Harmonizing Patient-Centric Requirements for Secure Digital Health Services in Hetero-geneous Settings

Harmonizing Patient-Centric Requirements for Secure Digital Health Services in Hetero-geneous Settings | 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 Harmonizing Patient-Centric Requirements for Secure Digital Health Services in Hetero-geneous Settings Luigi Assom, Thashmee Karunaratne, Aron Larsson This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4991954/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 11 Feb, 2025 Read the published version in BMC Health Services Research → Version 1 posted 4 You are reading this latest preprint version Abstract The primary challenge this research addresses is the lack of harmonization of healthcare technologies in emergent regions. Despite the high demand for digital transformation in the healthcare domain, a significant disparity remains in the capacity to implement digitized health services that leverage electronic identification for patient-centricity and adapt to the know-how processes that depend on the specificity of local contexts. This paper aims to bridge this gap by establishing a template of modular requirements supporting the design of viable Electronic Health Recored (EHR) transmitting and sharing of patient data through primary, secondary and specialized care, also being adaptable to diverse healthcare environments and scalable across varying socio-economic landscapes. The research is anchored in design science and conforms to an action research strategy having northern Brazil as an empirical case. The exaptation process extracted suggested requirements from standards set forth by the European Union, the Fast Healthcare Interoperability Resources (FHIR) and the Swedish ePrescription journal system, subject to be adapted to the Brazilian healthcare context using a participatory approach characterised by divergent developmental landscapes across municipalities. Harmonization requirements were refined from Brazilian healthcare policies for the digitization of healthcare. Patient-centricity requirements were extracted through fieldwork iterations from a target audience of Healthcare Professionals and Patient Associations representatives. Strategies from Brazilian healthcare policies addressing chronic kidney disease, selected as a significant challenge for specialized healthcare in emergent areas, were integrated to generalize the design of EHR modules for the prevention and monitoring of the population at risk. Patient-centric care Underserved areas Harmonization requirements Secure electronic journal systems Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 11 Feb, 2025 Read the published version in BMC Health Services Research → Version 1 posted Editorial decision: Revision requested 03 Sep, 2024 Editor assigned by journal 03 Sep, 2024 Submission checks completed at journal 03 Sep, 2024 First submitted to journal 28 Aug, 2024 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-4991954","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":348893901,"identity":"23c94c80-4367-49ad-984d-2e999145824b","order_by":0,"name":"Luigi Assom","email":"","orcid":"","institution":"Stockholm University","correspondingAuthor":false,"prefix":"","firstName":"Luigi","middleName":"","lastName":"Assom","suffix":""},{"id":348893902,"identity":"cc682022-8bf0-427c-b9d7-2b47fe0bec72","order_by":1,"name":"Thashmee Karunaratne","email":"","orcid":"","institution":"Stockholm University","correspondingAuthor":false,"prefix":"","firstName":"Thashmee","middleName":"","lastName":"Karunaratne","suffix":""},{"id":348893903,"identity":"7dde3b79-5ef5-4856-b30d-1078be4df251","order_by":2,"name":"Aron Larsson","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAq0lEQVRIiWNgGAWjYLCCD2yk6mCcQbIWZh6StPDPPnzssU1ZXWID/xkDxh8VRGiROJeWbpxz7nBig0SOATPPGWKsOcNjJp3bdsCYQYLHgJmxjQgd8iAtlm11xgwgh/38R4QWA5AWxjZmOQaGHAMG3gYitBieYUuT7Dl3WI5NIq3gMM8xIrTInWE+JvGjrI6Hn//wxoc/aojQAgegqDlAioZRMApGwSgYBXgAAF5fKynkigFJAAAAAElFTkSuQmCC","orcid":"","institution":"Stockholm University","correspondingAuthor":true,"prefix":"","firstName":"Aron","middleName":"","lastName":"Larsson","suffix":""}],"badges":[],"createdAt":"2024-08-28 14:43:53","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4991954/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4991954/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12913-024-11978-x","type":"published","date":"2025-02-11T15:56:52+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":76487402,"identity":"9d126aa8-17d5-4c76-ab1b-a7d09b155941","added_by":"auto","created_at":"2025-02-17 16:01:56","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3340663,"visible":true,"origin":"","legend":"","description":"","filename":"hfhymtxqqyjqcsxdnmrmbjgfsrcgkxck.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4991954/v1_covered_af89e817-6b0d-4b35-8551-120879ca14e8.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Harmonizing Patient-Centric Requirements for Secure Digital Health Services in Hetero-geneous Settings","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Patient-centric care, Underserved areas, Harmonization requirements, Secure electronic journal systems","lastPublishedDoi":"10.21203/rs.3.rs-4991954/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4991954/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"The primary challenge this research addresses is the lack of harmonization of healthcare technologies in emergent regions. 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