Complete interoperability in healthcare : technical, semantic and process interoperability through ontology mapping and distributed enterprise integration techniques

Interoperability in healthcare is a requirement for effective communication between entities, to ensure timely access to up-to-date patient information and medical knowledge, and thus consistent patient care. This thesis focuses on the development of an interoperability solution for health by employing design science research methods to arrive at a final solution. First, background topics including Health Informatics standards and formats are covered, which leads to three major Health Informatics standards being used throughout the remainder of this work – HL7 for messaging, openEHR for patient records, and SNOMED CT as a standard terminology to facilitate clarity of information, and to discourage ambiguity between communicating entities. Ontology mapping methods between these standards designed to promote interoperability by using the standards in conjunction with each other are then presented, leading to a solution for semantic interoperability. A technical interoperability solution is required for sending these semantically interoperable messages, which leads to the development of a framework which uses a tuple-space paradigm to share messages. This framework is shown to have some scalability issues, which leads to the final solution – a scalable interoperability framework based on the Enterprise Service Bus methodology of enterprise integration which provides a real-world answer to communication in healthcare.