Interoperability in Healthcare: Nurturing Beyond Theory

By Janne Pitkänen, chief executive office and founder, Adusso Ltd.; a HIMSS Champion of Health

Janne Pitkänen

Interoperability plays an ever-increasing role in the future of healthcare. That we can say almost for sure – we just don’t know which approaches will most dominantly drive the change in the healthcare industry.

Take electronic health records (EHRs) as an example. You can basically see three different approaches for tackling the challenge of being able to transfer your patient journal data from a point of care to another for an uninterrupted patient journey. For now, I’ll be using the following three items to walk through the concept of interoperability in healthcare:

  1. Patient-centric approach
  2. Provider-/EHR-centric approach
  3. State-/country-centric approach

All these approaches call for different priorities for nurturing interoperability in healthcare beyond theory. Going from number one towards number three necessitates more trust by individuals towards the system, while making them more and more dependent on it – for good and for bad. Putting weight on either the patient-centric or state-/country-centric preference would provide their own advantages and be viable in different societies and regulatory environments.

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A patient-centric approach would give individuals the opportunity to take their information wherever they want. In practice, this would mean a mobile device on which they can carry the information and give access to a desired healthcare provider of their choice.

What’s required to make this happen? For an individual, being able to gather and collect the information would be the first necessity. How about backing up the information and, most importantly, a way of ensuring interoperability in healthcare providers’ systems? Personal backups you can take almost for granted with today’s mobile devices. The important part is the healthcare providers’ ability to access your information and make best of it to take care for you.


A provider-/EHR-centric approach makes it possible to solve the interoperability challenge between systems. This is where the traditional efforts around interoperability in healthcare are taking place in most parts of the world where electronic patient journals are already widely in use.

Either emerging industry standards or bilateral interfaces are used between systems from different vendors and the information exchange happens directly from system to another. As it goes in the patient-centric approach, here the information retrieval is similarly initiated by demand, created by the need for patient care. At will, the patient can usually opt-out from any default data interchange.


A state-/country-centric approach is something I know the most, being a citizen of Finland and dealing with more or less similar systems among the Nordic countries for work. Distinctive characteristic for such a system is a relatively large-scale implementation of centralized patient registry, either nationwide or at least covering certain type of healthcare operations in the whole country.

It goes without asking that this kind of approach would provide economies of scale even in smaller countries while the success of a system deployment project is crucial for not ending up with problems concerning all the 6 million inhabitants in a population-small country like Finland.

Provided that the third approach is working at least somehow, the centralized registry would enable leading edge opportunities to improve population health with preventive actions. By help of standardized data formats to store and retrieve patient journal information, the entire nation would be less dependent on any certain system or vendor.

The trick lies here in having a strong platform for hosting the patient journal information and having any operational EHR systems accessing it through industry standard data exchange protocols. On the other hand, high level of trust is needed by the individuals to let a centralized entity to do your “health information banking” on your behalf.

I feel honored being chosen as one of the Champions of Health globally for HIMSS19. Even more, I’m excited about the HIMSS Europe conference coming to Helsinki, Finland for its first time. I’m definitely looking forward to learning to know the most brilliant ideas and people in healthcare on both sides of the pond.

The views and opinions expressed in this blog or by commenters are those of the author and do not necessarily reflect the official policy or position of HIMSS or its affiliates.


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