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Inter-operability is just a fancy term for the ability to collate data from different systems. There are two strategies to address interoperability issues:

  1. Enforce standards - like HL7, NABH (India), JCI etc. which prescribe minimum requisite datasets for an EMR to be compliant. Some of these standards also specify communication standards between EMR systems
  2. Implement inter-operability at the backend - this is what we do in DoubleHelix. This is done through a Semantic Integration Service (SIS). This allows usergroups to select semantics from various sources (benchmark agencies e.g. ICD10 from WHO, other usergroups etc.) or create their own semantics.

Self-created semantics will not be interoperable unless other usergroups subscribe to it. The strategy is to ensure semantic integration through usergroup consensus. Standards may still be enforced by local agencies through prescribing minimum standard datasets. Anybody who has worked in this domain will appreciate that none of these standards fit the bill completely and usergroups or individual users always feel the necessity to extend such framework. The fact that there are so many standards within the domain of healthcare is testimony to the fact that none of them are adequate from an operational point of view.

So in DoubleHelix systems are made interoperable at the time of design of forms and workflow. It is a prospective decision not a retrospective implementation, although it may be effected retrospectively if the user changes his/her decision.