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Architectural patterns for health information systems: a systematic review
Rene Casanova1, Fernan A Villa-Garzon1, John W Branch-Bedoya1
1Departamento de Ciencias de la Computación y la Decisión, Universidad Nacional de Colombia, Medellín, Colombia.
Background:
Health information systems (HIS) are critical for digital health transformation, yet fragmentation and poor interoperability adoption remains a major challenge.
Objectives:
This study systematically reviews architectural patterns used in HIS and evaluates their alignment with ecosystem-level requirements.
Methods:
Following PRISMA 2020 guidelines, a systematic literature review was conducted across Scopus, IEEE Xplore, PubMed, and Web of Science (2020-2025). Eligible studies described, evaluated, or proposed HIS solutions.
Results:
From an initial set of 304 records, 89 met the inclusion criteria. Service-based and decentralized/distributed ledger architectures were predominant, with emerging models integrating edge computing and modular design. FHIR-based contracts are found as stabilizers of interfaces, enabling validation and reducing integration costs. However, gaps persist in cross-border care, sustainability, and artificial intelligence integration.
Conclusion:
While microservices dominate current HIS architectures, achieving resilient, interoperable ecosystems requires greater architectural diversity and intersectoral collaboration.
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