We dont need no Semantic Interoperability

May 2, 2011

What we need in healthcare is “Semantic Interoperability”. That’ll solve all our problems. That’s what they all say (here’s the most recent case). Really? I beg to differ.

We’ve had semantic interoperability in healthcare since we started having healthcare. Since the beginning of healthcare (by whatever definition you can use), healthcare practitioners have exchanged data using spoken and written words, and the semantic meaning has been clear (well, as clear as it can be given that human knowledge is limited).

So whatever it is that we are doing, it’s not introducing semantic interoperability. In fact, what we are doing is introducing a new player into the mix: computers. And not, in actual fact, computers, but the notion that there is something to be gained by processing healthcare information by persons or devices who don’t properly understand it. So, in fact, what we are actually doing is seeking for unsemantic interoperability.

Unsemantic Interoperability

Yes, that’s right: what we’re trying to achieve is un-semantic interoperability. That’s what people actually mean when they say Semantic Interoperability.

Of course, from a computer perspective, we are trying to get “more semantic”, and so that’s the focus. But from a people perspective, we are actually trying to get less semantic - to constrain the semantics. And that’s why clinicians (who are truly semantically enabled) have problems with this.

And since interoperability is all about the people, it follows important to remember that all this stuff we are trying to achieve is about unsemantic interoperability.

Aside: I know another case like this - it’s the word “Clinical”. From the point of view the general population, “Clinical” means cold, unemotional, not people focused. From the point of view of laboratory medicine, “Clinical” means people focused, messy, emotional.

I don’t know that looking at the interoperability this way makes much difference to what happens technically. But I think it makes a difference to how we assess our overall goals and progress, and how we socialize what we do in interoperability.

So the word “semantics” is a bit lacking in precise semantics of it’s own. No wonder we can never get anywhere.