There are three levels of interoperability, which are foundational, structural and semantic. All three are co-dependent and are necessary to achieve improved quality, safety, efficiency, and success of healthcare delivery.
Foundational interoperability means healthcare data exchange between two information technology systems and doesnt require these systems to understand the meaning of exchanged data. Structural interoperability is an intermediate level. It defines the format of exchanged data (message format standards). Healthcare data gets exchanged between two information systems where meaning of the data is preserved and unchanged. Structural interoperability specifies the syntax of the data exchange and interpretation of the exchanged data at the data field level. Semantic interoperability is a highest level of interoperability, where more than two information systems that exchange information are able to understand, interpret and use the exchanged information without difficulty. For instance: semantic interoperability allows the electronic exchange of patient results between healthcare providers and other institutions through disparate EHR systems and other systems.
The following are some of the functions that require interoperability include investigation reports from laboratories, radiology, and other diagnostic departments, administrative data such as patient registration and identification, clinic appointments, admissions, discharges, and transfers (ADT), letters and memos from one clinician to another, including referrals, clinic and discharge letters and opinions exchanged between specialist departments, private providers, and community services. Some of the systems and organizations that require interoperability are EHRs, health information organizations (HIOs), regional health information organization (RHIO) and the nationwide health information network (NHIN). .
In order for all systems, organizations and its users to achieve ultimate interoperability, common language standards are necessary.