What if different health systems, devices, and data sources share vital information seamlessly and instantly? This concept, known as healthcare interoperability, allows timely, informed decisions and ultimately ensures the best possible outcomes for patients. 

The Healthcare Information and Management Systems Society (HIMSS) defines four levels of healthcare interoperability: foundational, structural, semantic, and organizational. Each level builds upon the previous one to create an integrated and effective ecosystem. Understanding these levels is critical to drive transformative change in healthcare. In this blog, we explore four levels of interoperability and the critical benefits they unlock for healthcare.  

What is Interoperability?

According to the HIMSS, interoperability is the capability of different information systems, applications, and devices to access, integrate and use data in a coordinated manner within and across organizations, regions, or nations. When applied to healthcare data, this concept is referred to as healthcare interoperability. 

Interoperable systems automatically exchange accurate, accessible, and secure data. Achieving this requires all stakeholders to align on shared standards, technologies, and terminologies. 

Why is Interoperability Important in Healthcare?

Healthcare interoperability allows disparate healthcare IT systems to seamlessly share data regardless of geographic boundaries. This capability is essential for optimizing patient care, streamlining healthcare facilities’ workflows, and supporting data-driven clinical decision-making. The main benefits of interoperability in healthcare include fast and improved care processes, effective chronic disease management, and reduced burden on healthcare professionals.  

This ability guarantees that clinicians and healthcare providers have the right information at the right time. As a result, they can quickly access patient data like diagnoses, allergies, and medications during routine care transitions, emergencies, or natural disasters.  

Chronic diseases such as diabetes and cancer require coordinated care, and interoperability facilitates this by enabling real-time health data exchange. It also breaks down data silos, supports personalized treatment plans, and accelerates decision-making.  

Managing administrative tasks can be a major challenge for healthcare professionals, taking time away from patient care. Interoperability addresses this challenge by streamlining workflows, reducing redundant tests, and improving the accuracy of medical records, ultimately easing physician workload. 

What are the Four Levels of Interoperability in Healthcare? 

As interoperability is a complicated concept, the HIMSS splits this ability into four levels. Let’s dive into each level for a more comprehensive understanding of interoperability’s working mechanism. 

Foundational Interoperability (Level 1) 

Foundational interoperability is the most basic level of health IT data exchange, enabling one system to send information to another. For example, sharing a PDF summary of a patient’s hospital stay with another system illustrates this level.  

While this forms a critical building block for health information exchange (HIE), it has limitations: systems at this level cannot interpret or meaningfully use the exchanged data. The focus is on the technical infrastructure, ensuring systems are connected and can reliably transfer data between different platforms, such as electronic health records (EHRs) and laboratory systems. 

Structural Interoperability (Level 2) 

Structural interoperability, also known as syntactic interoperability, deals with the standardization of data format and organization. This level defines how the data is packaged and transmitted to ensure that systems can interpret and process it correctly. 

Structural interoperability typically utilizes established data standards such as Fast Healthcare Interoperability Resources (FHIR), Health Level Seven (HL7), and Consolidated Clinical Document Architecture (C-CDA). This level structures exchanged data in a way that both sender and receiver systems can recognize and utilize, like transforming words into sentences.  

Semantic Interoperability (Level 3) 

Semantic interoperability keeps the meaning of the data consistent across diverse systems. This level is not just about data exchange, it makes sure that everyone, regardless of the system they use, understands the data in the same way.  

By establishing a common vocabulary, semantic interoperability addresses issues like terminology differences. For instance, one system can use ‘hypertension’ while another one can use ‘high blood pressure’. These differences can create confusion and inefficiencies within healthcare organizations. On the other hand, data can be interpreted with the same context across various systems via this interoperability level. Clinical terminology standards such as SNOMED CT (Systematized Nomenclature of Medicine Clinical Terms), LOINC (Logical Observation Identifiers Names and Codes), and ICD (International Classification of Diseases) are essential at this level because they make clinical terms and codes consistent and universally understandable.    

Organizational Interoperability (Level 4) 

Organizational interoperability is the final level, bringing all other levels together. This level comprises governance, policy, social, legal, and organizational considerations which enable interoperability across different healthcare organizations.  

Going beyond technical standards, it focuses on establishing comprehensive agreements on how data will be shared, who has access to it, and how data privacy and security will be maintained. Essentially, it is about creating collaborative frameworks allowing different healthcare entities, from hospitals to insurance companies, to work together smoothly. For organizational interoperability, initiatives like the Trusted Exchange Framework and Common Agreement (TEFCA) play a pivotal role.  

Conclusion 

Four levels of interoperability begin with foundational interoperability and culminate in organizational interoperability. Foundational interoperability enables simple data transmission between systems. Structural interoperability (level 2) standardizes the format and structure of data to ensure it can be accurately exchanged. Semantic interoperability (level 3) goes a step further, using standard terminologies to ensure that data can be meaningfully understood and interpreted across systems. Finally, organizational interoperability focuses on governance, policy, and collaborative frameworks to enable seamless data sharing across healthcare entities. Although the common goal is organizational interoperability, most healthcare organizations have only achieved foundational and structural interoperability, falling short of reaching the organizational level. 

As Tiga Healthcare Technologies, we offer innovative healthcare interoperability solutions to contribute to seamless communication across different systems. Our HIE Suite excels in enabling all four levels of interoperability. FHIR Stack allows for standardized data formats while Enterprise Master Patient Index (EMPI) consolidates patient identities across systems for smooth collaboration. Terminology Server leverages international clinical terminology standards for consistent and accurate data interpretation while Clinical Viewer 360 provides healthcare professionals with seamless access to real-time patient data. This integrated approach ensures that healthcare organizations can achieve comprehensive interoperability, leading to improved patient outcomes and operational efficiency. 

Our data privacy and security-focused products are the answer of ‘How to improve interoperability in healthcare?’, safeguarding sensitive healthcare information throughout data access and sharing. 

Let’s shape the future together with interoperable healthcare systems!