Enhancing Interoperability for a Sustainable, Patient-Centric Health Care Value Chain: Systematic Review for Taxonomy...

Creating a sustainable, patient-centered health care system necessitates integrated supply chains supported by information technologies. However, achieving interoperability among various devices and systems remains a significant hurdle. Our research highlights the need for systematic reviews that address health care interoperability as a holistic knowledge domain. Notably, we observed a lack of studies that outline its structure or develop a comprehensive, high-order facet-based taxonomy from the perspective of supply or value chains. This study aims to address that gap.

The primary aim of this study is to elucidate the knowledge structure within the extensive domain of health care interoperability, with an emphasis on trending topics, critical hot spots, and the categorization of significant issues. Furthermore, we aim to model the higher-order elements of a taxonomy for health care interoperability within the context of the health care value chain framework.

We used both quantitative and qualitative methodologies. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework guided our selection process. We examined 6 databases-Scopus, Web of Science, IEEE Xplore, Embase, Cochrane, and PubMed-focusing on journal articles and gray literature published from 2011 onward. Articles were screened using predefined eligibility criteria. Quantitative bibliometric techniques-including cluster, factor, and network analyses-were applied to explore the structure of the knowledge. A subset of articles was selected for qualitative synthesis using an iterative coding process to develop a higher-order facet-based taxonomy.

We identified 370 articles for quantitative analysis. The bibliometric analysis revealed 2 major clusters. Key terms in the first cluster included interoperability, electronic health record, and eHealth-with betweenness centralities of 70.971, 59.460, and 12.000, respectively, and closeness centralities of 0.047, 0.043, and 0.034, respectively. In the second cluster, the most relevant terms were IoT, blockchain, and health care-with betweenness centralities of 6.765, 2.581, and 1.283, respectively, and closeness centralities of 0.034, 0.030, and 0.030, respectively. Factor analysis explained 59.46% of the variance in a 2-factor model, with the first dimension accounting for 36.78% and the second dimension for 22.68%. The qualitative review of 79 articles yielded a taxonomy with 4 higher-order facets: object (what is shared), source (what mechanism is used), ambit (space covered), and content (technology primarily involved). Each facet extended to a third level of classification.

The comprehensive domain of health care interoperability, viewed through the lens of a sustainable value chain, encompasses studies that highlight various facets or attributes. These studies underscore the relevance of eHealth within this knowledge domain and reflect a strong focus on 2 key health information technologies: electronic health records and the Internet of Things.