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Levels of EHR Interoperability

by | Jul 20, 2022


EHR interoperability supports more efficient operations and promotes better patient outcomes by making medical records and health information highly accessible and secure between patients, providers, and those involved in patient care.  

EHR Interoperability is as complex as it sounds, here are the core aspects to understand:  

  • Foundational – Reliable transfer of data from one system to another that is immediately usable upon receipt.   
  • Structural – Format, syntax and organization of data is defined, and remains unchanged in its meaningful and shareable form. 
  • Semantic – Standardized terminology and coding ensures that data can be understood between systems to make the analysis process easy. 
  • Organizational – Clearing social, legal, policy, and governance barriers to better streamline data exchange between organizations. 

When optimizing an EHR, it is important to understand the roles played by each aspect of interoperability to be successful.  

  • Foundational interoperability (Level 1): The ability to establish an interconnection between two information systems allows the exchange of information from one HIT system to another and does not require the receiver’s system to interpret the data. 
  • Structural interoperability (Level 2): This level defines the format, syntax and organization (structure) of data exchange. Ensures the ability of information systems to interpret data at the data field level. 
  • Semantic interoperability (Level 3): It is the highest and most desired level of interoperability that supports data exchange and fully interprets received data. Facilitates standard underlying models and codification of data comprising data elements so that the receiving system can analyze the data. 
  • Organizational interoperability (Level 4): Appended in March 2019, this level includes social, legal, policy, governance and organizational considerations to facilitate seamless, secure and timely communication and use of data within and outside the organization. 

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