LIMS, PACS, EHR, and Research Data Interoperability
Holding
Interoperability is not successful when two systems merely exchange messages. It is successful when clinical meaning, timing, identity, units, and responsibility survive the transfer.
Authority
ONC interoperability programs and HL7 FHIR provide a modern basis for structured health data exchange. Medical device and quality frameworks add a further duty: software that uses clinical data must preserve fitness for its intended purpose.
Issue
LIMS, PACS, EHR, and research platforms were built around different operational truths. A laboratory result, an imaging study, a clinical note, and a research-derived feature do not carry the same evidentiary status. Treating them as equivalent rows creates unsafe simplification.
Resolution
The architecture should define canonical identifiers, vocabulary mappings, unit conversion rules, time semantics, source authority, reconciliation logic, and exception handling. Research datasets should preserve links back to clinical source objects rather than severing provenance during export.
Evidence Package
The record should include interface specifications, mapping tables, conformance tests, reconciliation logs, data quality reports, and downstream validation evidence. Interoperability should be evaluated as a clinical safety property, not only an integration milestone.