Surmounting Barriers to Healthcare Data and Information: International Case Studies

Abstract

Objective: This article reviews the interoperability landscape from the early 2000s to the present in Eurasia and Australia. Interoperability, in the context of this article, is “the ability to share information across time and space from multiple devices, sources, and organizations,” as defined by the IEEE (Institute of Electrical and Electronic Engineers). This review is followed by recommendations for future policy proposals that may improve the standardization of heterogeneous healthcare data in a global setting. Methodology: A literature review was conducted on established national and supranational interoperability standards and systems in healthcare based on information obtained from journal publications, government, academy reports, published materials, and publicly available websites. Examples of specific interoperability efforts and an evaluation of their feasibility were conducted at three levels of healthcare interoperability, as defined by the National Academy of Medicine: Inter-facility (macro-tier) interoperability, Intra-facility (meso-tier) interoperability, and Point-of-care (micro-tier) interoperability. Results: Due to the lack of available data, it is difficult to assess, in some nations, the efficacy of having one centralized system for electronic health information storage, as in the case of Taiwan. Nevertheless, this literature review still reveals that small countries in the EU, where there is a higher volume of intrastate population movement, have made considerable progress toward achieving national interoperability in healthcare records, using international and national interoperability frameworks. Uniformity in data records is more easily achieved in smaller populations when there exists a less diverse consortium of data to store and transfer, and standardization initiatives are often successful when arising from government bodies or nationally prom-inent health organizations. Conclusions: As international travel becomes more commonplace and the diversity of data sources and health-care environments grows, there is an increasing need to create more interoperable healthcare systems, not only at the national level but also at an international scale as well. A mediation strategy that can reconcile differences between different individual nationally interoperable healthcare systems will need to be developed to surmount the geopolitical boundaries that encase healthcare information.