Semantic and systems interoperability

  • Identify needs and define how leading standards should be adapted and adopted.
  • Promote the use of leading international standards (FHIR, LOINC, DICOM, etc.).
  • Give the whole community access to clear, truthful and useful technical information of reference.
  • Provide recommendations and support to public bodies in adopting standards.

01. Interoperability

Interoperability is the ability to share information between components (such as systems or devices) without losing their meaning.

Interoperability ensures access to information regardless of where it has been registered, encouraging its re-use, minimizing blind spots and ensuring the continuum of care.

WIKI link

02. Partnerships

The TIC Salut Social Foundation collaborates and is a member of the following leading international organizations in standardization and interoperability:

HL7 Spain

HL7 Spain is the official HL7 International entity that promotes the use of HL7 standards in Spain through the participation of events throughout the country, training courses or the publication of guides and manuals about the use of standards. It is the only accredited organization in Spain that can certify in health professionals HL7.


Integrating the Healthcare Enterprise (IHE) is a Healthcare Standards Development Organization, founded in 1987 that operates internationally and is currently one of the largest in health informatics messaging standards. Its mission is to provide a comprehensive framework of standards related to the exchange, integration, and retrieval of electronic health information that supports clinical practice and management.

Personal Connected Health Alliance (PCHAlliance)

Personal Connected Health Alliance (PCHAlliance) is a non-profit association made up of health and technology companies working collaboratively to improve the quality of healthcare, establishing an interoperability ecosystem for personal health systems (such as PHRs) to enable individuals and organizations to improve health and welfare management.

SNOMED International

SNOMED International is an international non-profit organization that is the rights holder and owner of SNOMED CT clinical terms, and is responsible for updating and distributing it internationally.

Regenstrief Institute (LOINC)

The Regesntrief Institute is a non-profit medical research organization associated with Indiana University. This organization promotes the LOINC (Logical Observation Identifiers Names and Codes) international standard, which in SISCAT is mainly used to represent laboratory tests.

03. Semantic interoperability

Semantic interoperability aims to ensure that data is exchanged without losing its meaning through the use of controlled vocabularies..

These vocabularies allow information to be represented based on a conceptual model and to codify it clearly. Examples include SNOMED-CT (Systematized Nomenclature of Medicine- Clinical Terms) for clinical terminology and LOINC (Logical Observation Identifiers Names and Codes), for terminology used in medical laboratory results.

04. iSalut Clinical Dictionary

The Catalan Ministry of Health’s iSalut Clinical Dictionary is aimed at standardizing vocabulary so that semantic interoperability can be achieved at all levels of care between the information systems of SISCAT providers.


See iHealth Clinical Dictionary


The iSalut Clinical Dictionary is a transversal project of the Department of Health managed by the OFSTI, whose objective is to normalize SISCAT’s vocabulary so that semantic interoperability can be achieved between providers’ information systems at different levels healthcare. The base of the Dictionary is the clinical terminology SNOMED CT, which acts as an ontology and a homogeneous representation base, although it also contains other vocabularies that are already used at SISCAT (eg LOINC, ISCO/CNO, SERAM, SEMNim, etc.).

The technical part of the Dictionary is also led by the OFSTI, while the catalog area of ​​the eSalut Office of the General Coordination of ICT directs the functional part. The priorities and actions to follow in the Dictionary are marked by the Permanent Commission formed by representatives of different providers, CatSalut and the Department of Health, among others.

The iSalut Clinical Dictionary is organized in content domains, each of which is worked by a multidisciplinary team and at the level of subgroups, following the creation methodology of subsets defined by the OFSTI. In this way, the Dictionary has the participation of healthcare professionals from different centers, programs and institutions, the detailed list of which can be consulted in the documentation of each domain.


The dictionary domains that are currently available are listed below:

  • Allergies (ES): Subsets of SNOMED CT that contain disorders and allergic manifestations, differentiating if the type of causative agent is medicamentous, alimentary or another type. The subset, translated into Catalan by TERMCAT, can be downloaded at the following link by filling out the form: Allergy Subsets .
  • Pathological anatomy (ES): Subset and microglossary of SNOMED CT that contains the most frequent concepts of pathological anatomy such as morphologies or topologies. The subset can be downloaded at the following link by filling out the form: Subsets Pathological Anatomy.
  • Procedure qualifiers (ES and CAT): Subsets of SNOMED CT that contain the necessary concepts to complement the radiology procedure qualifiers: laterality, position / projection / functional, radiological contrast and anatomical location.
  • Clinical documents (ES): Subset of SNOMED CT that contains the list of documents that can be published in the Shared Cclinical History of Catalonia (HCCC). The subset, translated into Catalan by TERMCAT, can be downloaded at the following link by filling out the form: Clinical Document Subset .
  • Assessment scales (ES and CAT): Subset of SNOMED CT that contains the assessment scales, especially in the geriatrics and chronicity areas.
  • Surgical sheet (CAT): Recommendation document detailing the information that the surgical sheet must have in order to structure the procedures in this area based on the CIM-10-MC/SCP classification. The document can be consulted in the following link: Recommendation of minimum surgical sheet information.
  • Immunizations (ES and CAT): A subset of SNOMED CT that contains active and passive immunizations and, therefore, immunoglobulins and immune serum.
  • Spirometry report (ES): Subset of SNOMED CT that contains the concepts necessary to structure the fields and content of the spirometry report that can be published at the HCCC.
  • Cancer screening report (ES and CAT): A subset of SNOMED CT that contains the concepts necessary to structure the fields and content of the cancer screening report that can be published at the HCCC.
  • Laboratory (CAT): A subset of comparable LOINC tests to be tracked independently from the center that performs them (through HCCC), and a subset of single LOINC tests, which are only performed once in the patient’s life (also available at HCCC). The subset of comparable tests includes the part of serology corresponding to the publication of microbiology in Public Health. Both subsets can be downloaded at the following link by filling out the form: Comparable and unique LOINC test subsets.
  • Microbiology (ES): Subsets of SNOMED CT that contain the concepts necessary for the notification of microbiology to Public Health. The part of serology is worked in the field of laboratory.
  • Notification of adverse reactions to immunizations (ES): A subset of SNOMED CT that contains the necessary concepts to represent the information of notification of adverse reactions to Immunizations in Public Health.
  • Ophthalmology and neurology (ES): Subsets of SNOMED CT that contain the concepts related to ophthalmic and neurological examinations.
  • Procedures (ES and CAT): This domain is made up of three different controlled vocabularies that allow to represent the procedures that can be made in primary care by a nurse, a pediatrician or a doctor, in addition to those that can be derived from primary and specialized care, as well as from specialized care centers:


  • Health professions (ES and CAT): Subset of SNOMED CT that contains groups of health professionals.
  • Assistance services, specialties and functional units (CAT): Unified health services, medical and nursing specialties catalogs and functional units, available in Catalan at the following link filling the form: Catalog of services, specialties and units.
  • Clinical variables (ES and CAT): Subset of SNOMED CT that contains the clinical variables to be monitored independently from the center that performs them (through HCCC).
  • WiFIS (ES): Grouping SNOMED CT concepts specific to WiFIS messaging using the IS3 project. The associated subsets are available in Spanish.




SNOMED CT subsets form


05. mHealth mSocial subset of variables

The mHealth mSocial subset of variables is aimed at standardizing the information collected from different mobile applications so that it can be exchanged and used globally.

The subset is based on SNOMED CT terminology and contains different concepts such as findings, observable entities or qualifiers.

In the following link you can download the excel with the list of concepts:

Variable subset mHealth

06. Dictionary of terms for social services - Intersocial

Intersocial is the common controlled vocabulary defined with the aim of allowing the structured sharing of information between the different information systems of social services. The aim of this vocabulary is to facilitate the integration of social services data and to facilitate the work carried out by professionals in the field of social services.

The terminological standard that supports the homogenization of controlled vocabulary in terms of issues, answers, factors and observations in the social field is SNOMED CT.


With the aim of promoting networking and the adoption of standards, the social terminology server is made available to the community, enabling the following:


  • Downloading the catalogue that includes the lists of all the coded concepts
  • Searching for individualized concepts
  • Automatically encoding texts (in tests) through analysis tool and text encoding proposal (ViquiTermSocial)


07. Syntactic interoperability

Syntactic interoperability refers to the way in which data is communicated between components. The standards in this area define the structure and format of the data to be used in the exchange of information.

Examples of syntactic standards are 2.x messaging, the CDA R2 or FHIR document specification, all defined by HL7.

08. WiFIS Interoperability Framework (Work Flow for Health Institutions)

The WiFIS interoperability framework (Work Flow for Health Institutions), allows the centres of the Integrated Public Use Healthcare System of Catalonia (SISCAT) to exchange information in a standardized way, normalizing the processes and communications between the systems of primary, specialized or mental healthcare centres.

In order to carry out the standardization of processes and communications, Implementation Guides have been created which define the rules, information exchange models, messaging and terminology that must be used in order to carry out this standardization.All centres that follow the implementation guidelines, and therefore implement the WiFIS interoperability framework, will have the ability to connect to the interoperability platform defined in the iS3 project in order to exchange information with the other centres that use the same protocol.

The main standards on which the WiFIS Interoperability Framework is based are HL7 V2.5 messaging (with some adoptions from version 2.7 and later), and SNOMED CT terminology to represent its content.

HL7 V2.5 is the most successful health data exchange protocol in the world. It allows information to be structured so it can be exchanged in files, in XML format, representing events that are generated in real hospital situations, such as the referral of a patient from one centre to another.

SNOMED CT is also the clinical terminology standard used by doctors and other healthcare providers for the electronic exchange of clinical health information. It is the most accurate, broadest and most important standard deployed around the world.



The project implementation guides have been defined in different domains in order to differentiate the use cases and types of messaging that are involved in different processes, such as a referral of a patient (Referral Domain) or a request for laboratory testing (Laboratory Domain). These domains are:

  • Referral Domain: Contains the implementation guides that refer to patient referrals that are carried out from one healthcare facility to another. The Referral is the main process of a centre which allows it to request a specific test from another centre,The domain includes everything related to managing referrals: creating a new referral, cancelling it, requesting an additional test and obtaining the results, as well as creating an appointment for the patient, either from the requesting centre or from the provider.This domain currently includes the following implementation guides:
    • Referral implementation guide with provider appointment.
    • Referral implementation guide with requester appointment.
    • Referral implementation guide without appointment.
    • Intermediate Product Referral Implementation Guide.
  • Laboratory Domain: Contains the Laboratory Implementation Guide, which defines the use cases and messaging to integrate the management of laboratory requests (analytical determinations, anatomical pathology and microbiology) between the information systems of health institutions and laboratories. This Laboratory Implementation Guide includes only the process of requesting a laboratory test (as well as cancelling it, notifying the receipt of the sample and obtaining the results), and excludes and process of requesting the extraction of the sample from the patient, as this apples to the functional domain of Referrals.The Guide identifies six circuits depending on the number of centres (two or three) that interact in the process of a laboratory request and the role played by the centre (requester, extractor or implementer).
  • Event Notification Domain: Contains the Event Notification Implementation Guide which refers to various types of notifications that a centre may to send to another centre, and which does not involve the patient referral process. These notifications may include the notification of admission to or discharge from the hospital or emergency department, informing or cancelling hospital pre-discharge, or sending relevant documents, among other things.The use cases identified for Event Notification are detailed below:
    • Notification of admission to or discharge from the hospital or emergency department.
    • Informing or cancelling hospital pre-discharge.
    • Sending relevant documents.
    • Activity log for displaced professionals (RAPD).
    • PCC / MACA marking proposal.
    • RUMI notification (Unified Register of Child Abuse).
    • VINCat notification (Surveillance of nosocomial infections to hospitals in Catalonia).
    • MDO notification (Notifiable Disease).
  • Justice Domain: Contains the Justice Implementation Guide that includes the definition of messaging for sending alerts to a court from a health centre. The alert consists of a single message that includes information from the medical statement that the health centre wants to send to the corresponding court.This information includes the health centre details, the details of the doctor on duty, details of the patient and the medical report itself.

09. Downloadable

WiFIS v2.0.2

11176.9 Kb