{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T15:38:51Z","timestamp":1777045131370,"version":"3.51.4"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T00:00:00Z","timestamp":1566259200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T00:00:00Z","timestamp":1566259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["npj Digit. Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Digital data are anticipated to transform medicine. However, most of today\u2019s medical data lack interoperability: hidden in isolated databases, incompatible systems and proprietary software, the data are difficult to exchange, analyze, and interpret. This slows down medical progress, as technologies that rely on these data \u2013 artificial intelligence, big data or mobile applications \u2013 cannot be used to their full potential. In this article, we argue that interoperability is a prerequisite for the digital innovations envisioned for future medicine. We focus on four areas where interoperable data and IT systems are particularly important: (1) artificial intelligence and big data; (2) medical communication; (3) research; and (4) international cooperation. We discuss how interoperability can facilitate digital transformation in these areas to improve the health and well-being of patients worldwide.<\/jats:p>","DOI":"10.1038\/s41746-019-0158-1","type":"journal-article","created":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T10:02:54Z","timestamp":1566295374000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":388,"title":["Why digital medicine depends on interoperability"],"prefix":"10.1038","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8435-1374","authenticated-orcid":false,"given":"Moritz","family":"Lehne","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2068-7765","authenticated-orcid":false,"given":"Julian","family":"Sass","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0042-8088","authenticated-orcid":false,"given":"Andrea","family":"Essenwanger","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7350-2480","authenticated-orcid":false,"given":"Josef","family":"Schepers","sequence":"additional","affiliation":[]},{"given":"Sylvia","family":"Thun","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2019,8,20]]},"reference":[{"key":"158_CR1","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1038\/nrg3208","volume":"13","author":"PB Jensen","year":"2012","unstructured":"Jensen, P. B., Jensen, L. J. & Brunak, S. Mining electronic health records: towards better research applications and clinical care. Nat. Rev. Genet. 13, 395\u2013405 (2012).","journal-title":"Nat. Rev. Genet."},{"key":"158_CR2","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1001\/jama.2013.393","volume":"309","author":"TB Murdoch","year":"2013","unstructured":"Murdoch, T. B. & Detsky, A. S. The inevitable application of big data to health care. JAMA 309, 1351\u20131352 (2013).","journal-title":"JAMA"},{"key":"158_CR3","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1001\/jama.2014.17125","volume":"313","author":"EJ Topol","year":"2015","unstructured":"Topol, E. J., Steinhubl, S. R. & Torkamani, A. Digital medical tools and sensors. JAMA 313, 353\u2013354 (2015).","journal-title":"JAMA"},{"key":"158_CR4","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1001\/jama.2017.11295","volume":"318","author":"TR Insel","year":"2017","unstructured":"Insel, T. R. Digital phenotyping: technology for a new science of behavior. JAMA 318, 1215\u20131216 (2017).","journal-title":"JAMA"},{"key":"158_CR5","doi-asserted-by":"publisher","first-page":"R56","DOI":"10.1093\/hmg\/ddy114","volume":"27","author":"BS Glicksberg","year":"2018","unstructured":"Glicksberg, B. S., Johnson, K. W. & Dudley, J. T. The next generation of precision medicine: observational studies, electronic health records, biobanks and continuous monitoring. Hum. Mol. Genet. 27, R56\u2013R62 (2018).","journal-title":"Hum. Mol. Genet."},{"key":"158_CR6","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1056\/NEJMra1814259","volume":"380","author":"A Rajkomar","year":"2019","unstructured":"Rajkomar, A., Dean, J. & Kohane, I. Machine learning in medicine. N. Engl. J. Med. 380, 1347\u20131358 (2019).","journal-title":"N. Engl. J. Med."},{"key":"158_CR7","doi-asserted-by":"publisher","first-page":"1667","DOI":"10.1001\/jama.2016.12337","volume":"316","author":"JB Perlin","year":"2016","unstructured":"Perlin, J. B. Health information technology interoperability and use for better care and evidence. JAMA 316, 1667\u20131668 (2016).","journal-title":"JAMA"},{"key":"158_CR8","doi-asserted-by":"crossref","unstructured":"The Lancet. Making sense of our digital medicine Babel. Lancet 392, 1487 (2018).","DOI":"10.1016\/S0140-6736(18)32545-5"},{"key":"158_CR9","unstructured":"National Academy of Medicine. Procuring Interoperability: Achieving High-Quality, Connected, and Person-Centered Care. (2018)."},{"key":"158_CR10","doi-asserted-by":"publisher","first-page":"1216","DOI":"10.1056\/NEJMp1606181","volume":"375","author":"Z Obermeyer","year":"2016","unstructured":"Obermeyer, Z. & Emanuel, E. J. Predicting the future \u2014 big data, machine learning, and clinical medicine. N. Engl. J. Med. 375, 1216\u20131219 (2016).","journal-title":"N. Engl. J. Med."},{"key":"158_CR11","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1136\/svn-2017-000101","volume":"2","author":"F Jiang","year":"2017","unstructured":"Jiang, F. et al. Artificial intelligence in healthcare: past, present and future. Stroke Vasc. Neurol. 2, 230\u2013243 (2017).","journal-title":"Stroke Vasc. Neurol."},{"key":"158_CR12","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1038\/s41746-017-0012-2","volume":"1","author":"AL Fogel","year":"2018","unstructured":"Fogel, A. L. & Kvedar, J. C. Artificial intelligence powers digital medicine. Npj Digit. Med. 1, 5 (2018).","journal-title":"Npj Digit. Med."},{"key":"158_CR13","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6947-12-67","volume":"12","author":"ASM Mosa","year":"2012","unstructured":"Mosa, A. S. M., Yoo, I. & Sheets, L. A systematic review of healthcare applications for smartphones. BMC Med. Inform. Decis. Mak. 12, 67 (2012).","journal-title":"BMC Med. Inform. Decis. Mak."},{"key":"158_CR14","doi-asserted-by":"publisher","first-page":"1820","DOI":"10.1377\/hlthaff.2017.0546","volume":"36","author":"AJ Holmgren","year":"2017","unstructured":"Holmgren, A. J., Patel, V. & Adler-Milstein, J. Progress in interoperability: measuring US Hospitals\u2019 engagement in sharing patient data. Health Aff. 36, 1820\u20131827 (2017).","journal-title":"Health Aff."},{"key":"158_CR15","doi-asserted-by":"crossref","unstructured":"Benson, T. & Grieve, G. Principles of Health Interoperability: SNOMED CT, HL7 and FHIR (Springer-Verlag, London, 2016).","DOI":"10.1007\/978-3-319-30370-3"},{"key":"158_CR16","doi-asserted-by":"crossref","unstructured":"Oemig, F. & Snelick, R. Healthcare Interoperability Standards Compliance Handbook: Conformance and Testing of Healthcare Data Exchange Standards (Springer International Publishing, Switzerland, 2016).","DOI":"10.1007\/978-3-319-44839-8"},{"key":"158_CR17","doi-asserted-by":"publisher","unstructured":"IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries. IEEE Std 610 1\u2013217 (1991). https:\/\/doi.org\/10.1109\/IEEESTD.1991.106963","DOI":"10.1109\/IEEESTD.1991.106963"},{"key":"158_CR18","doi-asserted-by":"publisher","unstructured":"Bender, D. & Sartipi, K. HL7 FHIR: an Agile and RESTful approach to healthcare information exchange. in Proceedings of the 26th IEEE International Symposium on Computer-Based Medical Systems p. 326\u2013331 (2013). https:\/\/doi.org\/10.1109\/CBMS.2013.6627810","DOI":"10.1109\/CBMS.2013.6627810"},{"key":"158_CR19","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1093\/jamia\/ocv189","volume":"23","author":"JC Mandel","year":"2016","unstructured":"Mandel, J. C., Kreda, D. A., Mandl, K. D., Kohane, I. S. & Ramoni, R. B. SMART on FHIR: a standards-based, interoperable apps platform for electronic health records. J. Am. Med. Inform. Assoc. 23, 899\u2013908 (2016).","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"158_CR20","unstructured":"Beale, T. Archetypes: constraint-based domain models for future-proof information systems. in Eleventh OOPSLA Workshop on Behavioral Semantics. (2002)."},{"key":"158_CR21","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.ijmedinf.2018.12.011","volume":"123","author":"JA Mi\u00f1arro-Gim\u00e9nez","year":"2019","unstructured":"Mi\u00f1arro-Gim\u00e9nez, J. A. et al. Quantitative analysis of manual annotation of clinical text samples. Int. J. Med. Inf. 123, 37\u201348 (2019).","journal-title":"Int. J. Med. Inf."},{"key":"158_CR22","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1373\/49.4.624","volume":"49","author":"CJ McDonald","year":"2003","unstructured":"McDonald, C. J. et al. LOINC, a universal standard for identifying laboratory observations: a 5-year update. Clin. Chem. 49, 624\u2013633 (2003).","journal-title":"Clin. Chem."},{"key":"158_CR23","unstructured":"European Medicines Agency. https:\/\/www.ema.europa.eu\/en\/human-regulatory\/overview\/data-medicines-iso-idmp-standards-overview (2016)."},{"key":"158_CR24","doi-asserted-by":"publisher","first-page":"D619","DOI":"10.1093\/nar\/gkw1033","volume":"45","author":"B Yates","year":"2017","unstructured":"Yates, B. et al. Genenames.org: the HGNC and VGNC resources in 2017. Nucleic Acids Res. 45, D619\u2013D625 (2017).","journal-title":"Nucleic Acids Res."},{"key":"158_CR25","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1016\/j.ajhg.2008.09.017","volume":"83","author":"PN Robinson","year":"2008","unstructured":"Robinson, P. N. et al. The human phenotype ontology: a tool for annotating and analyzing human hereditary disease. Am. J. Hum. Genet. 83, 610\u2013615 (2008).","journal-title":"Am. J. Hum. Genet."},{"key":"158_CR26","unstructured":"Gandhi, R., Verma, S., Baltassis, E. & Gordon, N. Look Before You Leap into the Data Lake. https:\/\/www.bcg.com\/de-de\/publications\/2016\/big-data-advanced-analytics-technology-digital-look-before-you-leap-into-data-lake.aspx (2016)."},{"key":"158_CR27","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1038\/nature21056","volume":"542","author":"A Esteva","year":"2017","unstructured":"Esteva, A. et al. Dermatologist-level classification of skin cancer with deep neural networks. Nature 542, 115\u2013118 (2017).","journal-title":"Nature"},{"key":"158_CR28","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1038\/s41591-018-0335-9","volume":"25","author":"H Liang","year":"2019","unstructured":"Liang, H. et al. Evaluation and accurate diagnoses of pediatric diseases using artificial intelligence. Nat. Med. 25, 433 (2019).","journal-title":"Nat. Med."},{"key":"158_CR29","doi-asserted-by":"publisher","first-page":"2402","DOI":"10.1001\/jama.2016.17216","volume":"316","author":"V Gulshan","year":"2016","unstructured":"Gulshan, V. et al. Development and validation of a deep learning algorithm for detection of diabetic retinopathy in retinal fundus photographs. JAMA 316, 2402\u20132410 (2016).","journal-title":"JAMA"},{"key":"158_CR30","unstructured":"European Commission. https:\/\/ec.europa.eu\/digital-single-market\/en\/news\/european-standard-digital-patient-summary-has-been-approved (2018)."},{"key":"158_CR31","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/j.ajhg.2017.01.006","volume":"100","author":"RB Ramoni","year":"2017","unstructured":"Ramoni, R. B. et al. The undiagnosed diseases network: accelerating discovery about health and disease. Am. J. Hum. Genet. 100, 185\u2013192 (2017).","journal-title":"Am. J. Hum. Genet."},{"key":"158_CR32","unstructured":"European Commission. https:\/\/ec.europa.eu\/health\/ern_en (2016)."},{"key":"158_CR33","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1002\/humu.22078","volume":"33","author":"A Rath","year":"2012","unstructured":"Rath, A. et al. Representation of rare diseases in health information systems: The orphanet approach to serve a wide range of end users. Hum. Mutat. 33, 803\u2013808 (2012).","journal-title":"Hum. Mutat."},{"key":"158_CR34","doi-asserted-by":"publisher","first-page":"1381","DOI":"10.1056\/NEJMp1502918","volume":"372","author":"B Gates","year":"2015","unstructured":"Gates, B. The next epidemic \u2014 lessons from Ebola. N. Engl. J. Med. 372, 1381\u20131384 (2015).","journal-title":"N. Engl. J. Med."},{"key":"158_CR35","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1353\/bhm.2002.0022","volume":"76","author":"NPAS Johnson","year":"2002","unstructured":"Johnson, N. P. A. S. & Mueller, J. Updating the accounts: global mortality of the 1918-1920 \u2018Spanish\u2019 influenza pandemic. Bull. Hist. Med. 76, 105\u2013115 (2002).","journal-title":"Bull. Hist. Med."},{"key":"158_CR36","doi-asserted-by":"publisher","first-page":"2057","DOI":"10.1056\/NEJMp1806283","volume":"378","author":"B Gates","year":"2018","unstructured":"Gates, B. Innovation for Pandemics. N. Engl. J. Med. 378, 2057\u20132060 (2018).","journal-title":"N. Engl. J. Med."},{"key":"158_CR37","doi-asserted-by":"publisher","first-page":"3187","DOI":"10.1039\/C4LC00010B","volume":"14","author":"A Ozcan","year":"2014","unstructured":"Ozcan, A. Mobile phones democratize and cultivate next-generation imaging, diagnostics and measurement tools. Lab Chip 14, 3187\u20133194 (2014).","journal-title":"Lab Chip"},{"key":"158_CR38","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1016\/S0140-6736(18)30109-0","volume":"391","author":"SR Steinhubl","year":"2018","unstructured":"Steinhubl, S. R., Kim, K., Ajayi, T. & Topol, E. J. Virtual care for improved global health. Lancet 391, 419 (2018).","journal-title":"Lancet"},{"key":"158_CR39","unstructured":"European Commission. http:\/\/europa.eu\/rapid\/press-release_IP-18-6808_en.htm (2019)."},{"key":"158_CR40","unstructured":"European Commission. http:\/\/europa.eu\/rapid\/press-release_MEX-19-3351_en.htm#5 (2019)."}],"container-title":["npj Digital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41746-019-0158-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-019-0158-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-019-0158-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,17]],"date-time":"2022-12-17T18:31:46Z","timestamp":1671301906000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41746-019-0158-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,20]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,12]]}},"alternative-id":["158"],"URL":"https:\/\/doi.org\/10.1038\/s41746-019-0158-1","relation":{},"ISSN":["2398-6352"],"issn-type":[{"value":"2398-6352","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,20]]},"assertion":[{"value":"15 April 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 July 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 August 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"S.T. is vice chair of HL7 Deutschland e.V. The remaining authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"79"}}