I am always amused by statements saying that the system is only at the level of syntactic interoperability because it is not using standards for the data exchange, and it will be at level of semantic interoperability with the adoption of standards.
This kind of statement is not entirely true especially the second part, IMO, every two interconnected systems are semantically interoperable regardless of whether the data exchange is based on industry standards or not.
Let us look the IEEE's definition of Syntactic and Semantic Interoperability in the below figure.
Based on the above definition, as long as two interconnected systems function as per requirement, and satisfy the use cases, they are obviously qualified as "Semantic Interoperability" with one caveat - whether the capability is applicable for more participating systems.
This can be easily satisfied again as long as we mandate that every integration partner follows the existing data exchange specification, and the existing in-use data exchange specification eventually becomes the de-facto standards, which again is not bad thing at all. Every standard is originated from non-standard based implementation, just like what said - "Travelers, there is no path, paths are made by walking."
Now back to the caveat earlier mentioned - whether the capability is applicable for more participating systems. Let's list out what are the factors that will affect our ability to apply the existing capability to another system and more.
1) The development effort required to replicate the capability to another system or more in the entire healthcare ecosystem
2) The ability for the existing integrated interface to adapt for future use cases
3) How do I choose the right standards for my solution
Please tune in for the Part II and Part III in the following weeks to analyze what is the motivation for adopting industry standards, and what kind of standards you should be adopting considering the fact that healthcare standards arena is a complicated environment, there are good ones but also a lot of shady ones, or just simply being abused or misused.
In mean time, please let me know any comment or suggestion.