Summary
Interoperability is often framed as a standards problem, typically addressed through HL7 FHIR.
However, FHIR standardises structure, not semantics or implementation constraints.
Organisations define local profiles, extensions, and coding systems, resulting in syntactically valid but semantically inconsistent data.
This leads to systems that can exchange data but cannot reliably compose or analyse it without transformation.
True interoperability depends on alignment across:
- data models and canonical schemas
- terminology systems and controlled vocabularies
- implementation constraints and validation rules
- governance frameworks across institutions
Interested in collaborating?
If this perspective resonates and you are exploring collaboration across research, governance, or secure data environments, I welcome the conversation.