which
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immediately support a level of functional interoperability.The maximal
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dataset approach allows each archetype to contain mutliple varieties
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of e.g. mobility assessment and backed by the reference model, enables
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minimal 'functional' representations of these in non-native systems.
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Semantic interoperability will only come about when 2 or more agencies
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agree to share a particular variety of mobility assessment, via
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further template level constraint, adjusting their internal processes
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to match but this is a social/organisational commitment, requiring no
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change in the technical representation on
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the archetype.