IHE based Interoperability - Benefits and Challenges

INTRODUCTION Optimized workflows and communication between institutions involved in a patient's treatment process can lead to improved quality and efficiency in the healthcare sector. Electronic Health Records (EHRs) provide a patient-centered access to clinical data across institutional boundaries supporting the above mentioned aspects. Interoperability is regarded as vital success factor. However a clear definition of interoperability does not exist. The aim of this work is to define and to assess interoperability criteria as required for EHRs. METHODS The definition and assessment of interoperability criteria is supported by the analysis of existing literature and personal experience as well as by discussions with several domain experts. RESULTS Criteria for interoperability addresses the following aspects: Interfaces, Semantics, Legal and organizational aspects and Security. The Integrating the Healthcare Enterprises initiative (IHE) profiles make a major contribution to these aspects, but they also arise new problems. Flexibility for adoption to different organizational/regional or other specific conditions is missing. Regional or national initiatives should get a possibility to realize their specific needs within the boundaries of IHE profiles. Security so far is an optional element which is one of IHE greatest omissions. An integrated security approach seems to be preferable. DISCUSSION Irrespective of the so far practical significance of the IHE profiles it appears to be of great importance, that the profiles are constantly checked against practical experiences and are continuously adapted.