Objective: In this article, the authors review the progress in healthcare interoperability from 2010 to 2023 from an international perspective. Countries covered here include the Republic of China (Taiwan), the Republic of Croatia, the Republic of Estonia, and the Commonwealth of Australia. Interoperability, in the context of this paper, is “the ability to share information across time and space from multiple devices, sources, and organizations,” as defined by the Institute of Electrical and Electronic Engineers (IEEE). This is followed by recommendations for future work toward improving the standardization of heterogeneous data in the healthcare setting. Methodology: A literature review was conducted on established interoperability standards and systems in healthcare based on information obtained from journal publications, government, academy reports, published materials, and publicly available websites. Examples of specific interoperability efforts and an evaluation of their feasibility were conducted at three levels of healthcare interoperability, as defined by the National Academy of Medicine: 1) inter-facility (macro-tier) interoperability, 2) intra-facility (meso-tier) interoperability, and 3) Point-of-Care (micro-tier) interoperability. The authors assessed the adoption levels of each standard by looking at factors that support or limit its systemic adoption. Estimations on the number of users—medical professionals and patients—for each system were made in instances where verifiable data are available. Results: Presented here is an evaluation of four interoperability parameters: 1) device/equipment interoperability, 2) compatibility issues, 3) involved organizations, and 4) migration and conversion issues. Conclusions: Despite many parallel ongoing efforts to improve the standardization of healthcare information in the mobile devices, Internet of Things (IoT), and electronic health records (HER) sectors, there remains space for improvement. The recent development of the Trusted Exchange Framework and Common Agreement (TEFCA) framework has significantly reduced the friction of data exchange in many healthcare contexts. In addition, funding architectures for mediating data between separate healthcare organizations, or middleware architectures, may also be an effective strategy for consolidating healthcare data and improving information exchange.
Lesh K, Weininger S, Goldman JM, Wilson B, Himes G. Medical Device Interoperability-Assessing the Environment. 2007 Joint Workshop on High Confidence Medical Devices, Software, and Systems and Medical Device Plug-and-Play Interoperability (HCMDSS-MDPnP 2007). IEEE; 2007. p. 3–12.
3.
Pronovost P. Procuring Interoperability: achieving high-quality, connected, and person-centered care. 2018;1.
4.
Interoperability. composability, and their implications for distributed simulation: towards mathematical foundations of simulation interoperability. 2023;
5.
Mapping other code systems to SNOMED CTdata analytics with SNOMED CT-SNOMED confluence. 2023;
6.
Chute CG, Huff SM, Ferguson JA, Walker JM, Halamka JD. There Are Important Reasons For Delaying Implementation Of The New ICD-10 Coding System. Health Affairs. 2012;31(4):836–42.
7.
Jenco M. Ditch the spoon AAP: metric dosing of medications a safer choice. AAP News. 2015;(4):11–11.
8.
Kampala, Organization WH, Alliance GHW.
9.
2023;
10.
2023;
11.
Dumortier J, Verhenneman G. Legal regulation of electronic health records: a Comparative analysis of Europe and the US.
12.
Dumortier J, Verhenneman G. Legal Regulation of Electronic Health Records: A Comparative Analysis of Europe and the US. eHealth: Legal, Ethical and Governance Challenges. Springer Berlin Heidelberg; 2012. p. 25–56.
13.
Publications Office of the European Union | Archive-It Wayback Machine. 2023;
14.
2010;
15.
Internet of things, smart sensors, and pervasive systems: enabling connected and pervasive healthcare-ScienceDirect. 2023;
16.
Simalatsar A, Micheli D, G. Medical guidelines reconciling medical software and electronic devices: Imatinib case-study. Bioinformatics & Bioengineering. 2012;19–24.
17.
2023;
18.
Metsallik J, Ross P, Draheim D, Piho G. Ten years of the e-Health System in Estonia. Semantic Scholar. 2018;
19.
2023;
20.
The emergence of National Electronic Health record architectures in the United States and Australia: models, costs, and questions-PMC. 2023;
21.
Tehik. 2023;
22.
De Lusignan S, Ross P, Shifrin M, Hercigonja-Szekeres M, Séroussi B. Comparison of approaches to providing patients access to summary care records across old and new Europe: an exploration of facilitators and barriers to implementation. Stud Health Technol Inform. 2013;(7):397–401.
23.
Perugu B.
24.
Heston T. A case study in blockchain healthcare innovation.
25.
Atkinson C, Bostan P, Draheim D. Foundational MDA patterns for service-oriented computing. J Object Technol. 2015;(1):1.
26.
Oderkirk J. Readiness of electronic health record systems to contribute to national health information and research.
27.
Zeegers Paget D, Azzopardi Muscat N, Zeegers Paget D, Jakab Z, Andriukaitis V, Charpak Y. European Public Health News. European Journal of Public Health. 2019;29(2):381–4.
28.
MO. 2023;
29.
Priisalu J, Ottis R. Personal control of privacy and data: Estonian experience. Health and Technology. 2017;7(4):441–51.
30.
2023;
31.
Gvozdanovi_ D, Kon_ar M, Kojund_i_ V, Jezid_i_ H. National healthcare information system in Croatian primary care:
the foundation for improvement of quality and efficiency in patient
care. Journal of Innovation in Health Informatics. 2007;15(3):181–5.
32.
State of Health in the EU: Croatia Country Health Profile 2021. OECD/European Observatory on Health Systems and Policies (2021), Croatia: Country Health Profile 2021, State of Health in the EU.
33.
Budin A, Tesla E. 2017;
34.
Croatia to start the exchange of ePrescriptions and patient summaries. 2023;
35.
Mountford N, Kessie T, Quinlan M, Maher R, Smolders R, Van Royen P. Connected health in Europe: where are we today? 2023;
36.
Pearce C, Bainbridge M. A personally controlled electronic health record for Australia. Journal of the American Medical Informatics Association. 2014;21(4):707–13.
37.
2023;
38.
Hanna L, Gill SD, Newstead L, Hawkins M, Osborne RH. Patient perspectives on a personally controlled electronic health record used in regional Australia. Health Information Management Journal. 2016;46(1):42–8.
39.
Pdf] Sound. 2023;
40.
2023;
41.
Pulseit. 2023;
42.
2023;
43.
Andrews L, Gajanayake R, Sahama T. The Australian general public’s perceptions of having a personally controlled electronic health record (PCEHR). International Journal of Medical Informatics. 2014;83(12):889–900.
44.
Wu TY, Majeed A, Kuo KN. An overview of the healthcare system in Taiwan. London Journal of Primary Care. 2010;3(2):115–9.
45.
Design and prototype of a mechanism for active on-line emerging/notifiable infectious diseases control, tracking and surveillance, based on a national healthcare card system-PubMed. 2023;
46.
An Assessment of the Interoperability of Electronic Health Record Exchanges Among Hospitals and Clinics in Taiwan-PMC. 2023;
47.
National Health Insurance Administration Ministry of Health and Welfare. 2023;
48.
New NHI Mobile App Brings NHI Services at Your Fingertips-National Health Insurance Administration Ministry of Health and Welfare-NEWS. 2023;
49.
Creating online personal medical accounts: recent experience in two developed countries-ScienceDirect. 2023;
50.
Tseng YT, Chang EH, Kuo LN, Shen WC, Bai KJ, Wang CC, et al. Preliminary physician and pharmacist survey of the National Health Insurance PharmaCloud system in Taiwan. Computer Methods and Programs in Biomedicine. 2017;149:69–77.
51.
Rau HH, Wu YS, Chu CM, Wang FC, Hsu MH, Chang CW, et al. Importance-Performance Analysis of Personal Health Records in Taiwan: A Web-Based Survey. Journal of Medical Internet Research. 2017;19(4):e131.
52.
Machiavelli N. The Prince [Internet]. 1998;
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