Towards Interoperability of EHR Systems: The Case of Italy

Abstract

The great benefits that Electronic Health Records are able to provide in terms of improvement of the quality of care and reduction of costs have led many international organizations to implement enabling systems. However, the systems designed and realized are very often not able to interoperate each other, due to several reasons, varying from the existence of different local needs to the use of diverse health informatics standards. The lack of interoperability among these systems can result in decreased levels of quality of patient care and waste of financial resources. In Italy, the autonomy about healthcare delivered by the Italian Constitution to each region caused the spread of heterogeneous regional EHR systems, thus not able to interoperate each other. This paper presents the result of an effort made within a convention between the National Research Council of Italy and the Agency for Digital Italy, for the specification of the Italian architecture for the interoperability of regional EHR systems. Such an architecture has been defined according to the requirements provided by Italian Laws recently issued and approved by a National Technical Board.

Interoperability of heterogeneous health information systems: a systematic literature review

“…Semantic interoperability is distinguished from the other levels of interoperability because it assures that the receiving system understands the meaning of the sent information, even if the receiving system's algorithms are unknown to the sending system. That is why it is used more than other levels [25,26].…”

Automated extraction of standardized antibiotic resistance and prescription data from laboratory information systems and electronic health records: a narrative review

“…There are several possible methods to deal with information extraction from datasets, more specifically from EHRs. The wide range of adopted solutions is a direct consequence of the heterogeneity of the data structure: EHRs present a peculiar framework which varies by country and state, and may vary even by hospital within a limited geographic area (Ciampi et al, 2016). Moreover, EHRs often contain both structured and unstructured data, which require different extraction procedures, and may include missing data that need management (Tayefi et al, 2021).…”

An Ontology-Based Decision Support System for Tailored Clinical Nutrition Recommendations for Patients With Chronic Obstructive Pulmonary Disease: Development and Acceptability Study

“…Therefore, toward this aim, strategies for collecting the outputs and making them available in patients' data (or electronic health records) need to be investigated. In this regard, scientific literature offers some interesting approaches grounded in the Italian health care system that could be considered to make the COPD DSS interoperable with existing tools [68][69][70]. As the COPD DSS leverages ontologies to represent its data, this technology can be used to achieve semantic interoperability of the information [68], moving a step toward the longitudinal collection of health data about patients [70] while ensuring data protection according to the national and European laws [69].…”