4.2 Interop framework and use cases Defining interoperability is challenging because there is no one-size-fits-all definition. How one defines interop is based largely on context and perspective. For example, in the context of electronic health records, patients may define interoperability as seamless access to their medical records. But the third-party operator of the hospital’s e-health records database may define interoperability as the ability to technically interconnect with the hospital’s computer systems and integrate health records in a meaningful (and secure) way. In that regard, interop is not just one type of transaction or relationship, it encompasses many forms of interaction, often occurring simultaneously. A transaction as simple as sharing electronic vaccination records with a new doctor might require numerous and concurrent forms of interoperability in order to succeed. Although interop can mean many things, it is fundamentally the ability to transfer and render useful data and information across systems, applications, or components. But this definition does not fully embrace the complex and varying layers of interop. In theoretical terms, interoperability functions across four broad layers of complex systems, as shown in Figure 4.1.Many people think of the exchange of data through technological means when they think about interop. But case studies demonstrate that the human and institutional aspects of interoperability are often just as vital – and sometimes even more important -- than the technological aspects.3 How individuals work together, often relying upon technological tools, can determine whether the most seamlessly interoperable systems prove efective at their given tasks. For example recent research on online learning tools has shown that the students who have both human and online instruction get the most out of the experience.4 The human instructors bridge the gap for students when software alone falls short of meeting their individual needs. In other words, it is not sufficient simply to connect students with information without thinking about the other layers that afect their comprehension of the material.What, then, do each of these interop layers mean? • Technological: The technological layer is the hardware and code that allows one system to connect physically to another. Much like train tracks and roads allow cities to connect and share commerce, the technological layer allows systems to connect to one another and share data, often through an explicit, agreed-upon interface.• Data: The data layer is the ability of interconnected systems to understand each other. Technological interoperability is often worthless without the data layer and the ability of interconnected systems to make use of the transmitted bits. The data and technological layers often are considered together because they are inextricably linked in many ways. However, anyone who has ever received an e-mail atachment that their computer could not open understands that simply having the technological capacity to 100 Trends in Telecommunication Reform 2016 Figure 4.1: Diagram of interop layers INTEROP TECHNOLOGICAL DATA INSTITUTIONAL HUMAN Hardware and code that allows connection Efective engagement of societal systems Ability of interconnected systems to understand each other Ability to understand and act on data exchange Source: ITU