Maturity by Type of Interoperability Collaborative design; engineered processes Dynamic data models, ontologies; shared standards and vocabularies. (inference engines if robust) Dynamic shared services High (Future) Selected constraints on common model(s ) Shared data model (e.g. HL7 V.3 RIM) + domain - specific standards, cross- ref’d terminologies Specific shared standard(s ) for exchange of data and programs Medium (Near term) Varies by org- anization; with regulation prn Shared message syntax (e.g. HL7 V2.0) Reliable, secure connectivity, transmission Low (Now) Process Semantic Technical Level/Type à Maturity by Type of Interoperability March 1, 2006 Mayo Clinic

Types of Interoperability by Level of Urgency Routine Emergency Disaster Secure, reliable connectivity for trusted end-to-end exchange of data. Redundant infrastructures, backup (incl manual). Ability to access data from other sites. Decentralized (self-healing) infrastructures; “bleeding edge” detection; ability to reroute communications; deploy mobile units; knowledge of manual and automated alternatives. Thorough, natural or logical order of data collection. Semantic transparency to support all functions (clinical, financial, administrative, research) Focus, summarization, most critical information displayed first. Real-time alerts which do not delay or interfere with medical intervention. Access to important information from external sources. Situational awareness; rapid reporting, seamless alerting; coordinated responder communication w automated resource deployment and tracking. Post-event recovery and analysis. Standardized, routine work processes. Keys: ‘Best practice.’ Consistency, efficiency. Flexible, modular tasks combined in response to situation; well-defined roles with clear leadership. Keys: Triage, speed & discipline. Planning for various event types, for multiple scenarios. During incident, ability to improvise: heroism, role flexibility. Immediate post-incident: implement Plan, . Keys: Rapid detection & response; surge capacity; panic management. Teamwork (quality, consistency and efficiency) Command/Control (strong leadership & explicit roles) Before: planning; detect’n During: initiative; rapid response, ‘heroism,’ After: leadership, logistics Technical Semantic Process March 1, 2006 Mayo Clinic