Hospital information systems interoperability in Iran

Introduction: Interoperability is needed when the Hospital Information System (HIS) data
should be combined and shared with different systems. This study was aimed to determine
the semantic and technical interoperability of hospital information systems of Iran’s health
care centers and propose guidelines to create and develop interoperability of these centers.
Methods: This descriptive study was conducted on companies, which were qualified to
receive performance appraisal certificate of HIS softwares from statistics and information
technology office of health ministry. Standard questionnaire and checklist were used to
collect information in the first and second steps. List of companies, which provided and
produced HIS in Iran, was obtained, and then a self-administered questionnaire was sent for
them. Then, a health care center was selected from each company randomly, and its current
HIS interoperability was evaluated. Data were analyzed using SPSS 16.
Results: Based on the results, all companies were used Microsoft windows and SQL server
database in their HIS with consideration to technical interoperability. Also, the most frequent
corporate programming language was Visual C Sharp (46.7%) and Visual Basic (40%),
respectively. From semantic interoperability aspect, the most frequent terminology systems
were ICD-10 (86.7%), ICD-9CM (66.7%), and CPT (66.7%), respectively. For standard
messaging, 60%, 46.7% and 33.3% used XML, DICOM, and HL7 in order.
Conclusion: Health system interoperability is divided into two semantic and technical parts.
At the present, there is not any standard for electronic health record (EHR) to provide full
interoperability. HIS templates should be provided in order to make a national standard for
EHR. Therefore, it is necessary to have standard template for semantic and technical
interoperability in EHR national exchanges.