Interoperability is the capacity of different systems, platforms, or organizations to communicate and exchange data in ways that are accurate, timely, and usable without requiring custom integration work for each new connection. In an interoperable ecosystem, a piece of information created in one system can be read, understood, and acted upon in another system, regardless of vendor or implementation.
In healthcare, interoperability is both a technical challenge and a policy priority. Patient information generated at one care setting, a primary care physician's office, a specialist clinic, a hospital emergency department, has historically been trapped in siloed systems that could not communicate with each other. The result is fragmented care: clinicians making decisions without access to complete information, redundant testing, medication errors, and care gaps that occur in the transitions between settings. Federal interoperability mandates, particularly those requiring FHIR API adoption, represent a direct policy response to this problem.
Technical interoperability exists at several levels. At the syntactic level, systems agree on data formats so information can be transmitted and parsed correctly. At the semantic level, systems agree on what the data means, using shared terminologies like SNOMED CT for clinical concepts, LOINC for lab tests, and RxNorm for medications. At the process level, the workflows that produce and consume data align so that exchanged information arrives at the right place in the right context to be actionable. Full interoperability requires all three levels.
Beyond healthcare, interoperability is a relevant consideration in any technology ecosystem with multiple interconnected systems. API design, data standards adoption, and the choice of platforms that participate in open ecosystems versus proprietary closed ones are all interoperability decisions with long-term consequences for an organization's ability to connect its tools, adopt new capabilities, and avoid vendor lock-in.