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Wednesday, April 24, 2013

Finally, a new definition of Interoperability

And do you know how I respond to this?  I'm so very glad you figured that out.  Now that you understand it, can we get on to some real work?

It's good that various organizations take the time to define what they are after.  And there is value in looking at things over again from time to time to see what's changed.  And it is also a good thing to get everyone on the same page.  And I'm sure there was some good reason for this effort in 2013.  But it doesn't excite me in the least.

This project has been done, and redone, and frankly, overdone, by AHIMA (2006), HIMSS (2005), HL7 (2007), NAHIT (2005) and ONC and various others over the past decade.  For those of us who have been working in the field for the last decade or so are just a bit bored about new definitions for old concepts.

Was some or all of the prior work even considered?  Unfortunately I don't know.  The really sad part here is that I could have even helped out with these observations ahead of time, if I just had more time to pay attention.

One thing I truly find painful is when old definitions for old concepts are simply renamed.  What IEEE used to call Interoperability in 1990 is what HIMSS calls Semantic Interoperability in 2013.

The IEEE definition published the most oft-quoted definition of Interoperability I've seen:
... the ability of two or more systems or components to exchange information and to use the information that has been exchanged.
and comes from the IEEE Standards Dictionary, a compendium of glossaries published in 1990 (and is referenced from the HIMSS definition).

Would you like to know what the IEEE Standards Glossary says in 2013?
Ability of a system or a product to work with other systems or products without special effort on the part of the customer. Interoperability is made possible by the implementation of standards.
Quite different phrasing, but much the same meaning to those of us who work in the space. To those who don't work in the space, this is much clearer.  The without special effort on the part of the consumer is implied in the previous definition.  Here it is made explicit, and that is quite useful.  Was that even referenced?

Don't get me wrong, getting folks to agree on what you are doing is good.  Just don't expect me to get excited about redoing work that is already more than two decades old, and that comes to the same conclusions.  It's simply not notable.

To do it again?  Somehow I think there are better uses of our time, and wonder why nobody brought that up.  Perhaps it helped to educate the new crop of freshman. I don't know, and just cannot figure this one out.

  -- Keith


  1. IMO, every pair of interconnected systems is considered "semantic interoperable", there is no structural vs semantic difference. The real crux is how scalable the solution is from architecture perspective. More detail can be found at my own blog at

    1. Victor

      RE "Please tune in for the Part II and Part III" in the blog post you've linked to: Were any follow-up posts made?


    2. Victor,

      Here we fall again in the same ol'. Have we already defined "semantic interoperability"?

      We haven't yet defined what "discrete" data is in healthcare.

      We still don't know what an EHR is!


    3. Sorry, I do know what an EHR is.

      @theEHRGuy :-)

  2. >> "The without special effort on the part of the consumer is implied in the previous definition. Here it is made explicit, and that is quite useful."

    It's a lot better than useful -- IMHO it "fixes" the definition of interoperability more closely to the level of iteroperability that we're really striving for.

    We've *always* had interoperability if you're willing to overlook the fact that it usually took weeks or months of on-boarding, discovery meetings and coding to achieve it.

    The simple addition of "without special efforts" dramatically improves the definition of the brand of interoperability that we truly want and need today.


  3. Here is a link to the Definition of Interoperability approved by the HIMSS Board of Directors April 5, 2013 -

    And yes, Keith this HIMSS definition was based on 20 existing definitions. The process was consensus-based, to use the best of all of them and increase clarity in the definition of interoperability specifically for health IT.

    The process may not have been an exciting one, but I believe that some found it to be a useful exercise to look at what had been previously developed and how the best of the best could be pulled together to make a better definition.

    1. We (the #HealthIT and #HITsm community in social media) could do a better job at defining healthcare interoperability with a crowd-sourced approach rather than a SIG that precisely and primarily represents the BIG vendors that have been non-interoperable forever.

      According to the SIG, interoperability = "pay to play with us" otherwise you will NOT interoperate!

      Enough is enough!