Beyond Interoperability

The increasing digitalization of health care systems has intensified the need for mechanisms capable of ensuring interoperability among medical devices, clinical information systems, and complex hospital infrastructures. In this context, service-oriented device connectivity (SDC), defined within the IEEE 11073 family of standards, has emerged as one of the most advanced architectures for enabling standardized communication among heterogeneous medical devices. Despite its technical capabilities, the adoption of SDC in real-world clinical environments continues to face significant challenges that extend beyond purely technological considerations. The complexity associated with integrating SDC into existing hospital infrastructures, its coexistence with other interoperability standards, validation and certification requirements, cybersecurity implications, and implementation-related costs constitute critical factors influencing its large-scale deployment. This study provides a critical analysis of the main challenges associated with the implementation of SDC-based interoperable architectures. Particular attention is given to issues related to functional interoperability, integration within heterogeneous health care ecosystems, operational sustainability, technology governance, and adoption barriers from the perspectives of medical device manufacturers, technology providers, and health care organizations. The reviewed literature suggests that the potential of SDC depends not only on its communication capabilities but also on the health care ecosystem’s ability to address the technical, organizational, and economic challenges associated with its adoption. Consequently, the transition toward truly interoperable clinical infrastructures requires combining the technological maturity of interoperability standards with effective implementation, management, and governance strategies.