Contextualisation of syntactic interoperability data standards : a case for health information exchange in Uganda’s healthcare system

Abstract

Syntactic interoperability data standards are vital for the seamless exchange and effective utilisation of healthcare information within contemporary health systems. This study focuses on contextualising these standards to advance digital healthcare in Uganda, aligning with the World Health Organisation’s (WHO) strategic framework for 2020-2025. This framework aims to overcome gaps across six building blocks to achieve the Sustainable Development Goal of good health and well-being by enhancing health information systems for improved patient care continuity. Contextualised syntactic interoperability standards are essential for ensuring that patient data is consistently collected, processed, shared, and stored in compatible formats, thereby facilitating interoperability across diverse healthcare environments. Uganda’s healthcare system faces unique challenges that impede effective utilisation of health data, including the absence of standardised data formats, inadequate technical infrastructure, and insufficient data governance policies. Additional barriers include a shortage of skilled personnel, a weak data use culture, limited resources, poor data quality, complacency, limited political will, and inadequate leadership. Existing data interoperability standards, which are predominantly designed for developed countries, often fail to address Uganda’s specific needs due to differing levels of health information management maturity. This study addresses a critical literature gap by presenting a pragmatic approach to contextualising syntactic interoperability data standards specifically for Uganda, contrasting with successful contextualisation in other countries. A systematic three-phase methodology was employed: First, a descriptive cross-sectional survey identified essential Health Information Exchange (HIE) standards using Design Science Research (DSR) methodologies, including brainstorming, systems review, and literature review. Second, standards were developed based on these requirements, covering areas such as patient identification, health information exchange registries, medical imaging management, system digitisation, security, privacy, and capacity building. The contextualized standards were validated by Uganda’s Ministry of Health experts and reviewed by digital health stakeholders using the HIIRETWG tool. Aligned with global frameworks, they aim to enhance data use, improve patient care, foster innovation, and strengthen efficiency and interoperability within Uganda’s healthcare system.