The Language of Care: Why Semantic Interoperability is a Matter of Dignity
By Victor Piriz | Seniors International Consulting (SICs)
It is an effortless exercise to lose oneself in the "alphabet soup" of acronyms, standards, and technical jargon that defines modern health information systems (HIS). Yet, at its core, this discourse concerns something far more fundamental: human dignity.
Every digital record is, in essence, a person—a narrative of trust and a moment of vulnerability. HIS are not merely "digital infrastructure"; they constitute the silent scaffolding for clinical decision-making, resource optimization, and public policy robustness. As the WHO emphasizes, strong, well-governed systems are essential: it is not about the mere recording of data, but about using it responsibly to provide superior care.
Uruguay and Mercosur: Lessons from a Tangible Path Uruguay stands as a compelling case study. Through the National Electronic Health Record (HCEN) and the Salud.UY platform, the country has demonstrated that transformation is achievable. However, this journey has not been linear. Behind these milestones are dedicated professionals, such as Dr. Rosario Berterretche, who navigated the tension between acute care urgency and the painstaking work of standardization and integration.
In Mercosur, the landscape remains fragmented. While we share common challenges, we often succumb to the hollow trope: "We must connect the systems." Connectivity alone is insufficient.
The Digital "Broken Telephone" Much of the discourse stalls at technical interoperability—ensuring bits travel from point A to point B. Yet, what truly saves lives is semantic interoperability: ensuring the recipient understands precisely what the sender intended. Without a common lexicon, we play a game of "broken telephone." A diagnosis of "acute myocardial infarction" entered in one facility might arrive as an ambiguous "chest pain" in another if codes aren't shared. The consequences are visceral: redundant tests, compromised decisions, and patients held hostage by bureaucracy.
The SICs Proposition: Preserving Meaning At SICs, we have chosen a clear trajectory: we do not invent proprietary dialects. We adopt global ontologies and standards such as SNOMED CT, LOINC, and HL7 FHIR. This allows clinical data to transcend locality and become a universal asset. This foundation empowers our AI, MATIAS™, to be truly effective; instead of deciphering incompatible formats, it focuses on what matters: supporting decisions, detecting risks, and suggesting improvements.
Towards a Regional Baseline Semantic interoperability is not decreed; it is forged by multidisciplinary teams and the political courage to uphold long-term technical decisions. Mercosur has the opportunity to define a standard "common floor." Thus, a prescription issued in one nation would be legible in another, and a patient's clinical history would accompany them across borders without losing its essence.
References
Berterretche R, García S, Lens M. Aportes para la implementación de la Telemedicina en ASSE. Montevideo: Organización Panamericana de la Salud / Organización Mundial de la Salud (OPS/OMS); 2024.
Seniors International Consulting (SICs). Elementos clave de una nota conceptual de SICs para Partners: Transformación Organizacional y Gobernanza. Montevideo; 2025.
SICs. Grupo de Transformación Conjunto con Empresas Tecnológicas: Estrategia de IA Agencial en el Sector Salud. Documento interno de trabajo. 2025.
World Health Organization. Global strategy on digital health 2020-2025. Geneva: World Health Organization; 2020. Disponible en: https://www.who.int/docs/default-source/documents/gs4dhdaa2a9f352b0445bafbc79ca799dce4d.pdf
World Economic Forum. How digital transformation can help countries achieve 'digital maturity' in healthcare. Geneva: WEF; 2022. Disponible en: https://www.weforum.org/stories/2022/08/countries-achieve-digital-maturity-healthcare/
Health Information Systems Knowledge Hub. Framework and standards for country health information systems. 2nd ed. Geneva: World Health Organization; 2008.
HL7 International. HL7 FHIR (Fast Healthcare Interoperability Resources) Specification, Release 4. Ann Arbor (MI): Health Level Seven International; 2019.
IHTSDO. SNOMED CT: The Global Language of Healthcare. London: International Health Terminology Standards Development Organisation; 2024.
Regenstrief Institute. LOINC (Logical Observation Identifiers Names and Codes) users' guide. Indianapolis (IN): Regenstrief Institute, Inc.; 2024.