A Missing Link on Semantic Interoperability.

Syntactic interoperability among health ICT systems is well-established, but achieving semantic interoperability requires more than just exchanging codes. We present a pragmatic, safe, and effective approach towards an ambitious goal: enabling any software to process a critical mass of routine clinical information in a replicable manner across various systems and local contexts. We advocate for the use of reliable, parsimonious coding to handle the most replicable aspects of data processing for routine patient information, while reserving the intricate interpretation of individual patient data nuances for skilled professionals, possibly supported by Artificial Intelligence tools. We suggest coping with routine tasks by focusing on a limited set of a few thousand data elements, named the 'Clinical Documentation Kernel' (CDK). This approach will provide direct benefits to users and assist in the human interpretation of other patient information. Our preliminary study focuses on the 'primitives' and 'qualifiers' that bring the highest value to the health ecosystem in various authoritative scenarios in the field of diabetes.