What is interoperability in health, and where does the Dominican Republic stand?

The word appears in almost every health strategy document and is almost never defined in practical terms. It is worth doing, because in the Dominican Republic it has stopped being a concept and now has dates, tests and published results.

What does interoperability actually mean?

That two different systems understand the same thing when they exchange information about a person. Not that they connect: that the datum leaving one means exactly the same thing on arriving at the other.

It is usually broken into three layers, and confusing them is the most common reason an integration project fails:

• Technical: the two systems can transmit data to each other. This is the easy one and the one most projects solve.
• Syntactic: the message has a structure the receiver knows how to read, with fields in the right places.
• Semantic: "type 2 diabetes" means the same thing in both systems, because both use the same coded vocabulary. This is the hard one, and it decides whether the data can be added up.

A hospital can have the first two and not the third, and then it receives information it cannot aggregate or analyze. It looks like it interoperates and it does not.

What did the Dominican Republic prove in August 2026?

The country took part in the 5th Regional Digital Health Connectathon, held in Panama City within the PH4H 2026 Regional Conference, which brought together twenty countries around the Pan American Digital Health Route.

The result, according to the official statement from the Presidency:

• It placed among the top six of twenty countries.
• It completed 100% of the planned test cases, which put it among the best technical performers of the exercise.
• It received a plaque recognizing its commitment to advancing PH4H in the region.

The exercises covered five components, and they are worth listing because they describe what a connectathon actually tests:

• The International Patient Summary, a minimum set of clinical data any country should be able to read.
• Cross-border teleconsultation, exchanging requests and reports.
• The electronic yellow fever vaccination certificate.
• The electronic medicines prescription.
• Cybersecurity mechanisms: digital signatures, QR codes and trust verification between institutions.

In practice that means generating and sharing clinical summaries, correctly locating a patient who is not in their originating system, and validating that a certificate is genuine without phoning anyone.

What does that result NOT mean?

This is worth saying, because it is where wrong expectations start. A connectathon is a controlled exercise: test cases defined in advance, technical teams present and systems prepared for the occasion.

It demonstrates technical capability, which is real and not a small thing. It does not demonstrate that any health center in the country can exchange a patient record with another one today. Between the two sits the work.

What comes next?

Two announced things, and both have practical consequences for anyone providing health services or supplying them with technology.

The first is the Single Electronic Health Record, the objective the National Digital Health Strategy points toward: being able to reach a person's clinical information securely and with authorization, regardless of where it was generated.

The second, and nearer, is the First National Interoperability Connectathon, planned for this year in the Dominican Republic. According to the official statement it will bring together health service providers, technology vendors and ministry technical teams.

As Joel de Jesús Tavárez Estévez, head of Systems Development and Implementation at the Ministry of Public Health, put it: "Completing 100% of the test cases confirms that the Dominican Republic has the technical capability to interoperate under international standards. The next step will be to carry this learning into the First National Connectathon."

What does an institution need to arrive prepared?

Four things, and none of them starts with buying software:

• Knowing what data it holds and where. It sounds obvious and is almost never written down. Without an inventory there is nothing to map.
• A coded vocabulary. If diagnoses are written in free text, the semantic layer does not exist and no standard will supply it.
• A way to identify the same person across two systems. It is the most underestimated problem of all and the one that most often halts an integration that is already built.
• Someone answerable for the quality of the data being shared. Interoperating multiplies the reach of a wrong figure: it used to be seen by one service, now it is seen by the network.

That last one connects to everything else: an interoperable system carries whatever it is given. If what it is given has never been checked against the record it came from, interoperability distributes the error faster.

What this analysis does not claim

It does not claim the country is ready for the single record. It says it passed a demanding technical exercise, which is a necessary step and not a sufficient one.

It evaluates no institution and no vendor. It describes what was tested, what was announced and what is usually needed.

And it recommends no particular standard over another. That decision depends on what already exists in each institution, and taking it without that inventory is the most expensive mistake available here.

Sources

Statement from the Presidency of the Dominican Republic dated 7 August 2026 on the country's participation in the 5th Regional Digital Health Connectathon, the source of the sixth place among twenty countries, the 100% of test cases completed, the five components evaluated, the quotation from the head of Systems Development and Implementation at the Ministry of Public Health, and the announcement of the First National Connectathon. National Digital Health Strategy 2024-2028 of the Ministry of Public Health, for the Single Electronic Health Record. PH4H 2026 Regional Conference and Pan American Digital Health Route.