Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 30, 2024
Date Accepted: Mar 31, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Enhancing Interoperability for a Sustainable, Patient-Centric Healthcare Value Chain: A Systematic Review for Taxonomy Development
ABSTRACT
Background:
Developing a sustainable, patient-centric healthcare system requires integrated supply chains supported by information technologies. However, achieving interoperability among diverse devices and systems remains a significant challenge. Our research identified a need for systematic reviews addressing healthcare interoperability as a comprehensive knowledge domain. Specifically, we noted the absence of studies that present its structure and develop a high-order facet-based taxonomy from the perspective of supply or value chains. This study aims to fill that gap.
Objective:
The primary aim is to illustrate the knowledge structure of the comprehensive domain of interoperability in healthcare, focusing on trend topics, hotspots, and the classification of influential issues. Additionally, we aim to model the higher-order facets of a taxonomy of healthcare interoperability within the healthcare value chain framework.
Methods:
We employed both quantitative and qualitative techniques. The PRISMA framework was used to select data for quantitative analysis. We consulted six databases, selecting articles published in journals and grey literature from 2011 onward. We performed quantitative cluster, factor, and network analyses on 370 articles to explore the association and classification of topics. Furthermore, we conducted an in-depth review of 80 articles to develop a higher-order facet taxonomy. To minimize bias, these articles were selected based primarily on their contributions to the factor analysis and were evaluated through an iterative systematic procedure outlined in the literature. This procedure, which followed an empirical-to-conceptual approach, was designed to ensure a representative and balanced sample. We completed three iterations until saturation of categories was achieved.
Results:
The bibliometric analysis revealed that three terms are most relevant in the network: electronic health record (EHR), Fast Healthcare Interoperability Resources (FHIR), with betweenness centralities of 96.257, 68.984, and 61.801, respectively, and closeness centralities of 0.0169, 0.0167, and 0.0163, respectively. Our analysis identified two clusters and two factors; the two-factor solution explained 59.46% of the variance, with the first-dimension accounting for 36.78% and the second dimension for 22.68%. The literature review resulted in four higher-order facets: object, source, ambit, and content, with facets extending to the third level presented.
Conclusions:
The comprehensive healthcare interoperability domain from a sustainable value chain perspective encompasses studies that showcase various facets or attributes. Two groups of studies emerge, one reflecting the latest concerns and advancements in the field.
Citation
