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Quantitating and assessing interoperability between electronic health records

Lead article author Elmer Bernstam discusses this month's JAMIA Journal Club selection:

Bernstam EV, Warner JL, Krauss JC, et al. Quantitating and assessing interoperability between electronic health records [published online ahead of print, 2022 Jan 7]. J Am Med Inform Assoc. 2022;ocab289. doi:10.1093/jamia/ocab289 

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Elmer Bernstam, MD, MSE, FACMI
Professor of Biomedical Informatics & Internal Medicine
UTHealth School of Biomedical Informatics
Houston, TX

Dr. Bernstam received Bachelors’ degrees in Biomedical Sciences, Psychology, and Computer Engineering, an MD and a Masters of Science in Engineering, all from the University of Michigan. After an internal medicine residency, he matriculated as an NLM Fellow to the Medical Information Sciences program at Stanford and received his master’s degree in Informatics. He joined the School of Biomedical Informatics at the University of Texas Health Science Center (UTHSC) at Houston as an assistant professor in 2001. Currently, Dr. Bernstam is the Reynolds and Reynolds Professor of Clinical Informatics and Associate Dean for Research at the University of Texas School of Biomedical Informatics at Houston.

In addition, he is Professor of Internal Medicine and continues to practice inpatient general internal medicine (hospitalist). Academically, he focuses on clinical and translational research informatics including collecting and “making sense” of large-volume clinical data (clinical data warehousing), consumer informatics and precision oncology decision support. Dr. Bernstam’s group created and maintains the i2b2-based clinical data warehouse with data on over 5 million patients. His group also provides a variety of services to clinical/translational investigators at the University of Texas Health Science Center at Houston and other institutions. Dr. Bernstam is an elected fellow of the American College of Physicians (2004) and the American College of Medical Informatics (2010). 

JAMIA Journal Club managers and monthly moderators are JAMIA Student Editorial Board members:


Aaron Tierney, BA
PhD Candidate in Health Policy
UC Berkeley School of Public Health
Berkeley, CA



Christina Baker, MS, BSN, NCSN, RN-BC
PhD Student - Faculty Teaching Fellow
University of Colorado, Anschutz Medical Campus - College of Nursing
Denver, CO

Statement of Purpose

Interoperability is the “degree to which two or more systems, products or components can exchange information and use the information that has been exchanged.” The widespread implementation of electronic health records (EHRs) has focused attention on the ability to share structured (clinical) data between sites; or, to be more precise, between EHR implementations. However, interoperability is usually discussed as a binary property without consideration of any particular task or purpose. Clearly, it is possible for 2 systems to be able to share some data types (eg, demographics), but not others (eg, laboratory results). In addition, the sharing of a particular data type may be suitable for one purpose but not another. Thus, interoperability is a continuum based on context, rather than an absolute.

In this talk, we will discuss quantitating interoperability. Specifically, we will present an approach to define a metric (or metrics) of interoperability based on the ability of two or more systems to share and “understand” specific but representative data types. We demonstrate this approach with a real-world sample of 68 sites implementing a variety of EHR vendor products.

Target Audience

The target audience for this activity is professionals and students interested in health informatics.

Learning Objectives

After participating in this webinar the listener should be better able to:

  • Define interoperability
  • Understand a quantitative approach to measuring interoperability
  • Describe the state of interoperability based on a sample of EHR implementations


  • 35-minute presentation by article author(s) considering salient features of the published study and its potential impact on practice
  • 25-minute discussion of questions submitted by listeners via the webinar tools and moderated by JAMIA Student Editorial Board members. 

Accreditation Statement

The American Medical Informatics Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Dates and Times: -
Type: Webinar
Course Format(s): On Demand
Price: Free