The Challenge of Semantic Interoperability

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Semantic interoperability describes the process of creating a common vocabulary so computers in different systems can accurately share information. It’s vital in healthcare, where patient outcomes can depend on the ability to quickly transmit information from one system to another.

Achieving semantic interoperability presents challenges for software engineers and health informatics professionals. They include mapping data elements to how they are defined in each health care system’s Electronic Healthcare Records (EHRs), an enormous task as there is a lot of variation in how information is collected, coded and processed

The Value of Semantic Interoperability in Healthcare

Semantic interoperability is central to achieving many of the goals in modern healthcare. As more health systems turn to value-based payment models that focus on patient outcomes and efficiency, the ability to seamlessly transfer patient data is critical.

Semantic interoperability is viewed as critical for a number of healthcare initiatives including data warehousing, quality improvement and population health management. It’s also key to the creation of health information exchanges.

In a white paper on semantic interoperability, Orion Health noted that clinicians already spend a great deal of time assessing complex data and making connections between issues such as disorders, medications and diagnostic imaging. Semantic interoperability can provide a significant amount of support in dealing with these complex issues.

A 2014 study published by the National Institutes of Health reported that  the best healthcare outcomes depend on “the power of healthcare information” that is  “readily available and easily interpretable by both humans and machines.”

In another sign of the importance of semantic interoperability, the U.S. Secretaries of Veterans Affairs and Department of Defense committed  this year to adopting semantic interoperability. In a joint statement, they said they plan to roll out an EHR system that will allow the two agencies “to share patient data seamlessly.”

Cerner Corp. is creating the systems for both agencies.

The Challenges of Making Semantic Interoperability a Reality

International data standards, known as the Fast Healthcare Interoperability Resources (FHIR) are meant to support a smooth transition to semantic interoperability. FHIR creates standards for use in all healthcare computing systems with the goal of creating normalized data that can be read by all systems.

That’s also the goal of the Argonaut Project, launched by private industry to build upon the guidelines established by FHIR and create common computer language standards for all healthcare providers. The project includes representatives from the Mayo Clinic, Accenture, Cerner, Meditech, Boston Children’s Hospital, Intermountain and Beth Israel Deaconess.

The headwinds slowing efforts in making semantic interoperability a reality revolve around the sheer size of the task. Every healthcare operation – hospitals, physician clinics, diagnostic labs, outpatient clinics, long-term care facilities, community health centers – all have different systems.

Every step toward creating systems that can transmit information seamlessly is taken with the knowledge that a mistake which causes one system to misread information from another could result in severe medical consequences. That alone will make the transition to semantic interoperability slow.

But because the reward is so high, the work will continue. As Keith Campbell, director of informatics architecture at the U.S. Veterans Health Administration, said in an interview with Healthcare Informatics, healthcare organizations want to get the most value from their data.

“Part of getting better value out of their data,” he said, “is having it be better normalized.”

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