Health System Efficiency and eHealth Interoperability – How Much Interoperability Do We Need?

Abstract

Abstract. The generic concept of interoperability is briefly reviewed, before describing the approach taken in defining eHealth interoperability, based on a reflection of the diverse needs for exchanging patient, other healthcare and health system data with the aim to improve the overall quality and efficiency of healthcare provision. Next, the method applied for collecting global good practice evidence from national or district eHealth platforms is outlined. The information collected led us to revisit the concept of eHealth interoperability levels; a modified concept is presented identifying four distinct domains, and the identification of three levels for the data and access domain. The results are discussed under the perspective of 'Who needs why how much interoperability?' -including the impact of healthcare provider incentives, size of patient population, and the benefits from interoperability on the concrete instantiation of an interoperability platform. Finally, conclusions are drawn on the role of eHealth interoperability for better healthcare.

The Case of Organizational Innovation Capability and Health Information Technology Implementation Success

“…The healthcare industry has been characterized as complex, turbulent, fragmented, and tightly coupled (Shekelle et al, 2006;Greenhalgh et al, 2009). This is mirrored in research studies which have highlighted complexities inherent in the implementation of HIT innovations (Martikainen et al, 2020;Parks et al, 2019;Sittig & Singh, 2015;Sligo et al, 2017;Stroetmann, 2014). EMR implementations around the world have been slow and fraught with problems (Cresswell et al, 2020b;Jawhari et al, 2016a;Raut et al, 2017;Reisman, 2017, Yi, 2018.…”

Implementation of eHealth Technology in Community Health Care: the complexity of stakeholder involvement

“…technology in health care, welfare technology, mobile health care and innovation of health care solutions) [6][7][8][9]. Although the digitalisation of health care services is often the focus of these projects, the complexity of eHealth initiatives often lead to failure or less-thanoptimal solutions [10,11]. The digitalisation of health care services and the large-scale implementation of eHealth is a slow process, and many initiated projects are never fully realised as part of the normal routine [12].…”

A maturity model for interoperability in eHealth

“…The model has gained some following within the eHealth community, such as in [2,13], but has a rather technical focus and limits itself to describing how fields within electronic health records can be automatically filled from external sources (whose end-users are, predominantly, healthcare professionals). Interoperability in the current eHealth landscape is broader than that and refers to "facilitating and safeguarding the exchange, understanding and acting on patient and other health information and knowledge among linguistically and culturally dispersed medical professionals, patients and other actors within and across healthcare systems in a collaborative manner" [14]. So, when creating a maturity model for interoperability for the whole eHealth landscape, the collaboration among different organizations and experts, the way in which meaningful data is utilized within procedures as described in guidelines, and the role of standards that allow for smooth data-exchange among different systems, organizations and countries, are crucial aspects.…”