The US Government Accountability Office recently published a report on Electronic Health Information Exchange. The gist of the report is that electronic health information exchange has increased in numbers overall, but important challenges remain, especially for small and rural providers. One of the most common challenges limiting electronic health information exchange is linked to standards, stated in the report as “…a lack of implementation and adoption of standards”, and “…variation in standards across systems” on page 9.
Standards are helpful, but they are not enough. Data exchange standards like FHIR can help achieve structural interoperability for exchanging messages between systems, but not all parties in the exchange can “understand” the meaning of the message correctly. Semantic interoperability happens when all parties mean the same thing for the same exchanged message. The use of structural standards like FHIR or standardized coding systems is not sufficient to achieve such shared meaning. This is because there are multiple standards for overlapping concepts, and they rarely capture local nuances properly.
There is a critical need for a technological solution that can convey the meaning of messages including variations in local nuances. This cannot simply be achieved by enforcing strict standards that dictate the use of certain codes. In the end, these codes are entered by humans in the field, and their adoption and use heavily rely on local customs, organizational conventions, and even personal preferences. True semantic interoperability that respects local nuances can only be achieved by “annotating” messages using semantic layers. Such annotations should be purpose-built by provider organizations themselves to create a “local variant” of a standard. When these local variants are known by all parties of message exchange, everyone can interpret the data in the same way by using those annotations.
And when you make those “annotations” machine-readable and shareable, you get the Layered Schema Architecture.
Layered Schema Architecture is an interoperability technology that harmonizes data coming from disparate sources with varying implementations of standards or with non-standard data for information exchange.
Cloud Privacy Labs has been implementing the Layered Schema Technology to harmonize electronic health records, claims, social needs surveys, as well as geographical data to build AI models in a data warehouse setting.
Contact us to learn more about this unique data harmonization technology.