Interoperability platform of targeted systems

Interoperability is the ability of a system to ensure effective interaction with another system providing a service through which information is sent to and received from another application in a secured way [131]. It also means that targeted systems can read, understand, and process exchanged data in response to some unambiguous needs. In the healthcare system, there are different degrees of interoperability that mainly depend on medical appliances. Healthcare system applications interact with each other through standard communication protocols, such as the HL7 transfer protocol. However, in digital pathology, since there is a lack of standardization methods (described in Subchapter 2.3.2), most current digital microscopic systems face interoperability problems with different medical devices [132].

Before defining the road map for the interfacing solution, the degree of interoperability between the targeted systems should be evaluated. Based on the assessment of the requirements, a smart, secured, and safe interfacing solution should be developed.

Medical device manufacturers and information systems developers try to include services in their products that allow their customers to implement an interfacing solution for different purposes. Over the last few years, very few WSI and LIMS companies have developed interfacing solutions in collaboration with an individual laboratory. Since there is no standard

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solution used for any kind of microscopic systems, different degrees of interfacing solutions can be developed by each laboratory according to their own needs.

The interoperability mainly depends on the information that is exchanged among the systems.

Information can be different types used in a variety of ways, such as textual data for storage in another application, numerical measurements for analysis, medical images for display, etc.

As explained in Chapter 1, an interfacing solution is essential to linking microscopic images from the DPS to the corresponding specimen in the LIMS. For this reason, imaging metadata is required to be sent and registered into the laboratory software.

At the beginning of the interoperability analysis of the targeted system, it was revealed that both systems, the Olmypus NIS and the STARLIMS, support web service technologies that can be effective methods for implementing the DP workflow in the biobank research system. The STARLIMS system can use the Representational State Transfer (REST) or SOAP-based web services to operate with external application. As it was already mentioned, the STARLIMS system does not have an in-built interface for a DPS. On the other hand, the Olympus supports web services for connection to external applications, but it also has no experience working with any LIMS system via web services. Currently, integrators of the Olympus NIS use the web-services mostly for the integration of the proprietary Olympus file format in their application.

These kinds of integrators are mostly the companies that provide the image handling systems or image viewers on the market that support most of the file formats of the digital microscopic images established by different scanner manufacturers. Although web service technology is widely used for different purposes, up until now, neither customers nor the manufacturers of these systems (STARLIMS and Olympus) have used web services for the DP workflow implementation. Mostly, customers of WSI devices try to find a simple solution (such as direct file transfer or SQL stored procedures) that needs very limited human or time resources for development. However, these kinds of solutions are partly automated and are not able to provide a fully integrated digital workflow. Because of scarcity of the experience of web services in DP, interoperability requirements and an architectural model of the interfacing solution needs to be designed.

According to the definition of the Healthcare Information Management Systems Society, there are three levels of health information technology interoperability: technical, syntactic, and semantic interoperability (Figure 5.1) [133]. Technical interoperability is a basic level of

interoperability that provides technical ability to send/receive information between the systems by means of correct transmission protocols. This involves technical aspects such as data integration services, network specifications between connected systems, data transferring protocols, etc. Syntactic interoperability layer covers a well-defined format and encoding for data exchange, such as HL7, XML, SQL standards [134]. Using the defined syntax, systems can read the message and understand the type of information that was sent in an unambiguous manner, but it is unable to recognize the meaning of the information. Semantic interoperability, known as high level of interoperability, refers to the ability to rigorously understand the meaning of the exchanged information. Using the semantic layer, a system that receives the information, processes and interprets exchange information respectively.

For example, in the healthcare system, using a common vocabulary of terminology enables semantic understanding of information during system-to-system communication. From the biobank point of view, in digital pathology, semantic interoperability is achieved when the system can read, understand, process, and interpret the complex retrieved data.

Figure 5.1. Three levels of interoperability

Interoperability requirements:

Interoperability requirements are requirements that ensure the optimal levels of interoperability platforms so that data can be shared between the targeted systems in a secure and effective manner. In conjunction with technical and syntactic interoperability, a small degree of semantic interoperability could be concerned with providing an advanced level of information sharing. Furthermore, one of the main requirements is to use the services provided by the manufacturers of the systems and develop the interfacing solution without changing the system. As the DPS and the LIMS are located in the same medical center, sharing information across the systems should be performed via a local network, which will provide secure and safe data transmissions.

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