From integration to interoperability: The role of public health systems in the emerging world of health information exchange

With the rise of health information exchanges, public health systems are playing a key role in data exchange outside of the public health agency. This presentation will trace the evolution of public health systems from standalone deployment, to intra-agency integration, and finally to external systems interoperability. First, two types of system integration will be addressed: data integration, and application integration. These types of integration will then be generalized into approaches to enterprise-wide integration in public health. Next, the transition from integration to interoperability will be discussed, including the distinction between technical, semantic, and process interoperability (with examples), and the distinction between a data-centered and a document-centered interoperability approach. Finally, the implications for public health will be identified and discussed. Emphasis will be placed on the role of national standards development in helping to define and explain these concepts.