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Cited by 35Electronic Health Records SystemsArtificial Intelligence in Healthcare and EducationInnovation in Digital Healthcare Systems

Challenges and strategies in building a foundational digital health data integration ecosystem: a systematic review and thematic synthesis

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Ambalavanan, Radha, Snead, R Sterling, Marczika, Julia, Towett, Gideon, Malioukis, Alex, Mbogori-Kairichi, Mercy·2025·Frontiers in Health Services
DOI 10.3389/frhs.2025.1600689PMC PMC12226485
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Abstract

Background: Chronic conditions require robust healthcare data integration to support personalized care, real-time decision-making, and secure information exchange. However, fragmented data ecosystems disrupt interoperability, complicate patient-centered care (PCC), and present challenges for incorporating genomic data into clinical workflows. Objective: This systematic review with thematic synthesis aims to identify key challenges and synthesize existing strategies from the literature to inform the development of a foundational digital health data integration ecosystem. Methods: Following PRISMA guidelines, we systematically screened literature across multiple databases. A thematic synthesis approach was used to categorize findings into three primary themes: interoperability, PCC, and genomic data integration. Results: A total of 161 studies were included. Key challenges identified include semantic misalignment across commonly used healthcare standards such as HL7 FHIR and SNOMED CT, limited cross-system data exchange, inadequate patient engagement features in EHRs, and concerns regarding the security and clinical utility of genomic data. Strategies described across the literature include ontology-based interoperability models, AI-supported PCC frameworks, and blockchain-enabled genomic data governance. Conclusion: By analyzing current methodologies, research gaps, and implementation challenges, this review offers an evidence-based foundation to guide future advancements in healthcare data integration. It supports the development of scalable, privacy-preserving, and ethically governed data-sharing infrastructures that enable personalized medicine and real-time clinical interventions. Systematic Review Registration: https://osf.io/c2xvw.

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  • Technological dependency risks must be mitigated-when students overemphasize quantitative metrics (e.g., CMI values), individualized patient needs may be overlooked, necessitating strengthened medical humanities modules in future curricula.

    “Paradoxically, technological dependency risks must be mitigated—when students overemphasize quantitative metrics (e.g., CMI values), individualized patient needs may be overlooked, necessitating strengthened medical humanities modules in future curricula [24, 25].”

    From Reforming hospital management education with the P-MASE pedagogy: a randomized controlled trial (2026) · cites this paper as [25]

    The Discussion section on patient-centered care says that current EHR systems can lack tools for personalized care and patient-specific recommendations. It does not discuss students, overreliance on CMI or other quantitative metrics, or strengthening medical humanities curricula; its proposed response is better patient-centered digital tools. (LLM, conf=0.78)

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Cited by

Sorted by citations

Authors
Ambalavanan, R., Snead, R. S., Marczika, J., Towett, G., Malioukis, A., & Mbogori-Kairichi, M.
Corresponding author
Ambalavanan, Radha
ORCID
Venue
Frontiers in Health Services
Publisher
Frontiers Media SA
Published
2025-06-20
Volume
5
Pages
1600689-1600689
ISSN
2813-0146 (ISSN-L)
DOI
10.3389/frhs.2025.1600689
PMC
PMC12226485
OpenAlex
W4411500954
Cited by
35
References
5
Citations by year
2026: 26 · 2025: 9
FWCI
4.50
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Health Services (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
  • Health Sciences › Health Professions › Health Information Management › Innovation in Digital Healthcare Systems
Keywords
health data integration, interoperability, patient-centered care, genomic data integration, HL7 FHIR, SNOMED CT, semantic misalignment, electronic health records, patient engagement, genomic data security, blockchain, data sharing infrastructure, chronic disease, personalized medicine

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