Interoperability Challenges in Multi-Vendor Telehealth Systems: A Standards-Driven Evaluation

Abstract

Interoperability is one of the most persistent barriers limiting the scalability, usability, and clinical effectiveness of telehealth ecosystems, especially when multiple vendors supply hardware, software, and data-management components. This research conducts a standards-driven evaluation of interoperability challenges in multi-vendor telehealth systems, focusing on data exchange protocols, device compatibility, semantic consistency, workflow integration, and regulatory compliance. By examining established interoperability standards—such as HL7, FHIR, IEEE 11073, DICOM, ISO/IEC 82304, and Continua guidelines—the study identifies technical, operational, and organizational gaps that hinder seamless integration. A mixed-methods approach involving technical assessments, clinical workflow mapping, system audits, and stakeholder interviews reveals that inconsistent data schemas, proprietary communication protocols, limited semantic interoperability, and weak API standardization remain major barriers. The paper also develops a multi-layer interoperability framework for evaluating vendor systems and proposes a standards-aligned reference architecture to guide telehealth deployments. Findings suggest that aligning vendor systems with FHIR-based APIs, IEEE medical device communication standards, and robust terminology services can significantly enhance telehealth performance and patient outcomes. The study concludes that interoperability must shift from a vendor-dependent  feature to a regulatory-mandated requirement to ensure scalable, secure, and patient-centered telehealth ecosystems