INTEROPERABILITY IN CLINICAL DATA INTEGRATION SYSTEMS: A FRAMEWORK FOR HEALTHCARE INFORMATION EXCHANGE

The ability to share clinical information seamlessly between various electronic health record (EHR) systems, among lab platforms, imaging repositories, and mobile health devices is a growing necessity in healthcare delivery. Even with significant investment in digital health infrastructure, data silos, messaging standards and terminology bindings are still fragmented, which stand in the way of real-time clinical decision-making and care coordination. This paper presents a six-layer interoperability model for integration of clinical data that brings together data sourcing interoperability, security governance interoperability, integration engineering interoperability, syntactic interoperability, semantic interoperability, and application-level analytics to a unified interoperability model. The framework combines existing standards such as Health Level Seven (HL7) Fast Healthcare Interoperability Resources (FHIR), Digital Imaging and Communications in Medicine (DICOM) and Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) in a governance-aware exchange model. The semantic and syntactic interoperability, ease of implementation, and ability to exchange information in real-time are compared across five current standards, and adoption trends over a 7-year period (2015-2022) are analyzed. The results show that architectures that use FHIR provide better syntactic flexibility and real-time exchange capabilities compared to legacy HL7 v2.x messaging, and that the key challenge among all of the standards assessed is semantic interoperability. The proposed structure provides a standards-based, scalable and secure blueprint for health information exchange in healthcare organizations.