Contextualising international digital health terminology standards for semantic interoperability of Uganda's Health Information Systems

Abstract

Background: Semantic interoperability is defined as the ability of information systems to interpret exchanged linguistic information in meaningful and consistent ways using medical terminologies and nomenclatures. Although international digital health terminology standards exist to facilitate semantic interoperability, these standards are generic; therefore, they may not adequately address the unique needs of Uganda’s health system. Yet, there is no documented process for using the standards in national health information systems. Aim: This research aimed to develop a process for contextualising international digital health terminology standards to support the semantic interoperability of Uganda’s health information systems. Methodology: The research study adopted the pragmatic information systems research philosophy and various methods, including descriptive cross-sectional, qualitative case study, socio-technical walkthrough and design science, to answer the research questions. Study respondents were purposively sampled. Data were collected by reviewing documents, conducting surveys, key informant interviews and workshops, and analysed using descriptive statistics and thematic analysis. Findings: The research findings indicate scanty implementation of the international digital health terminology standards in Uganda’s health information systems; this is attributed to limited expertise in digital health terminology standardisation, a deficit of human resources trained in terminologies and unmatched national terminologies to international digital health terminologies. Accordingly, requirements were derived to guide the development of the contextualisation process of the international digital health terminology standards. The derived contextualisation process entails six phases: assessing the national health information system context, extracting data elements in the national health information system, mapping existing national data elements to international terminologies, identifying and coding unmatched data elements, validating the contextualised terminologies, and digitising the validated terminologies. Conclusion: This research demonstrates how Uganda can contextualise the international digital health terminology standards to address the semantic interoperability challenges of health information systems. The study recommends developing terminology services and vocabulary interfaces for Uganda’s health information systems, as well as implementing contextual terminology standards.