Simplifying interoperability for health care and research


Sintero develops specifications and software to simplify interoperability across distributed health care and research information systems. This is worth doing because systematic interoperability can improve information sharing to benefit patient care.  In research, these methods can improve quality of data aggregation and linkage ‘at scale’ e.g. for conducting wide-area distributed fair tests of treatments, patient-centred outcomes studies, service quality improvements, audits and ethical pharmaceutical research.

Achieving multiple cross-system interoperability is often difficult and complex, but community-collaborative approaches based on adoption of common standards can help. For first application purposes, this site provides trial metadata and document architecture specifications. These can be implemented by multiple EHR/PHR systems, portals, apps and/or with XDS registry-repository software modules to provide wide-area consistency for building scalable health and research ecosystems.

The Sintero Server ‘core’ software (openXDS, i.e. Sintero Architecture, Layer 2: cross-community document sharing) has recently passed its initial accreditation as part of an NHS ITK (Interoperability Toolkit) Information Sharing Challenge Fund project. This was hosted by South Devon Healthcare NHS Foundation Trust, part of the SWPenAHSN. More detailed information on the software availability to NHS IT users will follow soon. The ‘core’ modules will aim to support a peer review consensus-based UK-wide affinity domain (metadata) specification for document sharing when this becomes more stable. Current work is ensuring relevance of this to the English AHSN (Academic Health Science Network), the UK-wide eHIRC (eHealth Informatics Research Centres) and US-EU eHealth interoperability programmes.

Current work also includes the development of a robust, fully-internationalised (HL7 International) semantic interoperability framework for high quality structured data analysis directly aimed at refining “point-of-care” decision support messages and evidence-based guidelines. This is a real-world example of  the generic mechanism proposed for bringing benefits of international research directly to patient care as cited in the SWPenAHSN prospectus (figure below). This simple, direct mechanism aims to target “high-end” informatics research outputs directly into the improvement of individual patient care. The same mechanism is adaptable for scaling innovative translational technology adoption across health services (which generally involves some aspect of knowledge management).

Benefiting patient care by internationalised research in as short a time as possible

Benefiting patient care by internationalised research in as short a time as possible


In health care or research, Sintero does not aim to be competitive with external information standards (or architectures). It will aim to evolve by open health informatics community peer review e.g. for principles of standards selection and their ‘fitness’ for particular purposes.

Note: is establishing as a community interest (social) enterprise with approval from The Wellcome Trust and Cardiff University.  This maintains continuity of patient benefit objectives from the Wellcome Trust-funded prototype and in so doing will develop and refine the underlying technology.  
Sintero software modules are already contributed to Open Health Tools as part of collaborative development with Misys Open Source Solutions and others such as IBM in the OpenExchange project. Vendors and NHS IT professionals can email the site moderator directly with any concerns or interests relevant to their interoperability plans.  


The site moderator is Dr Ed Conley ( who can be contacted here for discussion of any content on this site or for developing/using Sintero Server in a UK health service or internationalised research context.

Ed has been involved in recent HL7 UK and IHE UK initiatives promoting vendor-neutral interoperability and also BSI and ISO-affiliated work streams in electronic health records for clinical research. He was Co-Principal Investigator for the Sintero prototype funded by Wellcome Trust along with his Computer Science buddy Dr Ian Taylor (below) -

Ed is also co-founder of miConsent for patient control of information sharing. He works with the CIPHER hub of the four UK eHealth Informatics Research Centres (eHIRCs) and also the informatics team of the SW Peninsula AHSN.

Dr. Ed Conley

Dr. Ian Taylor