1. Managing multiple client systems and building a shared interoperability vision in the Health Sector Dennis Wollersheim Health Information Management

2. Fred visits the Doctor

3. Interoperability?

5. Interoperability Common semantics –Terms, and –meanings of Terms Common structure –Archetypes

6. 'When I use a word,' Humpty Dumpty said, in a rather scornful tone, ' it means just what I choose it to mean, neither more nor less.' 'The question is,' said Alice, 'whether you can make words mean so many different things.' 'The question is,' said Humpty Dumpty, 'which is to be master - that's all.' Semantics

7. METeOR – Metadata Repository Categories we care about Agreed semantic meaning METeOR – Via Australian Institute of Health and Welfare (AIHW) Health Data Dictionary (DD) Community Services DD

8. Terminologies Agreed lists of concepts for a category Concepts, descriptions, hierarchies, relationships Eg: ICD-10, SNOMED CT Eg: Heart attack, Myocardial Infarction, MI

9. Structure – Yes, but

10. Archetypes – Structural solution Describes a health concept Some level of granularity Agreed basic structure Consists of elements: –simple – numeric, or term –other archetypes Required or optional

11. Archetype Example Has required elements – eg, Blood pressure has systolic and diastolic values Optional components –Patient Position Blood Pressure archetype is optional component of Patient Observation archetype Clinical notes archetype has Patient Observations

12. Best Practice Electronic Discharge summary Direct transmittal Agreed structure Agreed semantics Direct integration into doctor’s system

13. Summary Semantics Structure Problem is not technical Agreement needs leadership