A review of implementation challenges and potentials of an interoperable e-health system in LMICs

A review of implementation challenges and potentials of an interoperable e-health system in LMICs | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A review of implementation challenges and potentials of an interoperable e-health system in LMICs Rohan Dhakal, Aditya Khadka, Saugat Adhikari, Amrit Bhandari, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5674022/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract E-health solutions in low-income countries are isolated, cater to specific institutions , and cannot share data across organizations. Existing interoperability frameworks don’t work well in these contexts due to various factors. This research investigates the levels of interoperability frameworks for eHealth data integration and data sharing across the globe and how they are in use in different developing countries. Also, the research suggests the potential of FHIR (Fast Healthcare Interoperability Resources) in LMICs (Low-and middle-income countries) for interoperability of EHR (Electronic Health Records). The research uses PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) of various articles, papers, and research available on web databases, Google Scholar, JMIR (Journal of Medical Internet Research) and PubMed, etc. of the e-health and interoperability in healthcare to analyze the FHIR potentials in LMIC’s like Nepal for interoperability. The result of the research highlights the levels of inter-operability frameworks for healthcare systems, analyzes the potentials of HL7 FHIR, and suggests its implementation in LMICs like Nepal for interoperability. e-health interoperability frameworks LMICs HL7 FHIR EHR developing countries Nepal Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5674022","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":395332158,"identity":"4d558504-5ebe-4894-9f51-616b4a676831","order_by":0,"name":"Rohan Dhakal","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCUlEQVRIiWNgGAWjYDCCGwzMDAwFDAwGDAyMDz5U2ACFGBsPENZiAEbMhjPOpIG0NBCthU2at+0wWBCvFr7bzY8NfhjckzNnP3tAgrftvN3a9sNAW2psonFpkbxzzDixx6DY2LInL8FA4tzt5G1nEoFajqXlNuDQYnAjwfgAj0FC4oYDOQYJBmW3k80OALUwNhzGoyX988E/IC3n3xgcSGA7l2x2/iEhLTnGyWBbbuQYNhxoO2BndoOALZI3coqNZQwSjA1uvDFmbDiTnGB2A2hLAh6/8N1I3yz5piJBzuB8jvnvPxV29mbn0x8++FBjg1MLBkgEq0wgVjkI2JOieBSMglEwCkYGAAAUumuYcNmNGgAAAABJRU5ErkJggg==","orcid":"","institution":"Kathmandu University","correspondingAuthor":true,"prefix":"","firstName":"Rohan","middleName":"","lastName":"Dhakal","suffix":""},{"id":395332159,"identity":"d7ff2bcc-34aa-4f72-bb28-6b1490924c42","order_by":1,"name":"Aditya Khadka","email":"","orcid":"","institution":"Kathmandu University","correspondingAuthor":false,"prefix":"","firstName":"Aditya","middleName":"","lastName":"Khadka","suffix":""},{"id":395332160,"identity":"6043819d-21d0-4bbd-a211-c6a1c6d97ba0","order_by":2,"name":"Saugat Adhikari","email":"","orcid":"","institution":"Kathmandu University","correspondingAuthor":false,"prefix":"","firstName":"Saugat","middleName":"","lastName":"Adhikari","suffix":""},{"id":395332161,"identity":"ac1452b4-e4e8-4531-a156-3fd966f5bc68","order_by":3,"name":"Amrit Bhandari","email":"","orcid":"","institution":"Kathmandu University","correspondingAuthor":false,"prefix":"","firstName":"Amrit","middleName":"","lastName":"Bhandari","suffix":""},{"id":395332162,"identity":"c1ef0ec2-1766-4057-b3b1-49b4afce1c3e","order_by":4,"name":"Sushil Shrestha","email":"","orcid":"","institution":"Kathmandu University","correspondingAuthor":false,"prefix":"","firstName":"Sushil","middleName":"","lastName":"Shrestha","suffix":""}],"badges":[],"createdAt":"2024-12-19 06:23:24","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5674022/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5674022/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":72663872,"identity":"7124623b-519e-4593-8f0d-80566ea2088a","added_by":"auto","created_at":"2024-12-31 02:45:20","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":818543,"visible":true,"origin":"","legend":"","description":"","filename":"ehealthSpringerPaper1.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5674022/v1_covered_5b8eebd0-cdfe-4396-8935-6778d1668ec0.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A review of implementation challenges and potentials of an interoperable e-health system in LMICs","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"e-health, interoperability, frameworks, LMICs, HL7, FHIR, EHR, developing countries, Nepal","lastPublishedDoi":"10.21203/rs.3.rs-5674022/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5674022/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"E-health solutions in low-income countries are isolated, cater to specific institutions , and cannot share data across organizations. 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