Towards interoperability of EHR systems: the case of Italy

The great benefits that Electronic Health Records are able to provide in terms of improvement of the quality of care and reduction of costs have led many international organizations to implement enabling systems. However, the systems designed and realized are very often not able to interoperate each other, due to several reasons, varying from the existence of different local needs to the use of diverse health informatics standards. The lack of interoperability among these systems can result in decreased levels of quality of patient care and waste of financial resources. In Italy, the autonomy about healthcare delivered by the Italian Constitution to each region caused the spread of heterogeneous regional EHR systems, thus not able to interoperate each other. This paper presents the result of an effort made within a convention between the National Research Council of Italy and the Agency for Digital Italy, for the specification of the Italian architecture for the interoperability of regional EHR systems. Such an architecture has been defined according to the requirements provided by Italian Laws recently issued and approved by a National Technical Board.