ISO 23903:2021

Overview - ISO 23903:2021 (Health informatics)

ISO 23903:2021 defines an Interoperability and Integration Reference Architecture - model and framework for health informatics. The standard advances interoperability beyond data/information exchange into knowledge sharing and cross‑domain cooperation, supporting ICT‑supported business systems from IT concept level (semantic coordination) up to individual, skills‑based end‑user collaboration. It provides a harmonized, domain‑independent model to represent existing or intended systems and to enable ontology/knowledge harmonization without continuous revision of individual specifications.

Key technical topics and requirements

• Interoperability levels: foundational, structural (syntactic), semantic, coordination (service-level), knowledge‑based (cross‑domain), and skills‑based (individual context).
• Generic Reference Architecture model: an abstract, system‑oriented meta‑architecture for representing components, functions, relations, and policies across granularity levels.
• Framework components:
  • Basic requirements for system representation and integration.
  • Management of relationships between domain representations and system components.
  • Business process modelling guidance using the reference architecture.
• Ontology and knowledge harmonization: supports linking domain‑specific ontologies (e.g., SNOMED‑CT, OBO) to a top‑level, architecture‑centric representation to enable knowledge‑level interoperability.
• Systems approach: emphasizes architecture‑centric, policy‑driven, and ontology‑based methods for adaptive, scalable health and social care ecosystems.
• Scope and limits: tools and languages for ontology or process representation (e.g., Common Logic, OWL 2, UML, BPML) are referenced but their specific languages/formats are outside the standard’s scope.
• Informative annexes: examples for cross‑domain EHR communication, integrating existing communication standards, and deployment considerations (e.g., relations to ISO 12967 and ISO 13972).

Practical applications and target users

• Who will use ISO 23903:2021:
  • Health informatics architects and system designers
  • Standards developers and specification writers
  • Systems integrators, implementers and vendors of EHR and health IT
  • Policy makers and program leads designing multi‑domain digital health ecosystems
• Practical uses:
  • Designing interoperable, knowledge‑aware health IT systems and ecosystems
  • Harmonizing multiple domain ontologies and standards to enable cross‑domain services
  • Analyzing and integrating legacy systems with new ICT‑supported business processes
  • Guiding enterprise architecture and business process modelling for health and social care

Related standards and references

• ISO/IEC 24707 (Common Logic), OWL 2 (W3C), UML (ISO/IEC 19505) - referenced as representation languages (out of scope)
• ISO 13940 (continuity of care concepts), ISO 12967 (systems integration), ISO 21838 (top‑level ontologies)
• Domain standards: SNOMED CT, openEHR, HL7

ISO 23903:2021 is essential when planning robust, scalable interoperability strategies that move from message exchange to true knowledge and process‑level integration in digital health.