Recently, I was asked by an executive of a provider EMR software vendor what was the difference between integration and interoperability.
Those of you that know me professionally are obviously visualizing my cringed forehead as I was asked this question.
But, as I always do, I composed myself and I patiently attempted to eloquently as possible answer this question as best as I could to someone that obviously had little clue what industry she was in.
I tried to explain the different maturity levels of interoperability:
- Maturity Level 1: Integration or technical interoperability
- Maturity Level 2: Syntactic and Workflow Interoperability (this includes integration)
- Maturity Level 3: Semantic Interoperability (this includes both integration and workflow)
- Maturity Level 4: Pragmatic Interoperability (this includes all of the above with a dash of artificial intelligence (AI)
Level 0 is no maturity whatsoever.
There are other levels, 5 and 6, but I will not get into the details because it’s a miracle that we would ever achieve level 4 in our lifetime.
Here’s a diagram (from Wikipedia) that illustrates the levels:
I wasn’t expecting the healthcare IT executive to understand this explanation, just by the mere fact that she asked this question, but that she would respect the fact that there was a difference, at least holistically speaking.
My big concern wasn’t that this person asked the question, although it did surprise me. An executive that leads a health IT company but doesn’t understand the difference between integration and interoperability is a short-sighted person in a position of power.
We can’t achieve interoperability without integration but for the sake of the improvement of our healthcare system we shouldn’t stop here.
And, by the way, these maturity levels are by no means a “carved-in-stone” standard, but many interoperability experts have agreed to them. Believe it or not, one day in a meeting several interoperability gurus were discussing after a presentation and we all came to a conclusion and agreement on the aforementioned levels. Coincidence? I don’t think so. It’s pragmatism that comes from experience.
But, did you really have to ask this question?