IntroductionSintero develops methods to simplify interoperability across distributed health care and research information systems. This is worth doing because systematic interoperability can improve information sharing to benefit patient care.  In research, these methods can improve quality of data aggregation and linkage ‘at scale’ e.g. for conducting wide-area distributed fair tests of treatments, patient-centred outcomes studies, service quality improvements, audits and ethical pharmaceutical research.Achieving multiple cross-system interoperability is often difficult and complex, but community-collaborative approaches based on adoption of common standards can help. For first application purposes, this site provides trial metadata and document architecture specifications. These can be implemented by multiple EHR/PHR systems, portals, apps and/or with XDS registry-repository software modules to provide wide-area consistency for building scalable health and research ecosystems.In health care or research, Sintero does not aim to be competitive with external information standards (or architectures). It will aim to evolve by open health informatics community peer review e.g. for principles of standards selection and their ‘fitness’ for particular purposes. Note: Sintero.org is establishing as a community interest (social) enterprise with approval from The Wellcome Trust and Cardiff University.  This maintains continuity of objectives from the Wellcome Trust-funded prototype and in so doing will develop and refine the underlying technology.   Some Sintero software modules are already contributed to Open Health Tools as part of collaborative development with MOSS and others in the OpenExchange project.Vendors and NHS IT professionals can email the site moderator directly with any concerns or interests relevant to their interoperability plans.