Pragmatic Interoperability for eHealth Systems: The Fallback Workflow Patterns

摘要

Despite decades of research and development on interoperability standards, semantic interoperability among electronic health (eHealth) systems has largely remained an elusive goal. Interoperability functionality that has been implemented as part of national or provincial initiatives often ends up being considered unreliable in practice. We believe that a stronger focus on workflows and other pragmatic aspects of interoperability functions may be a key to overcoming these difficulties. Specifically, we argue that eHealth system interoperability should be modelled as dynamically evolving socio-technical processes, rather than as technical functions of certified devices. In this paper, we explore the example of patient referrals to highlight common problems with eHealth system interoperability. We define a system-theoretic model of the socio-technical e-referral system to derive two pragmatic interoperability workflow patterns to address these problems. The presented research is carried out in collaboration with industry.