Managing multiple client systems and building a

shared interoperability vision in the Health Sector

Dennis Wollersheim

Health Information Management

Fred visits the Doctor

Interoperability?

Interoperability?

Interoperability

• Common semantics– Terms, and– meanings of Terms

• Common structure– Archetypes

'When I use a word,' Humpty Dumpty said, in a rather scornful tone, ' it means just what I choose

it to mean, neither more nor less.'

'The question is,' said Alice, 'whether you can make words mean so many different things.'

'The question is,' said Humpty Dumpty, 'which is to be master - that's all.'

Semantics

METeOR – Metadata Repository

• Categories we care about

• Agreed semantic meaning

• METeOR – Via Australian Institute of Health and Welfare (AIHW)

• Health Data Dictionary (DD)

• Community Services DD

Terminologies

• Agreed lists of concepts for a category

• Concepts, descriptions, hierarchies, relationships

• Eg: ICD-10, SNOMED CT

• Eg: Heart attack, Myocardial Infarction, MI

Structure – Yes, but

Archetypes – Structural solution

• Describes a health concept

• Some level of granularity

• Agreed basic structure

• Consists of elements:– simple – numeric, or term – other archetypes

• Required or optional

Archetype Example

• Has required elements – eg, Blood pressure has systolic and diastolic values

• Optional components –Patient Position

• Blood Pressure archetype is optional component of Patient Observation archetype

• Clinical notes archetype has Patient Observations

Best Practice

• Electronic Discharge summary

• Direct transmittal

• Agreed structure

• Agreed semantics

• Direct integration into doctor’s system

Summary

• Semantics

• Structure

• Problem is not technical

• Agreement needs leadership