Sociotechnical Factors and Technical Standards for EHR and PHR Interoperability in Primary Care
Year: 2026
Type: conference-paper
Study design: Systematic Review
Abstract: Primary healthcare systems increasingly rely on seamless interoperability between Electronic Health Records (EHRs) and Personal Health Records (PHRs) to deliver patient-centered care; however, primary care settings face distinct sociotechnical barriers that remain under-researched compared to hospital environments. This study aims to identify and analyze the specific interoperability barriers hindering EHR–PHR integration by systematically reviewing 36 peer-reviewed publications from 2015 to 2024. Utilizing the Systems Engineering Initiative for Patient Safety (SEIPS) framework, the research maps technical components including HL7 FHIR standards, APIs, and semantic models to organizational outcomes such as workflow efficiency and governance capacity. The results indicate that while technical standards offer promising solutions, their adoption is severely constrained by legacy system dependencies, vendor lock-in, and a significant lack of clearly defined interoperability approaches in current literature. Furthermore, organizational challenges, including limited digital literacy and workflow disruptions, compound these technical hurdles. This study concludes that a structured, phased implementation roadmap is essential for overcoming these barriers, particularly in resource-constrained settings like Indonesia’s SATUSEHAT platform under the Personal Data Protection Law. By addressing the identified gap regarding primary care-specific integration, these findings provide theoretical clarity and practical guidance for advancing interoperable digital health systems, while suggesting that future research should focus on the long-term scalability of cloud-based health information exchanges.
Institutions: Binus University, University of Salford, University of Oslo
Language: English
Subfield: Health Information Management
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7225200036