Definitions, components and processes of data harmonisation in healthcare: a scoping review

Background Data harmonisation (DH) has emerged amongst health managers, information technology specialists and researchers as an important intervention for routine health information systems (RHISs). It is important to understand what DH is, how it is defined and conceptualised, and how it can lead to better health management decision-making. This scoping review identifies a range of definitions for DH, its characteristics (in terms of key components and processes), and common explanations of the relationship between DH and health management decision-making. Methods This scoping review identified relevant studies from 2000 onwards (date filter), written in English and published in PubMed, Web of Science and CINAHL. Two reviewers independently screened records for potential inclusion for the abstract and full-text screening stages. One reviewer did the data extraction, analysis and synthesis, with built-in reliability checks from the rest of the team. We developed a narrative synthesis of definitions and explanations of the relationship between DH and health management decision-making. Results We sampled 61 of 181 included to synthesis definitions and concepts of DH in detail. We identified six common terms for data harmonisation: record linkage, data linkage, data warehousing, data sharing, data interoperability and health information exchange. We also identified nine key components of data harmonisation: DH involves (a) a process of multiple steps; (b) integrating, harmonising and bringing together different databases (c) two or more databases; (d) electronic data; (e) pooling data using unique patient identifiers; and (f) different types of data; (g) data found within and across different departments and institutions at facility, district, regional and national levels; (h) different types of technical activities; (i) has a specific scope. The relationship between DH and health management decision-making is not well-described in the literature. Several studies mentioned health providers’ concerns about data completeness, data quality, terminology and coding of data elements as barriers to data utilisation for clinical decision-making. Conclusion To our knowledge, this scoping review was the first to synthesise definitions and concepts of DH and address the causal relationship between DH and health management decision-making. Future research is required to assess the effectiveness of data harmonisation on health management decision-making.

[1]  G. Kuperman,et al.  Approaches to patient health information exchange and their impact on emergency medicine. , 2006, Annals of emergency medicine.

[2]  Elizabeth A November,et al.  Creating sustainable local health information exchanges: can barriers to stakeholder participation be overcome? , 2008, Research brief.

[3]  Theo Lippeveld,et al.  PRISM framework: a paradigm shift for designing, strengthening and evaluating routine health information systems , 2009, Health policy and planning.

[4]  Joachim Rix,et al.  Data Harmonisation Put into Practice by the HUMBOLDT Project , 2011, Int. J. Spatial Data Infrastructures Res..

[5]  Saurabh Rahurkar,et al.  Despite the spread of health information exchange, there is little evidence of its impact on cost, use, and quality of care. , 2015, Health affairs.

[6]  Paul G Shekelle,et al.  Usage and Effect of Health Information Exchange , 2014, Annals of Internal Medicine.

[7]  Leora I. Horwitz,et al.  An observational study of the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities , 2017, Medicine.

[8]  PolitiLiran,et al.  Use patterns of health information exchange through a multidimensional lens , 2014 .

[9]  Hilde van der Togt,et al.  Publisher's Note , 2003, J. Netw. Comput. Appl..

[10]  A. Manya,et al.  DHIS2: The Tool to Improve Health Data Demand and Use in Kenya , 2014 .

[11]  Bita A. Kash,et al.  Review of successful hospital readmission reduction strategies and the role of health information exchange , 2017, Int. J. Medical Informatics.

[12]  Paul Jen-Hwa Hu,et al.  System for Infectious Disease Information Sharing and Analysis: Design and Evaluation , 2007, IEEE Transactions on Information Technology in Biomedicine.

[13]  J. Haughney,et al.  Views of healthcare professionals to linkage of routinely collected healthcare data: a systematic literature review , 2013, Journal of the American Medical Informatics Association : JAMIA.

[14]  Thais Abreu Maia,et al.  Health Information Exchange for Continuity of Maternal and Neonatal Care Supporting: A Proof-of-Concept Based on ISO Standard , 2017, Applied Clinical Informatics.

[15]  Joshua R. Vest,et al.  Organizational Uses of Health Information Exchange to Change Cost and Utilization Outcomes: A Typology from a Multi-Site Qualitative Analysi , 2015, AMIA.

[16]  Sharon E. Straus,et al.  A scoping review on the conduct and reporting of scoping reviews , 2016, BMC Medical Research Methodology.

[17]  T. Fahey,et al.  Nutrient-enriched formula versus standard term formula for preterm infants following hospital discharge. , 2016, The Cochrane database of systematic reviews.

[18]  L. Schilling,et al.  Systematic Review of Health Information Exchange in Primary Care Practices , 2010, The Journal of the American Board of Family Medicine.

[19]  Joshua R. Vest,et al.  Health information exchange: persistent challenges and new strategies , 2010, J. Am. Medical Informatics Assoc..

[20]  B. Criel,et al.  The Health System Dynamics Framework: The introduction of an analytical model for health system analysis and its application to two case-studies , 2012 .

[21]  Pouyan Esmaeilzadeh,et al.  Health Information Exchange (HIE): A literature review, assimilation pattern and a proposed classification for a new policy approach , 2016, J. Biomed. Informatics.

[22]  Tara Nutley,et al.  Improving the use of health data for health system strengthening , 2013, Global health action.

[23]  B. B. Zaidan,et al.  A Security Framework for Nationwide Health Information Exchange based on Telehealth Strategy , 2015, Journal of Medical Systems.

[24]  H. Suri Purposeful sampling in qualitative research synthesis , 2011 .

[25]  Pouyan Esmaeilzadeh,et al.  Patients’ support for health information exchange: a literature review and classification of key factors , 2017, BMC Medical Informatics and Decision Making.

[26]  J. Marc Overhage,et al.  A Framework for evaluating the costs, effort, and value of nationwide health information exchange , 2010, J. Am. Medical Informatics Assoc..

[27]  Michael Weiner,et al.  Health information exchanges - Unfulfilled promise as a data source for clinical research , 2016, Int. J. Medical Informatics.

[28]  N. Leon,et al.  Defining and conceptualising data harmonisation: a scoping review protocol , 2018, Systematic Reviews.

[29]  J. Naaldenberg,et al.  Health information exchange in general practice care for people with intellectual disabilities--a qualitative review of the literature. , 2014, Research in developmental disabilities.

[30]  P. Plsek Complexity and the Adoption of Innovation in Health Care , 2003 .

[31]  Jennifer Lai,et al.  Unintended Consequences of Information Technologies in Health Care—An Interactive Sociotechnical Analysis , 2007 .

[32]  David W. Bates,et al.  Ten key considerations for the successful optimization of large-scale health information technology , 2017, J. Am. Medical Informatics Assoc..

[33]  H. Arksey,et al.  Scoping studies: towards a methodological framework , 2005 .

[34]  J. Popay,et al.  Guidance on the conduct of narrative synthesis in sytematic reviews , 2006 .

[35]  Joshua R. Vest,et al.  How are Health Professionals Using Health Information Exchange Systems? Measuring Usage for Evaluation and System Improvement , 2012, Journal of Medical Systems.

[36]  Lior Fink,et al.  Use patterns of health information exchange through a multidimensional lens: Conceptual framework and empirical validation , 2014, J. Biomed. Informatics.

[37]  Jeong-Whun Kim,et al.  Technology and Policy Challenges in the Adoption and Operation of Health Information Exchange Systems , 2017, Healthcare informatics research.

[38]  Jianping Hu,et al.  Harmonization of health data at national level: A pilot study in China , 2010, Int. J. Medical Informatics.

[39]  Dean F Sittig,et al.  A new sociotechnical model for studying health information technology in complex adaptive healthcare systems , 2010, Quality and Safety in Health Care.

[40]  A. Sheikh,et al.  Undertaking sociotechnical evaluations of health information technologies. , 2014, Informatics in primary care.

[41]  Hossein Ahmadi,et al.  The impact of health information exchange on healthcare quality and cost-effectiveness: A systematic literature review , 2018, Comput. Methods Programs Biomed..

[42]  Michael Marschollek,et al.  Automated population of an i2b2 clinical data warehouse from an openEHR-based data repository , 2016, J. Biomed. Informatics.

[43]  Gilad J. Kuperman,et al.  Potential Unintended Consequences of Health Information Exchange , 2013, Journal of General Internal Medicine.

[44]  James J. Cimino,et al.  Consumer-mediated health information exchanges: The 2012 ACMI debate , 2014, J. Biomed. Informatics.

[45]  Jennie Popay,et al.  Guidance on the conduct of narrative synthesis in systematic Reviews. A Product from the ESRC Methods Programme. Version 1 , 2006 .

[46]  A. Kwamie,et al.  Routine Health Information System (RHIS) interventions to improve health systems management , 2015 .

[47]  A. Sheikh,et al.  Barriers and facilitators to health information exchange in low- and middle-income country settings: a systematic review. , 2016, Health policy and planning.

[48]  Sean M. Randall,et al.  Technical challenges of providing record linkage services for research , 2014, BMC Medical Informatics and Decision Making.