Interoperable support for collaborative, mobile, and accessible health care

E-Health systems, through their use of Internet and wireless technologies, offer the possibility of near real-time data integration to support the delivery and management of health care. In practice, the wide range of choice in technologies, vendors, protocols, formats, and information representations can make even simple exchanges of information between systems problematic. Much of the focus on healthcare interoperability has been on resolving interoperability issues of system to system information exchanges. But issues around people to people interactions and people to system interactions are just as important to address from an interoperability point of view. In this paper, we identify interoperability deficiencies in collaborative care delivery and develop a methodology in two parts. In the first part, an ontology is developed to represent collaborative care delivery. In the second part, the ontology is used to design an architecture for interoperable clinical information system design. We then use a case study in palliative care to provide a proof of concept of the methodology. The case study provides an inventory of the interoperability requirements for palliative care and a perspective on the design and implementation of a people oriented clinical information system that supports collaborative health care delivery in palliative care.