Semantic Interoperability for Reliable Information Interchange: Status and Challenges
This report is an account of the author’s work performed at Canada Health Infoway (Infoway) during the work term from June 14th to September 3rd, 2004. Infoway is an independent but publicly funded organisation responsible for building Canada’s interoperable electronic health record (EHR). The organisation is set up as an independent, private company to enable collaboration with private as well as public partners. Infoway strives to leverage its investment in interoperable EHR initiatives in Canada in three ways: • By co-sponsoring EHR-related initiatives at less than 100% • By introducing results-based reimbursement of eligible costs • By replicating working solutions in other domains and geographies The author performed his responsibilities in the Solution Architecture department, which holds responsibility for the business and technical architecture of the pan-Canadian interoperable EHR. The author has performed the following activities for Infoway: • Compared e-prescribing message standards proposals from Canada and the Netherlands. • Managed the definition phase of an investment initiative up to the final budget proposal to the operational management committee. • Analysed the problem of semantic interoperability for the EHR architecture and provided recommendations. The members of the Solution Architecture department have expressed their satisfaction with the reports and project artefacts resulting from these activities. As a result of the wide variety of activities, the author has been able to apply a variety of topics from the Health Informatics curriculum, from “Health Informatics Systems and Issues” to “Research Methods.” The work-term requirement in the health informatics curriculum is also a valuable component that adds to the education of future health informatics professionals. The detailed problem of semantic interoperability was analyzed during the work term. Though information standards may help avoid semantic misinterpretation it is likely to be an impractical solution to change the systems and system users in a massive approach. The architecture used in Infoway’s EHR blueprint also favours a composite standard where current systems can be integrated through add-on modules. Future work-term engagements should be discussed early on with the prospective organisation, preferably during the end-of-year budget cycle. What worked well was the fact that the author was seen as health informatics professionals “in training” rather than a student, which allowed Infoway to realize maximum value from the engagement. A practical change the organisation should consider is have the work term participant engage with many stakeholders in the organisation during the first few weeks of the work term and establish efficient working relations.