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What are the four levels of interoperability?
Interoperability ensures that different technological systems work together, resulting in optimized workflows and improved care coordination. Hospitals should recognize the significance of this capability. According to a recent survey, healthcare leaders are planning to increase their spending on interoperability measures by 5-20% compared to the previous year.
While interoperability might seem complex, this data exchange can be broken down into four distinct types. With 62% of hospitals reporting that they were functioning on all levels of interoperability in 2021, it’s best practice to know where your healthcare organization stands so you can make improvements toward streamlining the flow of clinical information.
Foundational Interoperability
As the first of the interoperability levels, foundational interoperability is defined as having “inter-connectivity requirements needed for one system or application to securely communicate data to and receive data from another.”
Foundational interoperability is necessary for other types of interoperability to perform as expected. At the same time, hospitals can’t use meaningful data with only this level.
For example, securely transferring a patient’s lab results with a secure messaging app relies on foundational interoperability, yet the system can’t fully interpret the incoming information without the other levels of interoperability.
Structural Interoperability
Structural interoperability is when data is successfully transmitted between systems while being preserved in a recognizable and usable way by the receiving end. Compared to other interoperability levels, structural interoperability emphasizes the syntax and format of the information exchange.
An example would be using HL7 standards to exchange patient information between one brand of electronic health record (EHR) with another brand at a different facility, i.e. transferring information from Epic to Cerner.
Semantic Interoperability
Semantic interoperability refers to transferring information in a way that preserves the original intent. AI and machine learning are used to “translate” and ensure that the data is clear on both ends.
For example, different health systems might use different codes or abbreviations for an allergy. One system might enter “penicillin allergy” in the record. Another might use the SNOMED CT (Systematized Nomenclature of Medicine — Clinical Terms) code 91936005. Both systems require semantic interoperability to achieve this seamless communication.
Organizational Interoperability
In previous years, interoperability was traditionally described with three levels. Organizational interoperability is the most recent addition by HIMSS and includes policy, social, and legal considerations with its technical components.
Organizational interoperability differs from the previous levels of interoperability by being more closely related to the 21st Century Cures Act, which further supports the access and exchange of electronic health information (EHI).
One specific case is a Health Information Exchange (HIE) network that connects different organizations to share patient data for better care coordination.
Interoperability is not just empty jargon—but a significant capability that will set up hospitals for future success. With a deeper understanding of the different types of interoperability, you can identify your healthcare organization’s current abilities and make the right moves toward a better experience for your care teams, non-clinical staff, and patients alike.
