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Cited by 45Electronic Health Records SystemsMobile Health and mHealth ApplicationsArtificial Intelligence in Healthcare and Education

Interoperability as a Catalyst for Digital Health and Therapeutics: A Scoping Review of Emerging Technologies and Standards (2015–2025)

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Adegoke, Kola, Adegoke, Abimbola, Dawodu, Deborah, Adekoya, Akorede, Bayowa, Ayoola, Kayode, Temitope, Singh, Mallika·2025·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph22101535PMC PMC12563453
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Abstract

Background: Interoperability is fundamental for advancing digital health and digital therapeutics, particularly with the integration of technologies such as artificial intelligence (AI), blockchain, and federated learning. Low- and middle-income countries (LMICs), where digital infrastructure remains fragmented, face specific challenges in implementing standardized and scalable systems. Methods: This scoping review was conducted using the Arksey and O’Malley framework, refined by Levac et al., and the Joanna Briggs Institute guidelines. Five databases (PubMed, Scopus, IEEE Xplore, ACM Digital Library, and Google Scholar) were searched for peer-reviewed English language studies published between 2015 and 2025. We identified 255 potentially eligible articles and selected a 10% random sample (n = 26) using Stata 18 by StataCorp LLC, College Station, TX, USA, for in-depth data charting and thematic synthesis. Results: The selected studies spanned over 15 countries and addressed priority technologies, including mobile health (mHealth), the use of Health Level Seven (HL7)’s Fast Healthcare Interoperability Resources (FHIR) for data exchange, and blockchain. Interoperability enablers include standards (e.g., HL7 FHIR), data governance frameworks, and policy interventions. Low- and Middle-Income Countries (LMICs) face common issues related to digital capacity shortages, legacy systems, and governance fragmentation. Five thematic areas were identified: (1) policy and governance; (2) standards-based integration; (3) infrastructure and platforms; (4) emerging technologies; and (5) LMIC implementation issues. Conclusions: Emerging digital health technologies increasingly rely on interoperability standards to scale their operation. Although global standards such as FHIR and the Trusted Exchange Framework and Common Agreement (TEFCA) are gaining momentum, LMICs require dedicated governance, infrastructure, and capacity investments to make equitable use feasible. Future initiatives can benefit from using science- and equity-informed frameworks.

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  • More than 70% of surveyed countries are actively using FHIR standards in some or all of their use-cases.

    “Other standards like the FHIR of the HL7 standard have experienced increased adoption across the globe where surveys have shown that more than 70% of the surveyed countries are actively using FHIR standards in some or all of their use-cases with full implementation and regulatory alignment being an on-going challenge [11].”

    From Cloud-based Electronic Health Records (EHR) Adoption Rate in Nigeria: Barriers and Performance Bottlenecks (2026) · cites this paper as [11]

    The Introduction (§2.1.3) says HL7 FHIR has gained global traction, and the Discussion (§5.1) calls it the most widely adopted interoperability standard. Neither passage reports a survey of countries or supports the specific figure of more than 70% actively using FHIR in some or all use cases; searches for that figure and survey found no such passage. (LLM, conf=0.86)

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Authors
Adegoke, K., Adegoke, A., Dawodu, D., Adekoya, A., Bayowa, A., Kayode, T., & Singh, M.
Affiliations
  • New York Medical College (US)
  • The University of Texas Health Science Center at Houston (US)
  • McMaster University (CA)
  • Thompson Rivers University (CA)
  • School of Health Sciences and Practice, New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY 10595, USA
Corresponding author
Adegoke, Kola
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2025-10-08
Volume
22
Issue
10
Pages
1535
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph22101535
PMC
PMC12563453
OpenAlex
W4414929483
Cited by
45
References
8
Citations by year
2026: 39 · 2025: 6
FWCI
5.79
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • Preprints.org (acceptedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • ScholarWorks @ UTRGV (The University of Texas Rio Grande Valley) (acceptedVersion, cc-by)
  • Touro Scholar (Touro College) (acceptedVersion)
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
Keywords
interoperability, digital health, digital therapeutics, HL7 FHIR, blockchain, federated learning, artificial intelligence, data governance, health information standards, low- and middle-income countries, digital health policy, legacy systems, digital capacity
MeSH terms
Health Information Interoperability, Digital Health, Artificial Intelligence, Developing Countries, Humans, Telemedicine

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