Problem: Annotated Bibliography on this article
The digitalization of medicine promises great advances for global health. Electronic medical records, mobile health apps, medical imaging, low-cost gene sequencing as well as new sensors and wearable devices provide an ever-increasing flow of digital health data. Combined with artificial intelligence, cloud computing and big data analytics, this wealth of data holds huge potential for healthcare and can improve the lives of millions of patients worldwide - with better diagnostics, personalized treatments, and early disease prevention.1,2,3,4,5,6
But medical data are only useful if they can be turned into meaningful information. This requires high-quality datasets, seamless communication across IT systems and standard data formats that can be processed by humans and machines. Judged by these criteria, however, large parts of today's medical data are virtually useless: Hidden in isolated data silos and incompatible systems, the data are difficult to exchange, process and interpret. In fact, the current medical landscape seems less characterized by "big data" but rather by a large number of disconnected small data. These are suboptimal conditions for the data-driven technologies anticipated to drive medical innovation. Uncovering the full potential of digital medicine requires an interconnected data infrastructure with fast, reliable and secure interfaces, international standards for data exchange as well as medical terminologies that define unambiguous vocabularies for the communication of medical information. In short: Digital health depends on interoperability.
The aim of this article is to show why interoperability is so important for achieving the full potential of digitalization in healthcare and medicine. Although the importance of interoperable health IT systems is increasingly acknowledged,7,8,9 awareness of this topic is still relatively low among healthcare professionals - especially compared with topics such as artificial intelligence, big data or mobile technologies, which are generally seen as the main drivers of digital health innovation.6,10,11,12,13 Accordingly, progress in health interoperability is slow.14 Here, we argue that interoperability is indispensable for advances in digital health and that it is, in fact, a prerequisite for most of the innovations envisioned for future medicine.
Our article starts with an overview of interoperability and its different levels: technical, syntactic, semantic, and organizational. It then shows how interoperability can improve medicine, focusing on four areas that especially benefit from (and sometimes crucially depend on) interoperable health IT systems: (1) artificial intelligence and big data; (2) medical communication; (3) research; and (4) international cooperation (Fig. 1). We chose these four areas because they illustrate particularly well how interoperability can facilitate digital transformation and improve medicine and healthcare (however, the areas are not mutually exclusive, and advancing, for example, medical communication can also improve international cooperation). Note that our views are shaped by our German/European perspective. However, we discuss points general enough to be relevant for international readers. Also note that, though giving some examples of specific health IT standards and medical terminologies that can improve interoperability, this article does not aim to provide detailed technical discussions of specific standards or terminologies (this information can be found elsewhere15,16).
Digital medicine depends on interoperable and standardized data. In this article, we discussed how interoperable health data can help to realize the full potential of AI and big data, improve the communication of medical information, make medical research more efficient and foster international cooperation. As interoperability requires the collaborative efforts of healthcare professionals, researchers, IT experts, data engineers, and politicians, it is important to make interoperability a prominent topic in medicine and healthcare. Eventually, efforts to improve interoperability will pay huge dividends: With international standards and medical terminologies, interoperability can pave the way for an interconnected digital health infrastructure that overcomes barriers between individuals, organizations and countries. This will make it possible to turn digital medical data into meaningful information and improve the health and well-being of patients worldwide.