Context: Now a days Information technology has become a part of health-care delivery this makes life much easier for patients and health-care professionals. The increase in demand for communication among the different health information systems and health professionals has made interoperability complex and whereas interoperability is mainly focused at semantic and technical levels of communication. Yet, the social interoperability, an important part of communication between computerized systems and health professionals, is overlooked. Obje ctive s: In this study we explore the differences between interoperability and social interoperability. Furthermore investigate the social interoperability in practice and the problems that affect the health-care. Methods: We start with the literature survey to learn the definitions of interoperability and social interoperability. Later, case study approach is carried out to investigate the social interoperability in Interoperability. Interviews were also conducted as part of the observations in cases. Re sults: The similarities and differences in definitions of interoperability and social interoperability are sorted out from the literature study. Five cases have been investigated to identify the social interoperability in practice. Analyses of these cases have identified some of the major problems for health information systems that do not meet social interoperability. Conclusions: Interoperability definitions agree that interoperability is undoubtedly important for health data communication, but their goals in achieving interoperability is concerned only about computerized systems and very less focused on social interoperability. The case studies are used to find out the social communication using in health information systems. We realize that the communication between the users and the information systems are quite complex. The developed systems are witnessing the usability difficulties to the health-care providers that affect the patient care.

Healthcare is delivered by diagnosing diseases, prescribing medicines, prevention of illness. Doctors, nurses and medical organizations deliver the service to the patients. Most of the communication between patients, caregivers and computers are observed in the care setting. eHealth is the healthcare and delivery process that are supported by electronic and communication technology. Some of the eHealth applications used today are patient information system, ePrescription, lab systems, electronic health records etc. One or more times every eHealth tool (here tool represents a software application) will communicate with other eHealth tools for information exchange. The communication of these tools gave birth to interoperability that should actually make the information exchange easier. eHealth interoperability is the ability of one or more computers and software applications communicate with each other for health information exchange and make use of the information. More communication among the tools makes the communication complex and interoperability challenging. Furthermore, interoperability among the heath information systems is observed majorly at three levels and they are semantic, social, and technical. Semantic is about how two or more tools share information and make use of that information. Technical interoperability is about the technologies and networks used to communicate among those applications. Social interoperability is concerned about the environment and the human processes involved in the information exchange. In our study we explore through various definitions of interoperability and social interoperability in a focus to find the differences and similarities among those definitions. Furthermore we have observation of some cases from various primary care centers in order to find out how social interoperability is in practice. We apply our findings to figure out the social problems involved in the care environment. Though, technical and semantic interoperability is mostly concerned by the researchers, but here we find, social interoperability (along with the technical and semantic), is also playing important role in healthcare. The audience of this study can be healthcare professionals, like doctors, nurses and information technology people, Research workers, Academia and all the people who are interested in eHealth.