What is interoperability in healthcare?
Healthcare interoperability securely connects patient data so the right information reaches the right care team exactly when it's needed. This means better outcomes for both patients and providers.
The last thing on any patient’s mind is how their lab results, prescriptions, or past procedures are getting from point A to point B. They just hope they do – and that the people they’re dealing with have the full picture. Healthcare interoperability is the complex web of technology, standards, and cooperation that goes into providing this reliable and accurate data trail that patients expect and depend upon. The good news is that today’s interoperability technology has evolved to make all healthcare data more available, connected, and usable – for everyone from emergency room physicians to public health researchers.
Healthcare interoperability definition
Healthcare interoperability can be defined as the ability of different healthcare information systems, devices, and applications to access, exchange, and integrate data across organisational boundaries. This shared data can then be used cooperatively to support more informed care, better outcomes, and improved population health.
Healthcare interoperability is what allows a patient’s medical history to follow them from a family doctor to a specialist, or from a hospital discharge to their at-home care. Instead of making patients or providers hunt down records, true interoperability ensures that authorised users get real-time access to accurate, complete health information, no matter where that data originated.
More than just syncing files or linking databases, interoperability depends on a shared foundation: consistent standards, secure data exchange protocols, and software tools designed to bridge differences between systems. To work properly, it also requires clarity so that when the sending system says “blood pressure,” the receiving system interprets it in exactly the same way. Today’s best interoperability solutions and technologies turn fragmented medical records into something unified, actionable, and trusted.
Why is interoperability important in healthcare?
When patients see new providers, it shouldn’t feel like starting from scratch. Without electronic health record (EHR) interoperability, clinicians face fragmented information, repeated tests, and emotional stress for patients and families. Modern interoperability solves these operational and care-quality challenges by letting patient data automatically follow them – sharing medical history, prior test results, treatments, provider insights, and allergy information instantly.
Beyond patient care, interoperability enhances hospital resource planning, helps government health services anticipate population needs, enables early outbreak detection, and supports faster, deeper medical research. The benefits reach clinicians, hospital administrators, public health planners, and researchers alike.
Healthcare data integration: Four levels of interoperability
It would be hard to imagine a sector where the stakes are higher than healthcare. Likewise, it would be hard to find one that has more compliance and regulatory obligations, and such a broad range of processes, protocols, systems, and software. For interoperability to be successful, it has to do more than simply enable systems to talk to each other. It has to also ensure that those conversations are meaningful, safe, and actionable. And for that to happen, the data has to be commonly understandable, structured and secure. For all these reasons, the Healthcare Information and Management Systems Society (HIMSS) breaks interoperability into four distinct levels. Each one builds on the last, and each plays a vital role in the bigger picture.
LEVEL 1: Foundational
This is the most basic level: The ability to transport manageable data from one system to another. Think of it like emailing an attachment. The data gets there, but once it does, will the recipient know what do with it, where to put it, or even be able to open it? Foundational interoperability moves data between systems without assuming any shared format or interpretation.
LEVEL 2: Structural
Here, the format of the data starts to matter. Structural interoperability ensures that critical information such as patient demographics, lab results, or medication lists, is exchanged using consistent data structures and syntax. This level enables systems to automatically recognise what each field means and where it belongs. Standards like HL7, CDA, and FHIR operate here, helping to eliminate manual re-entry and transcription errors.
LEVEL 3: Semantic
Now we’re getting into meaning. Semantic interoperability ensures that when one system says “heart rate,” the receiving system understands not just the term, but the clinical context behind it – including units, timing, and measurement method. It enables richer, more accurate exchanges between systems that may have different architectures but need a shared “language” to collaborate effectively. Examples include:
- Mapping between different medical vocabularies or coding systems (e.g., SNOMED CT, LOINC)
- Translating between DICOM and non-DICOM image formats (meaning the standardised DICOM medical image format, and non-standard formats such as JPG, TIFF, or PNG)
- Aligning structured data with unstructured notes using natural language processing tools
LEVEL 4: Organisational
At the highest level, interoperability also depends on the rules that govern who can access what – and how. Organisational interoperability addresses privacy regulations, patient consent, information governance, and security protocols. It also involves building shared trust frameworks and legal agreements across health networks, regions, or countries.
Healthcare data standards and regulations
Over time, a wide and complicated range of standards, rules, and safeguards have been established to support secure and reliable management and sharing of healthcare data. To fully understand the challenges and demands of interoperability, it’s important to get an idea of the extent of complexity within this regulatory landscape. Below are just some of the most important frameworks shaping how healthcare systems share information in practise.
HIPAA
The Health Insurance Portability and Accountability Act is one of the foundational laws for health data privacy and security in the United States. It sets the groundwork for how protected health information (PHI) must be stored, transmitted, and accessed. It’s not specific to interoperability, but any data exchange must comply with its privacy and security rules.
The 21st Century Cures Act & the ONC Final Rule
Passed in 2016, the Cures Act includes provisions that specifically push interoperability forward. The Office of the National Coordinator for Health Information Technology (ONC) issued a Final Rule requiring health IT systems to support secure APIs and patient access to electronic health information (EHI). Just as importantly, it prohibits “information blocking” or the practise of restricting access to patient data for non-clinical reasons.
HL7
Health Level Seven is a family of international data standards that define how health information is packaged and exchanged. It’s used to structure clinical data like lab orders, medication lists, and discharge summaries in a way that multiple systems can interpret. HL7’s early standards laid the groundwork for more advanced data sharing.
CDA
The Clinical Document Architecture (CDA) is an HL7 standard used to format clinical documents like discharge summaries or progress notes. It ensures that both the structure and content of these documents can be shared and interpreted across systems.
FHIR
Fast Healthcare Interoperability Resources (FHIR, pronounced “fire”) is the next-generation standard for exchanging healthcare data. Built on modern web protocols like RESTful APIs and using formats like JSON and XML, FHIR makes it easier for developers to build secure, flexible apps that plug into existing systems. Many of the most ambitious interoperability initiatives today – including federal mandates and commercial APIs – are built on FHIR.
TEFCA
The Trusted Exchange Framework and Common Agreement is a U.S. initiative to create a “network of networks.” It sets out shared principles and technical specifications that enable secure, nationwide exchange of health data. TEFCA also includes rules for how data should be accessed and verified, and lays the groundwork for public-private cooperation on a national scale.
Other key standards and vocabularies
Benefits of interoperability in healthcare
When data flows securely, accurately, and in real time, everyone in the healthcare system benefits. Clinicians get the full picture. Administrators get better planning tools. Patients stay informed and safe. Interoperability helps remove the friction from care delivery, while unlocking insights that can improve outcomes across the board. Here are just a few of the many benefits:
Fewer duplicate tests and procedures
Interoperability helps eliminate redundant lab work and imaging, reducing patient burden, avoiding unnecessary costs, and freeing up clinical resources for higher-value activities.
Information at the point of care
Providers can instantly access accurate patient history, medications, and test results – helping reduce delays, prevent errors, and improve decision-making when time and accuracy matter most.
Improved care team coordination
When specialists, primary care physicians, and support staff can access and share the same data, care becomes more connected, efficient, and patient-centred, especially for chronic conditions.
Reduced clerical burden for staff
By minimising manual data entry and repeat documentation, clinicians and administrative teams can spend less time clicking and typing, and more time focusing on patient care.
Better patient experience and engagement
Patients who can access and understand their own health records feel more informed and empowered, leading to better advocacy, shared decision-making, and adherence to treatment.
Support for public health and research
Aggregated, de-identified data can reveal patterns, track disease outbreaks, and support faster, more inclusive research – without compromising patient privacy or data integrity.
Stronger data for planning and operations
Hospitals and health systems can spot utilisation trends, manage capacity, and forecast demand more effectively. This improves both day-to-day operations and long-term planning.
Challenges of interoperability in healthcare
As with any important and useful initiative, there is no magic pill for achieving true interoperability. It requires dedication, effort, and strong commitment from the boardroom on down. Systems speak different languages. Data lives in silos. Regulations shift, and legacy infrastructure is often held together by patches and workarounds. Here are some of the most common hurdles and how a good interoperability strategy can help alleviate them:
Legacy systems and outdated architecture
Many healthcare organisations still rely on older software that wasn’t designed to connect easily with outside platforms. These systems often use proprietary formats or lack modern APIs, making integration slow, brittle, or outright impossible without middleware and translation layers.
→ Modern interoperability platforms can act as bridges, translating data from legacy systems into standardised formats and powering real-time exchange – without requiring a rip-and-replace overhaul.
Fragmented data sources
Patient information may be spread across hospitals, labs, pharmacies, insurers, home care providers, and wearables – all using different standards and timelines. Without shared frameworks, data can become duplicated, inconsistent, or just plain inaccessible when it’s needed most.
→ Smart integration engines and unified data layers can bring fragmented information together, harmonising inputs across diverse sources and surfacing what matters, when it matters.
Inconsistent data standards
Even with industry-wide protocols like FHIR or HL7, not every organisation implements them the same way. One system might record “blood pressure” in millimeters of mercury, another in coded values – and a third in a scanned PDF. That makes automated interpretation tricky and reduces trust in the data itself.
→ Data normalisation and mapping tools help align mismatched vocabularies and formats, giving providers a shared language and reducing the risk of errors or omissions.
Resource and staffing constraints
Implementing interoperability solutions requires time, expertise, and budget. These resources may not be easily at hand for all providers. Smaller hospitals and rural clinics, in particular, may find it difficult to modernise systems while maintaining daily operations.
→ Cloud-based, modular tools allow organisations to start small and scale at their own pace — minimising disruption while still connecting to larger networks.
Regulatory complexity and information blocking
While laws like the Cures Act aim to prevent information blocking, real-world enforcement is still evolving. Legal concerns over liability, data ownership, and HIPAA compliance can create hesitation or overly cautious data-sharing policies, even when patients would benefit.
→ Interoperability frameworks built around consent, auditability, and access control help organisations meet compliance goals with greater confidence and transparency.
Gaps in semantic understanding
Semantic interoperability – the ability to share not just data, but meaning – remains one of the hardest problems to solve. Even with shared standards, aligning vocabularies, units, and context across systems is a complex and ongoing challenge.
→ Semantic engines and metadata-driven workflows help translate clinical intent across systems, ensuring that data retains its meaning, even as it moves.
Security and governance concerns
The more systems you connect, the larger your surface area for risk. Organisations need to ensure strong authentication, audit trails, consent management, and data governance policies that protect patients while still enabling access.
→ From encryption and access logs to role-based permissions and governance tooling, robust interoperability platforms include enterprise-grade security features by default.
Interoperability in healthcare examples
Behind every data connection is a person whose care, safety, or peace of mind improves because the right information got where it needed to go. Here are a few ways that interoperability plays out in practise:
Chronic disease management
A man newly diagnosed with diabetes sees an endocrinologist, a nutritionist, and a family doctor. Instead of relying on phone calls or printed reports, each provider sees shared results and notes instantly. This lets him jump-start his treatment and lifestyle changes.
ER coordination
A paramedic arrives at the ER with a stroke patient who can’t speak. Precious minutes wasted can affect the quality of the rest of her life. Thanks to interoperable systems, the hospital already has access to her allergies, medication history, and past scans.
Remote care
A rural mother connects with a specialist through a telehealth platform. Interoperability allows for an instant review of records from the child’s local clinic, making the resultant diagnosis and treatment as informed and effective as an in-person consult.
Streamlined follow-up
When an elderly man is discharged from the hospital, his care plan and prescriptions are immediately available to the pharmacy, home care nurse, and primary care provider. This means his daughter can spend more time caring and less time chasing down information.
Public health monitoring
A regional health worker notices a sudden spike in flu cases. Instead of waiting for hospitals to submit manual reports days or weeks later, she can access de-identified case data in near real time, helping her team quickly respond with supplies, staffing, or public alerts.
Conclusion
Healthcare is complex and always will be. But accessing the right information at the right time no longer has to be. Interoperability brings us closer to that reality, making healthcare more connected, coordinated, and responsive. It reduces errors, empowers patients, and lightens the load for clinicians. And while the journey isn’t over, the building blocks are already in place. By aligning on standards, investing in usability, and bridging the last mile between systems, the industry is steadily transforming fragmented records into meaningful, actionable insights – and delivering better care because of it.
Learn how the Infor Cloverleaf® healthcare data integration platform enables seamless interoperability between providers, payors, and life sciences companies.
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