Inter-Operating, It’s a real thing

Integration, interface, and Interoperability are confusing buzzwords. 

By definition, integration means to add, mix, or combine and to unite. On the other hand, interface means border, boundary line, a point where two systems, subjects, or organizations meet and interact. Throw in the term “interoperability,” which describes the extent to which systems and devices can exchange data and interpret it. You’ve got some serious thinking and the most sophisticated approach, resulting in a richer experience for any interface to present as output.

In layman’s terms: interoperable systems speak the same language.

Where in, integration is more like having a conversation through an interpreter. (Like going to Canada not knowing how to speak French and needing two Germans to help you communicate: one who speaks English and one who speaks French.) With Interoperability, everybody speaks English (or German or French, or whatever the agreed-upon language is…). The point is the systems can talk to each other with no added complexity or delay.

Every industry has a unique vocabulary, and Technology is no exception. The problem: some of those sticky, often-used words take on a life of their own, are easily misunderstood, and can even end up misused to the point of meaninglessness. These so-called “buzzwords” (and their actual meanings) may seem inconsequential on the surface. Still, suppose we will effectively communicate and address challenges in an industry as complex as healthcare. In that case, it’s essential that we all clearly understand the terms we’re fighting for—and against. To help define one of the biggest buzzwords in Tech today: Interoperability is one found, people often use without knowing what it means.

Interoperability isn’t integration.

People use the words integration and Interoperability interchangeably, but there’s a pretty big difference between the two. Integration refers to connecting applications so that the other one can access data from one system. Where integration involves a third party—in software terms, middleware—translating data and making it “work” for the receiving system. In this scenario, it’s not a direct path for information from point A to point B.

Interoperability is a real-time data exchange between systems without middleware.

When systems are interoperable, they can share information and interpret incoming data and present it as it was received, preserving its original context.

It is about more than semantics.

Currently, most data exchange in our industry is the result of integration, but achieving Interoperability is vital to technical operations in the future. Why? The immediate access to information interoperability makes it possible to allow for both a complete view and the ability to be agile when it comes to complying with requests and reporting requirements. And these data-driven activities are crucial to success in the value-based world.

An example of this level of information access is particularly vital for an ambulatory surgery center, where they are entities outside of large hospitals (typically having their closed data systems). In an interoperable world, all stakeholders in the continuum can easily access and use the data within other systems, making up-to-date—even up-to-the-minute—information retrieval possible.

The change to true Interoperability won’t be an evolution—it’ll be a revolution requiring a large amount of future-focused thinking. The Kantara Initiative is the most likely place to lead the way with guidelines. Still, the onus is on providers to partner with vendors that support a universal standard. In this way, the future of Interoperability is in our hands—and yours. And that’s a sentiment that needs no translation.

Interoperability–An Exchange

In an optimal implementation and a software sense, “Interoperability is a characteristic of a product or system whose interfaces are completely understood to work with other products or systems, at present or future, in either implementation or access, without any restrictions,” according to Wikipedia. 

The definition becomes even more robotic from there: “Semantic interoperability is the ability to automatically interpret the information exchanged meaningfully and accurately to produce useful results as defined by the end-users of both systems.” In my opinion, Interoperability means if you are expecting information to come from two or more sources, and you get it, and it makes sense, then you have a win on your hands.

Here’s the catch: 

Upon further definition, “Interoperability would allow different systems to work together in their existing state; however, future upgrades, developments, or improvements to any of these products can cause interoperability to cease.”

In short:

  • Interoperability implies exchanges between a range of products. (see interface)
  • Interoperable systems work together now, but the future is uncertain
  • A guiding principle rather than a technical specification
  • Upgrades or product advances can terminate Interoperability

Integration–Full Functionality

With the integration, software product works as one solution instead of passing information between different systems. ‘One system contains the same code and database. Integrated systems work tightly together, like the pieces of the whole are ‘one.’ System updates are more accessible, as are real-time reporting requirements. Integrated solutions share the same databases, so there are no mapping codes between systems, substantially reducing errors and downtime. Any changes are automatically applied to your whole operation. The integration provides a unified user experience that combines data, reporting, and workflow across a single business platform. Integration is indisputably the most authentic, most unified way a software system can be utilized.

Of Note: 

An integrated system allows a series of products to talk to each other in their current state and provides backward and forwards compatibility with future versions of each product within the structure.

  • One uninterrupted system
  • Real-timeAll data is immediately gathered, stored, mediated, and reportable
  • Information is not decentralized; no synchronization is needed
  • Data transfers are reliable and workflow performance is accelerated
  • No mapping updates required, less maintenance
  • Business Intelligence Reporting is up-to-the-minute

Interface–The Bridge

An interface is like a bridge that lets two programs share information. The information can come from different sources that may use different programming languages. Business systems can send and receive data, but otherwise, they act independently of each other.

An interface doesn’t allow you to sync data between systems in real-time. If and when you need to sync your data from separate policies, ensure that your system network is powerful enough to handle running data sync, often sufficient to be close to real-time.

Another consideration is the maintenance of mapping codes between systems. Mapping codes act as the directory for information from one system into another. If any changes are made in either mode, your mappings table may have to be updated, or the software might pull information from the wrong place giving you incorrect data.

In short:

  • Separate software products communicate under limited capacity.
  • Data is maintained in multiple locations requiring more administration.
  • Additional steps to exchange data
  • Consistently preserve, monitor, and update mappings.
  • Real-time synchronization is not available.

Differences between nomadicity, portability, and mobility?

  1. Nomadicity is the tendency of a person, or group of people, to move with relative frequency. Leonard Kleinrock and others have written of the need to support today’s increasingly mobile workers with nomadic computing, the use of portable computing devices, and, ideally, constant access to the Internet and data on other computers.
  2. Nomadicity means none restrictive connectivity or limited connectivity.
  3. Portability means the ability to jump across networks.
  4. Portability means the ability to transfer from one machine or system to another.
  5. Mobility means when you have seamless and wireless connectivity.
  6. Mobility means the ability to move freely and easily.


Portability, on the other hand (at least as the term is used in the computer software domain), concerns the ease with which some software artifact can be made to function correctly in some computing platform environment other than that for which it was designed. For example, can the software artifact run under a different operating system or execution framework or on a computer with a different instruction set? How much modification/configuring is required for a given target execution environment? Although portability may have some relationship to a software component’s ability to interact with other elements. 

Mobility is focused on the ability to run regardless of the system, framework, computer platform, or instruction set. To accomplish mobility with true Interoperability, the use of a shared ontology must be present. Software instruction sets can and should behave differently from others; however, both the unstructured data with metadata and fully structured data with defined mappings. Must behave the same to maintain integrity, speed of delivery, and use to disparate applications regardless of platform or systems.

About jimpasquale
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