Health Data Standards and Terminologies A Tutorial

1: Functions and Types of Health Information Standards

Interoperability


Graphic showing interoperability levels - Foundational, Structural, Semantic, and Organizational

For reliable communication to happen, systems must be able to communicate with one another and the information that they send needs to be useable on both ends. This is facilitated through the creation of standards that enable system interoperability.

The Healthcare Information and Management Systems Society (HIMSS) defines interoperability as “the ability of different information systems, devices and applications (systems) to access, exchange, integrate and cooperatively use data in a coordinated manner, within and across organizational, regional and national boundaries, to provide timely and seamless portability of information and optimize the health of individuals and populations globally” (from Interoperability in Healthcare | HIMSS) HIMSS describes four levels of interoperability.

Levels of Interoperability

One system can receive data from another. This is predominantly facilitated through IT developments rather than information policy or design.

The format (or syntax) of the data. The format must preserve the data’s purpose and framework.

Preservation of clear and precise meaning and context.

Includes governance, policy, social, legal, and other organizational considerations that enable shared consent, trust and integrated processes and workflows.

These levels of interoperability correspond to different types of standards.

Health Hero App Example

Before we dive into the standards that make interoperability possible, let’s revisit the work of Dr. Judith Dexheimer, the principal investigator who worked on the Health Hero app that we learned about in the video on foster care (NLM Funding Spotlight | After Foster Care, Empowering Youths with Personal Health Records - YouTube).

Let’s imagine how the levels of interoperability might work in the Health Hero app example:

Cincinnati Children’s Hospital Medical Center can send and receive data (any data) from the welfare system.

Cincinnati Children’s can take the EHR and welfare records and use the file types that are shared.

Elements of the data such as a laboratory result are communicated in the same way in both systems (e.g., they both define a Hemoglobin A1C test the same way).

The hospital and welfare system agree on policies regarding data sharing, consent and privacy.

Dr. Dexheimer’s project and EHR interoperability in general are facilitated using health data standards.

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