The near-future for the digital innovation of health and social care services is bright and filled with possibilities; a person-held record enabling immediate sharing of relevant information between services; data from consumer devices providing a more complete overview of a citizen’s wellbeing and powering preventative approaches to health and wellbeing; automated processes reducing administration and allowing staff time to focus on meaningful citizen-facing interactions – the list goes on.

Over the coming months we’ll be exploring some of these possibilities, and the wider benefits that better use of data could bring, through a series of articles, blogs and infographics.

A uniting theme in all the examples given above is interoperability, that is the ability of different systems and devices to share data, and so this seemed like the perfect topic with which to begin.

All the examples given hold true for telecare and have been presented as possible benefits of the transition to digital telecare. For telecare services however, achieving this future utopia at times feels like an up-hill struggle.

Proprietary software and a reluctance from some suppliers to embrace a more open approach can leave telecare service providers with the feeling of remaining on the wrong side of a locked door.

Variation in approach to telecare service delivery across Scotland has led to numerous service models designed to meet local needs but creating challenges for the definition of key terms and metrics.

These are challenging issues, and while I won’t present a full solution in this blog, what I will demonstrate is that through a greater understanding of what interoperability means, we can start to chart a path forward.

Interoperability

The idea I would like to present with this blog is that interoperability is as much a cultural and organisational concept, as it is technical. There are technical elements to interoperability, this is beyond dispute, but that is only part of the picture. By exploring the broader picture I’ll begin to outline how each of us has the ability to influence meaningful change.

The model I will present here is based on the European Interoperability Framework[1], and is made-up of four key layers: 

• • Political - A shared vision
  • Organisational - Aligned with business processes 
  • Semantic - Defined data formats and definitions 
  • Technical - Applications and infrastructure 

I’ll now explore each of these layers in a little more detail.

Political Interoperability

What is it?

Before we start to answer the ‘how’ it is essential that we have a clear, shared understanding of the ‘why’. What is driving our push for interoperability? What is it we are hoping to achieve and what are the timescales for this?

Without a clear shared vision which answers these questions, it will be next to impossible to coordinate different stakeholders and the task of achieving interoperability becomes that much harder.

There is also a further governance component to this layer, defining the standards we must all comply with to ensure the vision can be achieved, and how this will be monitored and assessed to ensure sustainability of the approach.

What can we do?

Co-create a shared vision statement setting out the future we would like to see for telecare data.

Organisational Interoperability

What is it?

Organisational interoperability is the process of stakeholders bringing the business processes within their various organisations into alignment with the shared vision and defined standards.

What can we do?

Become champions for better use of data within our own organisations, exploring possibilities and embedding the shared vision. Receive support from peers and learn how others are using data, through participation in telecare benchmarking.

Semantic Interoperability

What is it?

With this layer we enter the domain of what most people would normally think about when considering the concept of interoperability. Semantic interoperability describes the process of defining terms, metrics and interrelations, so that when data is shared it is interpreted and understood correctly.

What can we do?

The work currently being undertaken by TEC around defining a minimum data set will begin the process of defining semantic interoperability. Engaging with this work, and adopting a common Scottish approach to telecare terminology will help create a firm foundation for the vision.

Technical Interoperability

What is it?

Finally technical interoperability looks at applications and infrastructure; how our various devices and systems need to interact in order for data to be shared between them. Legacy systems will always present a challenge, but through clear standards outlining what is expected from suppliers, we can move towards a future state where all systems are interoperable.

What can we do?

By adopting a shared vision, bringing our organisational processes and terminology into closer alignment, we can create momentum behind a case for change and use this to positively influence suppliers to bring their products into alignment.

A Path Forward

What I hope to have demonstrated through this short blog is that no element of interoperability is beyond our influence, and that working together we can bring about positive change.

Over the next few months, we’ll highlight some of the benefits better use of data could bring, as well as some of the initiatives which are already underway to enable these benefits. The scene set, we will then bring all of this together in a series of engagements aimed at co-creating a vision statement for the future of telecare data.