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
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 immediatley
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.