Article: AI and linguistics give a new meaning to the concept of semantic interoperability in electronic medical records systems Journal: International Journal of Healthcare Technology and Management (IJHTM) 2024 Vol.21 No.5 pp.1 - 27 Abstract: Interoperability, the exchange of information from a user of one electronic medical record system (EMR) to a user on another system, is of practical importance and is theoretically an unsolved problem. Most modelling has used ontologies and assumed that meaning of texts and information can be preserved. This elusive goal was named semantic interoperability and was never realised in practice. This work shows, using deep arguments from linguistics, that fundamentally this is a problem stemming from what "meaning" in human communication is. Certain ambiguities are studied in linguistics and cannot be avoided. The problems are especially pertinent if the sender and receiver come from a different culture, have a different medical background, or the receiver is a patient with limited medical knowledge. Also discussed is to what degree large language models can improve on these fundamental linguistic problems and on ontologies. Inderscience Publishers - linking academia, business and industry through research

Title: AI and linguistics give a new meaning to the concept of semantic interoperability in electronic medical records systems

Authors: Leslie Klieb; Marko Niinimaki; Raghid El-Yafouri; Pinnaree Tea-Makorn; Thanakij Wanavit; Samuel Sallee; Atamfon Udofia

Addresses: Tenxor Inc., 584 Castro St #2639, San Francisco, CA 94114-2512, USA; Webster University Tashkent, Navoi Avenue 11A, 100011, Tashkent, Uzbekistan ' Chulalongkorn School of Integrated Innovation, Chamchuri 10, Wang Mai, Pathum Wan, 10330, Bangkok ' Fanooce LLC, 2665 Aster Dr, Palm Harbor, FL 34684, USA ' Sasin School of Management, Soi Chulalongkorn 12, Wang Mai, Pathum Wan, 10330, Bangkok ' Tenxor Inc., 584 Castro St #2639, San Francisco, CA 94114-2512, USA ' Tenxor Inc., 584 Castro St #2639, San Francisco, CA 94114-2512, USA ' Chulalongkorn School of Integrated Innovation, Chamchuri 10, Wang Mai, Pathum Wan, 10330, Bangkok

Abstract: Interoperability, the exchange of information from a user of one electronic medical record system (EMR) to a user on another system, is of practical importance and is theoretically an unsolved problem. Most modelling has used ontologies and assumed that meaning of texts and information can be preserved. This elusive goal was named semantic interoperability and was never realised in practice. This work shows, using deep arguments from linguistics, that fundamentally this is a problem stemming from what "meaning" in human communication is. Certain ambiguities are studied in linguistics and cannot be avoided. The problems are especially pertinent if the sender and receiver come from a different culture, have a different medical background, or the receiver is a patient with limited medical knowledge. Also discussed is to what degree large language models can improve on these fundamental linguistic problems and on ontologies.

Keywords: EMR; electronic medical record systems; semantic interoperability; large language models; automatic translation of medical records; linguistic approaches to ambiguities.

DOI: 10.1504/IJHTM.2024.154280

International Journal of Healthcare Technology and Management, 2024 Vol.21 No.5, pp.1 - 27

Received: 23 Oct 2025
Accepted: 09 May 2026
Published online: 18 Jun 2026 *

Title: AI and linguistics give a new meaning to the concept of semantic interoperability in electronic medical records systems

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