### Existing Interoperability Frameworks  
An interoperability framework establishes rules and guidelines to enable different components or systems to work together to achieve interoperability. This section discusses existing interoperability frameworks for EHRs/EMRs in chronological order. The eHealth European Interoperability Framework (eEIF) constitutes a blueprint developed to effectively address the interoperability and standardization challenges within Europe's eHealth sector [7]. It was developed based on the foundations of the Antilope project and embodies a refinement of the broader European Interoperability Framework (EIF) to cater exclusively to the dynamic and evolving eHealth landscape [8]. At its core, the eEIF is designed to bolster the provision of European public services by cultivating an environment conducive to smooth interoperability that goes beyond both geographic and sectoral boundaries. The main purpose of the eEIF is to establish a universal framework and shared definition that systematically dissects interoperability challenges and eliminates eHealth-centric resolutions across the European Union landscape. The refined interoperability model in the eEIF consists of six levels: (i) legal and regulatory; (ii) policymaking; (iii) care execution; (iv) applications; (v) IT infrastructure; (vi) and information exchange. Each level represents various aspects and stakeholders involved in achieving interoperability in the eHealth domain. The eEIF also provides a template for describing high-level use cases and realization scenarios, which helps in the provision of a consistent set of descriptions of and solutions to problems. Overall, the eEIF is a valuable tool for implementers and purchasers deploying eHealth systems, enhancing interoperability in the eHealth domain. It offers a common language and framework for addressing interoperability challenges and improving the delivery of eHealth services across Europe. The eEIF is dated and employs technical standards that have limitations and are difficult to implement. The current research aims to develop an alternative framework that focuses on the use of modern technologies and different standards that are easier to implement. An interoperability framework was proposed by [9], with a focus on granting patients total control over their data and regulating how hospitals and healthcare organizations access such data. The framework leverages blockchain security and prioritizes network consensus, relying on proof of structural and semantic interoperability for consensus. While the framework achieved some success, it exhibited certain limitations. The inconsistent use of healthcare terminology among institutions posed challenges in interpreting and comprehending the shared data of patients and participating organizations. Standardizing this terminology emerged as a crucial challenge, as this impacts semantic interoperability within the framework. Additionally, while the approach eliminated the need for a single, centralized source of trust, it introduced new security concerns due to the distributed nature of the blockchain network. Ensuring data privacy and protection from cyber-attacks remains a critical concern. Moreover, achieving a consistent view of patient records across the data-sharing network became problematic due to the distributed data sources and potential conflicts in data updates. As the number of participants and the volume of data increase, maintaining the scalability and performance of the Blockchain network will represent significant system performance challenges [10; 11; 12]. This research proposes an alternative framework that addresses the aforementioned limitations, including implementing a semantic mechanism for deriving the meaning and interpretation of standard data and prioritizing access control implementation to provide more robust data security.