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Literature Review Overview

What is a Literature Review? Why Are They Important?

A literature review is important because it presents the "state of the science" or accumulated knowledge on a specific topic. It summarizes, analyzes, and compares the available research, reporting study strengths and weaknesses, results, gaps in the research, conclusions, and authors’ interpretations.

Tips and techniques for conducting a literature review are described more fully in the subsequent boxes:

Literature review steps
Strategies for organizing the information for your review
Literature reviews sections
In-depth resources to assist in writing a literature review
Templates to start your review
Literature review examples

Literature Review Steps

literature review on health care administration

Graphic used with permission: Torres, E. Librarian, Hawai'i Pacific University

1. Choose a topic and define your research question

Try to choose a topic of interest. You will be working with this subject for several weeks to months.
Ideas for topics can be found by scanning medical news sources (e.g MedPage Today), journals / magazines, work experiences, interesting patient cases, or family or personal health issues.
Do a bit of background reading on topic ideas to familiarize yourself with terminology and issues. Note the words and terms that are used.
Develop a focused research question using PICO(T) or other framework (FINER, SPICE, etc - there are many options) to help guide you.
Run a few sample database searches to make sure your research question is not too broad or too narrow.
If possible, discuss your topic with your professor.

2. Determine the scope of your review

The scope of your review will be determined by your professor during your program. Check your assignment requirements for parameters for the Literature Review.

How many studies will you need to include?
How many years should it cover? (usually 5-7 depending on the professor)
For the nurses, are you required to limit to nursing literature?

3. Develop a search plan

Determine which databases to search. This will depend on your topic. If you are not sure, check your program specific library website (Physician Asst / Nursing / Health Services Admin) for recommendations.
Create an initial search string using the main concepts from your research (PICO, etc) question. Include synonyms and related words connected by Boolean operators
Contact your librarian for assistance, if needed.

4. Conduct searches and find relevant literature

Keep notes as you search - tracking keywords and search strings used in each database in order to avoid wasting time duplicating a search that has already been tried
Read abstracts and write down new terms to search as you find them
Check MeSH or other subject headings listed in relevant articles for additional search terms
Scan author provided keywords if available
Check the references of relevant articles looking for other useful articles (ancestry searching)
Check articles that have cited your relevant article for more useful articles (descendancy searching). Both PubMed and CINAHL offer Cited By links
Revise the search to broaden or narrow your topic focus as you peruse the available literature
Conducting a literature search is a repetitive process. Searches can be revised and re-run multiple times during the process.
Track the citations for your relevant articles in a software citation manager such as RefWorks, Zotero, or Mendeley

5. Review the literature

Read the full articles. Do not rely solely on the abstracts. Authors frequently cannot include all results within the confines of an abstract. Exclude articles that do not address your research question.
While reading, note research findings relevant to your project and summarize. Are the findings conflicting? There are matrices available than can help with organization. See the Organizing Information box below.
Critique / evaluate the quality of the articles, and record your findings in your matrix or summary table. Tools are available to prompt you what to look for. (See Resources for Appraising a Research Study box on the HSA, Nursing , and PA guides )
You may need to revise your search and re-run it based on your findings.

6. Organize and synthesize

Compile the findings and analysis from each resource into a single narrative.
Using an outline can be helpful. Start broad, addressing the overall findings and then narrow, discussing each resource and how it relates to your question and to the other resources.
Cite as you write to keep sources organized.
Write in structured paragraphs using topic sentences and transition words to draw connections, comparisons, and contrasts.
Don't present one study after another, but rather relate one study's findings to another. Speak to how the studies are connected and how they relate to your work.

Organizing Information

Options to assist in organizing sources and information :

1. Synthesis Matrix

helps provide overview of the literature
information from individual sources is entered into a grid to enable writers to discern patterns and themes
article summary, analysis, or results
thoughts, reflections, or issues
each reference gets its own row
mind maps, concept maps, flowcharts
at top of page record PICO or research question
record major concepts / themes from literature
list concepts that branch out from major concepts underneath - keep going downward hierarchically, until most specific ideas are recorded
enclose concepts in circles and connect the concept with lines - add brief explanation as needed

3. Summary Table

information is recorded in a grid to help with recall and sorting information when writing
allows comparing and contrasting individual studies easily
purpose of study
methodology (study population, data collection tool)

Efron, S. E., & Ravid, R. (2019). Writing the literature review : A practical guide . Guilford Press.

Literature Review Sections

Lit reviews can be part of a larger paper / research study or they can be the focus of the paper
Lit reviews focus on research studies to provide evidence
New topics may not have much that has been published

* The sections included may depend on the purpose of the literature review (standalone paper or section within a research paper)

Standalone Literature Review (aka Narrative Review):

presents your topic or PICO question
includes the why of the literature review and your goals for the review.
provides background for your the topic and previews the key points
Narrative Reviews: tmay not have an explanation of methods.
include where the search was conducted (which databases) what subject terms or keywords were used, and any limits or filters that were applied and why - this will help others re-create the search
describe how studies were analyzed for inclusion or exclusion
review the purpose and answer the research question
thematically - using recurring themes in the literature
chronologically - present the development of the topic over time
methodological - compare and contrast findings based on various methodologies used to research the topic (e.g. qualitative vs quantitative, etc.)
theoretical - organized content based on various theories
provide an overview of the main points of each source then synthesize the findings into a coherent summary of the whole
present common themes among the studies
compare and contrast the various study results
interpret the results and address the implications of the findings
do the results support the original hypothesis or conflict with it
provide your own analysis and interpretation (eg. discuss the significance of findings; evaluate the strengths and weaknesses of the studies, noting any problems)
discuss common and unusual patterns and offer explanations
stay away from opinions, personal biases and unsupported recommendations
summarize the key findings and relate them back to your PICO/research question
note gaps in the research and suggest areas for further research
this section should not contain "new" information that had not been previously discussed in one of the sections above
provide a list of all the studies and other sources used in proper APA 7

Literature Review as Part of a Research Study Manuscript:

Compares the study with other research and includes how a study fills a gap in the research.
Focus on the body of the review which includes the synthesized Findings and Discussion

Literature Reviews vs Systematic Reviews

Systematic Reviews are NOT the same as a Literature Review:

Literature Reviews:

Literature reviews may or may not follow strict systematic methods to find, select, and analyze articles, but rather they selectively and broadly review the literature on a topic
Research included in a Literature Review can be "cherry-picked" and therefore, can be very subjective

Systematic Reviews:

Systemic reviews are designed to provide a comprehensive summary of the evidence for a focused research question
rigorous and strictly structured, using standardized reporting guidelines (e.g. PRISMA, see link below)
uses exhaustive, systematic searches of all relevant databases
best practice dictates search strategies are peer reviewed
uses predetermined study inclusion and exclusion criteria in order to minimize bias
aims to capture and synthesize all literature (including unpublished research - grey literature) that meet the predefined criteria on a focused topic resulting in high quality evidence

Literature Review Examples

Breastfeeding initiation and support: A literature review of what women value and the impact of early discharge (2017). Women and Birth : Journal of the Australian College of Midwives
Community-based participatory research to promote healthy diet and nutrition and prevent and control obesity among African-Americans: A literature review (2017). Journal of Racial and Ethnic Health Disparities

Vitamin D deficiency in individuals with a spinal cord injury: A literature review (2017). Spinal Cord

Resources for Writing a Literature Review

These sources have been used in developing this guide.

Resources Used on This Page

Aveyard, H. (2010). Doing a literature review in health and social care : A practical guide . McGraw-Hill Education.

Purdue Online Writing Lab. (n.d.). Writing a literature review . Purdue University. https://owl.purdue.edu/owl/research_and_citation/conducting_research/writing_a_literature_review.html

Torres, E. (2021, October 21). Nursing - graduate studies research guide: Literature review. Hawai'i Pacific University Libraries. Retrieved January 27, 2022, from https://hpu.libguides.com/c.php?g=543891&p=3727230

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Hanna's Performing a qualitity literature review presentation slides

Link to the PPT slides via OneDrive anyone can view

Characteristics of a Good Literature Review in Health & Medicine

Clear Objectives and Research Questions : The review should start with clearly defined objectives and research questions that guide the scope and focus of the review.

Comprehensive Coverage : Include a wide range of relevant sources, such as research articles, review papers, clinical guidelines, and books. Aim for a broad understanding of the topic, covering historical developments and current advancements. To do this, an intentional and minimally biased search strategy.

Link to relevant databases to consider for a comprehensive search (search 2+ databases)
Link to the video "Searching your Topic: Strategies and Efficiencies" by Hanna Schmillen
Link to the worksheet "From topic, to PICO, to search strategy" to help researchers work through their topic into an intentional search strategy by Hanna Schmillen

Transparency and Replicability : The review process, search strategy, should be transparent, with detailed documentation of all steps taken. This allows others to replicate the review or update it in the future.

Appraisal of Studies Included : Each included study should be critically appraised for methodological quality and relevance. Use standardized appraisal tools to assess the risk of bias and the quality of evidence.

Link to the video " Evaluating Health Research" by Hanna Schmillen
Link to evaluating and appraising studies tab, which includes a rubric and checklists

Clear Synthesis and Discussion of Findings : The review should provide a thorough discussion of the findings, including any patterns, relationships, or trends identified in the literature. Address the strengths and limitations of the reviewed studies and the review itself. Present findings in a balanced and unbiased manner, avoiding over interpretation or selective reporting of results.

Implications for Practice and Research : The review should highlight the practical implications of the findings for medical practice and policy. It should also identify gaps in the current literature and suggest areas for future research.

Referencing and Citation : Use proper citation practices to credit original sources. Provide a comprehensive reference list to guide readers to the original studies.

Link to Citation Style Guide, includes tab about Zotero

Note: A literature review is not a systematic review. For more information about systematic reviews and different types of evidence synthesis projects, see the Evidence Synthesis guide .

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Open access
Published: 12 October 2020

A systematic literature review of researchers’ and healthcare professionals’ attitudes towards the secondary use and sharing of health administrative and clinical trial data

Elizabeth Hutchings ORCID: orcid.org/0000-0002-6030-954X 1 ,
Max Loomes ORCID: orcid.org/0000-0003-1042-0968 2 ,
Phyllis Butow ORCID: orcid.org/0000-0003-3562-6954 2 , 3 , 4 &
Frances M. Boyle ORCID: orcid.org/0000-0003-3798-1570 1 , 5

Systematic Reviews volume 9 , Article number: 240 ( 2020 ) Cite this article

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A systematic literature review of researchers and healthcare professionals’ attitudes towards the secondary use and sharing of health administrative and clinical trial data was conducted using electronic data searching. Eligible articles included those reporting qualitative or quantitative original research and published in English. No restrictions were placed on publication dates, study design, or disease setting. Two authors were involved in all stages of the review process; conflicts were resolved by consensus. Data was extracted independently using a pre-piloted data extraction template. Quality and bias were assessed using the QualSyst criteria for qualitative studies. Eighteen eligible articles were identified, and articles were categorised into four key themes: barriers, facilitators, access, and ownership; 14 subthemes were identified. While respondents were generally supportive of data sharing, concerns were expressed about access to data, data storage infrastructure, and consent. Perceptions of data ownership and acknowledgement, trust, and policy frameworks influenced sharing practice, as did age, discipline, professional focus, and world region. Young researchers were less willing to share data; they were willing to share in circumstances where they were acknowledged. While there is a general consensus that increased data sharing in health is beneficial to the wider scientific community, substantial barriers remain.

Systematic review registration

PROSPERO CRD42018110559

Peer Review reports

Healthcare systems generate large amounts of data; approximately 80 mB of data are generated per patient per year [ 1 ]. It is projected that this figure will continue to grow with an increasing reliance on technologies and diagnostic capabilities. Healthcare data provides an opportunity for secondary data analysis with the capacity to greatly influence medical research, service planning, and health policy.

There are many forms of data collected in the healthcare setting including administrative and clinical trial data which are the focus of this review. Administrative data collected during patients’ care in the primary, secondary, and tertiary settings can be analysed to identify systemic issues and service gaps, and used to inform improved health resourcing. Clinical trials play an essential role in furthering our understanding of disease, advancing new therapeutics, and developing improved supportive care interventions. However, clinical trials are expensive and can take several years to complete; a frequently quoted figure is that it takes 17 years for 14% of clinical research to benefit the patient [ 2 , 3 ].

Those who argue for increased data sharing in healthcare suggest that it may lead to improved treatment decisions based on all available information [ 4 , 5 ], improved identification of causes and clinical manifestations of disease [ 6 ], and provide increased research transparency [ 7 ]. In rare diseases, secondary data analysis may greatly accelerate the medical community’s understanding of the disease’s pathology and influence treatment.

Internationally, there are signs of movement towards greater transparency, particularly with regard to clinical research data. This change has been driven by governments [ 8 ], peak bodies [ 9 ], and clinician led initiatives [ 5 ]. One initiative led by the International Council of Medical Journal Editors (ICMJE) now requires a data sharing plan for all clinical research submitted for publication in a member scientific journal [ 9 ]. Further, international examples of data sharing can be seen in projects such as The Cancer Genome Atlas (TCGA) [ 10 ] dataset and the Surveillance, Epidemiology, and End Results (SEER) [ 11 ] database which have been used extensively for cancer research.

However, consent, data ownership, privacy, intellectual property rights, and potential for misinterpretation of data [ 12 ] remain areas of concern to individuals who are more circumspect about changing the data sharing norm. To date, there has been no published synthesis of views on data sharing from the perspectives of diverse professional stakeholders. Thus, we conducted a systematic review of the literature on the views of researchers and healthcare professionals regarding the sharing of health data.

This systematic literature review was part of a larger review of articles addressing data sharing, undertaken in accordance with the PRISMA statement for systematic reviews and meta-analysis [ 13 ]. The protocol was prospectively registered on PROSPERO ( www.crd.york.ac.uk /PROSPERO, CRD42018110559).

The following databases were searched: EMBASE/MEDLINE, Cochrane Library, PubMed, CINAHL, Informit Health Collection, PROSPERO Database of Systematic Reviews, PsycINFO, and ProQuest. The final search was conducted on 21 October 2018. No date restrictions were placed on the search; key search terms are listed in Table 1 . Papers were considered eligible if they: were published in English; were published in a peer review journal; reported original research, either qualitative or quantitative with any study design, related to data sharing in any disease setting; and included subjects over 18 years of age. Systematic literature reviews were included in the wider search but were not included in the results. Reference list and hand searching were undertaken to identify additional papers. Papers were considered ineligible if they focused on electronic health records, biobanking, or personal health records or were review articles, opinion pieces/articles/letters, editorials, or theses from masters or doctoral research. Duplicates were removed and title and abstract and full-text screening were undertaken using the Cochrane systematic literature review program Covidence [ 14 ]. Two authors were involved in all stages of the review process; conflicts were resolved by consensus.

Quality and bias were assessed at a study level using the QualSyst system for quantitative and qualitative studies as described by Kmet et al. [ 15 ]. A maximum score of 20 is assigned to articles of high quality and low bias; the final QualSyst score is a proportion of the total, with a possible score ranging from 0.0 to 1.0 [ 15 ].

Data extraction was undertaken using a pre-piloted form in Microsoft Office Excel. Data points included author, country and year of study, study design and methodology, health setting, and key themes and results. Where available, detailed information on research participants was extracted including age, sex, clinical/academic employment setting, publication and grant history, career stage, and world region.

Quantitative data were summarised using descriptive statistics. Synthesis of qualitative findings used a meta-ethnographic approach, in accordance with guidelines from Lockwood et al. [ 16 ].The main themes of each qualitative study were first identified and then combined, if relevant, into categories of commonality. Using a constant comparative approach, higher order themes and subthemes were developed. Quantitative data relevant to each theme were then incorporated. Using a framework analysis approach as described by Gale et al. [ 17 ], the perspectives of different professional groups (researchers, healthcare professionals, data custodians, and ethics committees) towards data sharing were identified. Where differences occurred, they are highlighted in the results. Similarly, where systematic differences according to other characteristics (such as age or years of experience), these are highlighted.

This search identified 4019 articles, of which 241 underwent full-text screening; 73 articles met the inclusion criteria for the larger review. Five systematic literature reviews were excluded as was one article which presented duplicate results; this left a total of 67 articles eligible for review. See Fig. 1 for the PRISMA diagram describing study screening.

PRIMSA flow diagram (attached)

This systematic literature review was originally developed to identify attitudes towards secondary use and sharing of health administrative and clinical trial data in breast cancer. However, as there was a paucity of material identified specifically related to this group, we present the multidisciplinary results of this search, and where possible highlight results specific to breast cancer, and cancer more generally. We believe that the material identified in this search is relevant and reflective of the wider attitudes towards data sharing within the scientific and medical communities and can be used to inform data sharing strategies in breast cancer.

Eighteen [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ] of the 67 articles addressed the perspectives of clinical and scientific researchers, data custodians, and ethics committees and were analysed for this paper (Table 2 ). The majority ( n = 16) of articles focused on the views of researchers and health professionals, [ 18 , 19 , 20 , 21 , 22 , 24 , 25 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], only one article focused on data custodians [ 27 ] and ethics committees [ 23 ] respectively. Four articles [ 18 , 19 , 21 , 35 ] included a discussion on the attitudes of both researchers and healthcare professionals and patients; only results relating to researchers/clinicians are included in this analysis (Fig. 1 ).

Study design, location, and disciplines

Several study methodologies were used, including surveys ( n = 11) [ 24 , 25 , 26 , 27 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], interviews and focus groups ( n = 6) [ 18 , 19 , 20 , 21 , 22 , 23 ], and mixed methods ( n = 1) [ 28 ]. Studies were conducted in a several countries and regions; a breakdown by country and study is available in Table 3 .

In addition to papers focusing on general health and sciences [ 18 , 21 , 22 , 24 , 25 , 26 , 29 , 30 , 31 , 32 , 33 , 34 ], two articles included views from both science and non-science disciplines [ 27 , 28 ]. Multiple sclerosis (MS) [ 19 ], mental health [ 35 ], and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)/tuberculosis (TB) [ 20 ] were each the subject of one article.

Study quality

Results of the quality assessment are provided in Table 2 . QualSyst [15] scores ranged from 0.7 to 1.0 (possible range 0.0 to 1.0). While none were blinded studies, most provided clear information on respondent selection, data analysis methods, and justifiable study design and methodology.

Four key themes, barriers, facilitators, access, and ownership were identified; 14 subthemes were identified. A graphical representation of article themes is presented in Fig. 2 . Two articles reflect the perspective of research ethics committees [ 23 ] and data custodians [ 27 ]; concerns noted by these groups are similar to those highlighted by researchers and healthcare professionals.

Graphic representation of key themes and subthemes identified (attached)

Barriers and facilitators

Reasons for not sharing.

Eleven articles identified barriers to data sharing [ 20 , 22 , 24 , 25 , 27 , 29 , 30 , 31 , 32 , 33 , 34 ]. Concerns cited by respondents included other researchers taking their results [ 24 , 25 ], having data misinterpreted or misattributed [ 24 , 27 , 31 , 32 ], loss of opportunities to maximise intellectual property [ 24 , 25 , 27 ], and loss of publication opportunities [ 24 , 25 ] or funding [ 25 ]. Results of a qualitative study showed respondents emphasised the competitive value of research data and its capacity to advance an individual’s career [ 20 ] and the potential for competitive disadvantage with data sharing [ 22 ]. Systematic issues related to increased data sharing were noted in several articles where it was suggested the barriers are ‘deeply rooted in the practices and culture of the research process as well as the researchers themselves’ [ 33 ] (p. 1), and that scientific competition and a lack of incentive in academia to share data remain barriers to increased sharing [ 30 ].

Insufficient time, lack of funding, limited storage infrastructure, and lack of procedural standards were also noted as barriers [ 33 ]. Quantitative results demonstrated that the researchers did not have the right to make the data public or that there was no requirement to share by the study sponsor [ 33 ]. Maintaining the balance between investigator and funder interests and the protection of research subjects [ 31 ] were also cited as barriers. Concerns about privacy were noted in four articles [ 25 , 27 , 29 , 30 ]; one study indicated that clinical researchers were significantly more concerned with issues of privacy compared to scientific researchers [ 25 ]. The results of one qualitative study indicated that clinicians were more cautious than patients regarding the inclusion of personal information in a disease specific registry; the authors suggest this may be a result of potential for legal challenges in the setting of a lack of explicit consent and consistent guidelines [ 19 ]. Researchers, particularly clinical staff, indicated that they did not see sharing data in a repository as relevant to their work [ 29 ]

Trust was also identified as a barrier to greater data sharing [ 32 ]. Rathi et al. identified that researchers were likely to withhold data if they mistrusted the intent of the researcher requesting the information [ 32 ]. Ethical, moral, and legal issues were other potential barriers cited [ 19 , 22 ]. In one quantitative study, 74% of respondents ( N = 317) indicated that ensuring appropriate data use was a concern; other concerns included data not being appropriate for the requested purpose [ 32 ]. Concerns about data quality were also cited as a barrier to data reuse; some respondents suggested that there was a perceived negative association of data reuse among health scientists [ 30 ].

Reasons for sharing

Eleven articles [ 19 , 20 , 21 , 22 , 24 , 25 , 29 , 30 , 31 , 32 , 33 ] discussed the reasons identified by researchers and healthcare professionals for sharing health data; broadly the principle of data sharing was seen as a desirable norm [ 25 , 31 ]. Cited benefits included improvements to the delivery of care, communication and receipt of information, impacts on care and quality of life [ 19 ], contributing to the advancement of science [ 20 , 24 , 29 ], validating scientific outputs, reducing duplication of scientific effort and minimising research costs [ 20 ], and promoting open science [ 31 , 32 ]. Professional reasons for sharing data included academic benefit and recognition, networking and collaborative opportunities [ 20 , 24 , 29 , 31 ], and contributing to the visibility of their research [ 24 ]. Several articles noted the potential of shared data for enabling faster access to a wider pool of patients [ 21 ] for research, improved access to population data for longitudinal studies [ 22 ], and increased responsiveness to public health needs [ 20 ]. In one study, a small percentage of respondents indicated that there were no benefits from sharing their data [ 24 ].

Analysis of quantitative survey data indicated that the perceived usefulness of data was most strongly associated with reuse intention [ 30 ]. The lack of access to data generated by other researchers or institutions was seen as a major impediment to progress in science [ 33 ]. In a second study, quantitative data showed no significant differences in reasons for sharing by clinical trialists’ academic productivity, geographic location, trial funding source or size, or the journal in which the results were published [ 32 ]. Attitudes towards sharing in order to receive academic benefits or recognition differed significantly based on the respondent’s geographic location; those from Western Europe were more willing to share compared to respondents in the USA or Canada, and the rest of the world [ 32 ].

Views on sharing

Seven articles [ 19 , 20 , 21 , 29 , 31 , 33 , 34 ] discussed researchers’ and healthcare professionals’ views relating to sharing data, with a broad range of views noted. Two articles, both qualitative, discussed the role of national registries [ 21 ], and data repositories [ 31 ]. Generally, there was clear support for national research registers and an acceptance for their rationale [ 21 ], and some respondents believed that sharing de-identified data through data repositories should be required and that when requested, investigators should share data [ 31 ]. Sharing de-identified data for reasons beyond academic and public health benefit were cited as a concern [ 20 ]. Two quantitative studies noted a proportion of researchers who believed that data should not be made available [ 33 , 34 ]. Researchers also expressed differences in how shared data should be managed; the requirement for data to be ‘gate-kept’ was preferred by some, while others were happy to relinquish control of their data once curated or on release [ 20 ]. Quantitative results indicated that scientists were significantly more likely to rank data reuse as highly relevant to their work than clinicians [ 29 ], but not all scientists shared data equally or had the same views about data sharing or reuse [ 33 ]. Some respondents argued that not all data were equal and therefore should only be shared in certain circumstances. This was in direct contrast to other respondents who suggested that all data should be shared, all of the time [ 20 ].

Differences by age, background, discipline, professional focus, and world region

Differences in attitudes towards shared data were noted by age, professional focus, and world region [ 25 , 27 , 33 , 34 ]. Younger researchers, aged between 20–39 and 40–49 years, were less likely to share their data with others (39% and 38% respectively) compared to other age groups; respondents aged over 50 years of age were more willing (46%) to share [ 33 ]. Interestingly, while less willing to share, younger researchers also believed that the lack of access to data was a major impediment to science and their research [ 33 ]. Where younger researchers were able to place conditions on access to their data, rates of willingness to share were increased [ 33 ].

Respondents from the disciplines of education, medicine/health science, and psychology were more inclined than others to agree that their data should not be available for others to use in the first place [ 34 ]. However, results from one study indicated that researchers from the medical field and social sciences were less likely to share compared to other disciplines [ 33 ]. For example, results of a quantitative study showed that compared to biologists, who reported sharing 85% of their data, medical and social sciences reported sharing their data 65% and 58% percent of the time, respectively [ 33 ].

One of the primary reasons for controlling access to data, identified in a study of data custodians, was due to a desire to avoid data misuse; this was cited as a factor for all surveyed data repositories except those of an interdisciplinary nature [ 27 ]. Limiting access to certain types of research and ensuring attribution were not listed as a concern for sociology, humanities or interdisciplinary data collections [ 27 ]. Issues pertaining to privacy and sensitive data were only cited as concerns for data collections related to humanities, social sciences, and biology, ecology, and chemistry; concerns regarding intellectual property were also noted [ 27 ]. The disciplines of biology, ecology, and chemistry and social sciences had the most policy restrictions on the use of data held in their repositories [ 27 ].

Differences in data sharing practices were also noted by world region. Respondents not from North American and European countries were more willing to place their data on a central repository; however, they were also more likely to place conditions on the reuse of their data [ 33 , 34 ].

Experience of data sharing

The experience of data sharing among researchers was discussed in nine articles [ 20 , 24 , 25 , 26 , 28 , 29 , 30 , 31 , 32 , 33 ]. Data sharing arrangements were highly individual and ranged from ad hoc and informal processes to formal procedures enforced by institutional policies in the form of contractual agreements, with respondents indicating data sharing behaviour ranging from sharing no data to sharing all data [ 20 , 26 , 31 ]. Quantitative data from one study showed that researchers were more inclined to share data prior to publication with people that they knew compared to those they did not; post publication, these figures were similar between groups [ 24 ]. While many researchers were prepared to share data, results of a survey identified a preference of researchers to collect data themselves, followed by their team, or by close colleagues [ 26 ].

Differences in the stated rate of data sharing compared to the actual rate of sharing [ 25 ] were noted. In a large quantitative study ( N = 1329), nearly one third of respondents chose not to answer whether they make their data available to others; of those who responded to the question, 46% reported they do not make their data electronically available to others [ 33 ]. By discipline, differences in the rate of refusal to share were higher in chemistry compared to non-science disciplines such as sociology [ 25 ]. Respondents who were more academically productive (> 25 articles over the past 3 years) reported that they have or would withhold data to protect research subjects less frequently than those who were less academically productive or received industry funding [ 32 ].

Attitudes to sharing de-identified data via data repositories was discussed in two articles [ 29 , 31 ]. A majority of respondents in one study indicated that de-identified data should be shared via a repository and that it should be shared when requested. A lack of experience in uploading data to repositories was noted as a barrier [ 29 ]. When data was shared, most researchers included additional materials to support their data including materials such as metadata or a protocol description [ 29 ].

Two articles [ 28 , 30 ] focused on processes and variables associated with sharing. Factors such as norms, data infrastructure/organisational support, and research communities were identified as important factors in a researcher’s attitude towards data sharing [ 28 , 30 ]. A moderate correlation between data reuse and data sharing suggest that these two variables are not linked. Furthermore, sharing data compared to self-reported data reuse were also only moderately associated (Pearson’s correlation of 0.25 ( p ≤ 0.001)) [ 26 ].

Predictors of data sharing and norms

Two articles [ 26 , 30 ] discussed the role of social norms and an individual’s willingness to share health data. Perceived efficacy and efficiency of data reuse were strong predictors of data sharing [ 26 ] and the development of a ‘positive social norm towards data sharing support(s)[ed] researcher data reuse intention’ [ 30 ] (p. 400).

Policy framework

The establishment of clear policies and procedures to support data sharing was highlighted in two articles [ 22 , 28 ]. The presence of ambiguous data sharing policies was noted as a major limitation, particularly in primary care and the increased adoption of health informatics systems [ 22 ]. Policies that support an efficient exchange system allowing for the maximum amount of data sharing are preferred and may include incentives such as formal recognition and financial reimbursement; a framework for this is proposed in Fecher et al. [ 28 ].

Research funding

The requirement to share data funded by public monies was discussed in one article [ 25 ]. Some cases were reported of researchers refusing to share data funded by tax-payer funds; reasons for refusal included a potential reduction in future funding or publishing opportunities [ 25 ].

Access and ownership

Articles relating to access and ownership were grouped together and seven subthemes were identified.

Access, information systems, and metadata

Ten articles [ 19 , 20 , 21 , 22 , 26 , 27 , 29 , 33 , 34 , 35 ] discussed the themes of access, information systems, and the use of metadata. Ensuring privacy protections in a prospective manner was seen as important for data held in registries [ 19 ]. In the setting of mental health, researchers indicated that patients should have more choices for controlling access to shared registry data [ 35 ]. The use of guardianship committees [ 19 ] or gate-keepers [ 20 ] was seen as important in ensuring the security and access to data held in registries by some respondents; however, many suggested that a researcher should relinquish control of the data collection once curated or released, unless embargoed [ 20 ]. Reasons for maintaining control over registry data included ensuring attribution, restricting commercial research, protecting sensitive (non-personal) information, and limiting certain types of research [ 27 ]. Concerns about security and confidentiality were noted as important and assurances about these needed to be provided; accountability and transparency mechanisms also need to be included [ 21 ]. Many respondents believed that access to the registry data by pharmaceutical companies and marketing agencies was not considered appropriate [ 19 ].

Respondents to a survey from medicine and social sciences were less likely to agree to have all data included on a central repository with no restrictions [ 33 ]; notably, this was also reflected in the results of qualitative research which indicated that health professionals were more cautious than patients about the inclusion of personal data within a disease specific register [ 19 ].

While many researchers stated that they commonly shared data directly with other researchers, most did not have experience with uploading data to repositories [ 29 ]. Results from a survey indicated that younger respondents have more data access restrictions and thought that their data is easier to access significantly more than older respondents [ 34 ]. In the primary care setting, concerns were noted about the potential for practitioners to block patient involvement in a registry by refusing access to a patient’s personal data or by not giving permission for the data to be extracted from their clinical system [ 21 ]. There was also resistance in primary care towards health data amalgamation undertaken for an unspecified purpose [ 22 ]; respondents were not in favour of systems which included unwanted functionality (do not want/need), inadequate attributes (capability and receptivity) of the practice, or undesirable impact on the role of the general practitioner (autonomy, status, control, and workflow) [ 22 ].

Access to ‘comprehensive metadata (is needed) to support the correct interpretation of the data’ [ 26 ] (p. 4) at a later stage. When additional materials were shared, most researchers shared contextualising information or a description of the experimental protocol [ 29 ]. The use of metadata standards was not universal with some respondents using their own [ 33 ].

Several articles highlighted the impact of data curation on researchers’ time [ 20 , 21 , 22 , 29 , 33 ] or finances [ 24 , 28 , 29 , 33 , 34 ]; these were seen as potential barriers to increased registry adoption [ 21 ]. Tasks required for curation included preparing data for dissemination in a usable format and uploading data to repositories. The importance of ensuring that the data is accurately preserved for future reuse was highlighted; it must be presented in a retriable and auditable manner [ 20 ]. The amount of time required to curate data ranged from ‘no additional time’ to ‘greater than ten hours’ [ 29 ]. In one study, no clinical respondent had their data in a sharable format [ 29 ]. In the primary care setting, health information systems which promote sharing were not seen as being beneficial if they required standardisation of processes and/or sharing of clinical notes [ 22 ]. Further, spending time on non-medical issues in a time poor environment [ 22 ] was identified as a barrier. Six articles described the provision of funding or technical support to ensure data storage, maintenance, and the ability to provide access to data when requested. All noted a lack of funding and time as a barrier to increased sharing data [ 20 , 24 , 28 , 29 , 33 , 34 ].

Results of qualitative research indicated a range of views regarding consent mechanisms for future data use [ 18 , 19 , 20 , 23 , 35 ]. Consenting for future research can be complex given that the exact nature of the study will be unknown, and therefore some respondents suggested that a broad statement on future data uses be included [ 19 , 20 ] during the consent process. In contrast, other participants indicated that the current consent processes were too broad and do not reflect patient preferences sufficiently [ 35 ]. The importance of respecting the original consent in all future research was noted [ 20 ]. It was suggested that seeking additional consent for future data use may discourage participation in the original study [ 20 ]. Differences in views regarding the provision of detailed information about sharing individual level data was noted suggesting that the researchers wanted to exert some control over data they had collected [ 20 ]. An opt-out consent process was considered appropriate in some situations [ 18 ] but not all; some respondents suggested that consent to use a patient’s medical records was not required [ 18 ]. There was support by some researchers to provide patients with the option to ‘opt-in’ to different levels of involvement in a registry setting [ 19 ]. Providing patients more granular choices when controlling access to their medical data [ 35 ] was seen as important.

The attitudes of ethics and review boards ( N = 30) towards the use of medical records for research was discussed in one article [ 23 ]. While 38% indicated that no further consent would be required, 47% required participant consent, and 10% said that the requirement for consent would depend on how the potentially identifying variables would be managed [ 23 ]. External researcher access to medical record data was associated with a requirement for consent [ 23 ].

Acknowledgement

The importance of establishing mechanisms which acknowledge the use of shared data were discussed in four articles [ 27 , 29 , 33 , 34 ]. A significant proportion of respondents to a survey believed it was fair to use other researchers’ data if they acknowledged the originator and the funding body in all disseminated work or as a formal citation in published works [ 33 ]. Other mechanisms for acknowledging the data originator included opportunities to collaborate on the project, reciprocal data sharing agreements, allowing the originator to review or comment on results, but not approve derivative works, or the provision of a list of products making use of the data and co-authorship [ 33 , 34 ]. In the setting of controlled data collections, survey results indicated that ensuring attribution was a motivator for controlled access [ 27 ]. Over half of respondents in one survey believed it was fair to disseminate results based either in whole or part without the data provider’s approval [ 33 ]. No significant differences in mechanisms for acknowledgement were noted between clinical and scientific participants; mechanisms included co-authorship, recognition in the acknowledgement section of publications, and citation in the bibliography [ 29 ]. No consentient method for acknowledging shared data reuse was identified [ 29 ].

Data ownership was identified as a potential barrier to increased data sharing in academic research [ 28 ]. In the setting of control of data collections, survey respondents indicated that they wanted to maintain some control over the dataset, which is suggestive of researchers having a perceived ownership of their research data [ 28 ]. Examples of researchers extending ownership over their data include the right to publish first and the control of access to datasets [ 28 ]. Fecher et al. noted that the idea of data ownership by the researcher is not a position always supported legally; ‘the ownership and rights of use, privacy, contractual consent and copyright’ are subsumed [ 28 ] (p. 15). Rather data sharing is restricted by privacy law, which is applied to datasets containing data from individuals. The legal uncertainty about data ownership and the complexity of law can deter data sharing [ 28 ].

Promotion/professional criteria

The role of data sharing and its relation to promotion and professional criteria were discussed in two articles [ 24 , 28 ]. The requirement to share data is rarely a promotion or professional criterion, rather the systems are based on grants and publication history [ 24 , 28 ]. One study noted that while the traditional link between publication history and promotion remains, it is ‘likely that funders will continue to get sub-optimal returns on their investments, and that data will continue to be inefficiently utilised and disseminated’ [ 24 ] (p. 49).

This systematic literature review highlights the ongoing complexity associated with increasing data sharing across the sciences. No additional literature meeting the inclusion criteria were identified in the period between the data search and the submission of this manuscript. Data gaps identified include a paucity of information specifically related to the attitudes of breast cancer researchers and health professionals towards the secondary use and sharing of health administrative and clinical trial data.

While the majority of respondents believed the principles of data sharing were sound, significant barriers remain: issues of consent, privacy, information security, and ownership were key themes throughout the literature. Data ownership and acknowledgement, trust, and policy frameworks influenced sharing practice, as did age, discipline, professional focus, and world region.

Addressing concerns of privacy, trust, and information security in a technologically changing and challenging landscape is complex. Ensuring the balance between privacy and sharing data for the greater good will require the formation of policy and procedures, which promote both these ideals.

Establishing clear consent mechanisms would provide greater clarity for all parties involved in the data sharing debate. Ensuring that appropriate consent for future research, including secondary data analysis and sharing and linking of datasets, is gained at the point of data collection, would continue to promote research transparency and provide healthcare professionals and researchers with knowledge that an individual is aware that their data may be used for other research purposes. The establishment of policy which supports and promotes the secondary use of data and data sharing will assist in the normalisation of this type of health research. With the increased promotion of data sharing and secondary data analysis as an established tool in health research, over time barriers to its use, including perceptions of ownership and concerns regarding privacy and consent, will decrease.

The importance of establishing clear and formal processes associated with acknowledging the use of shared data has been underscored in the results presented. Initiatives such as the Bioresource Research Impact Factor/Framework (BRIF) [ 36 ] and the Citation of BioResources in journal Articles (CoBRA) [ 37 ] have sought to formalise the process. However, increased academic recognition of sharing data for secondary analysis requires further development and the allocation of funding to ensure that collected data is in a usable, searchable, and retrievable format. Further, there needs to be a shift away from the traditional criteria of academic promotion, which includes research outputs, to one which is inclusive of a researcher’s data sharing history and the availability of their research dataset for secondary analysis.

The capacity to identify and use already collected data was identified as a barrier. Moves to make data findable, accessible, interoperable, and reusable (FAIR) have been promoted as a means to encourage greater accessibility to data in a systematic way [ 38 ]. The FAIR principles focus on data characteristics and should be interpreted alongside the collective benefit, authority to control, responsibility, and ethics (CARE) principles established by the Global Indigenous Data Alliance (GIDA) which a people and purpose orientated [ 39 ].

Limitations

The papers included in this study were limited to those indexed on major databases. Some literature on this topic may have been excluded if it was not identified during the grey literature and hand searching phases.

Implications

Results of this systematic literature review indicate that while there is broad agreement for the principles of data sharing in medical research, there remain disagreements about the infrastructure and procedures associated with the data sharing process. Additional work is therefore required on areas such as acknowledgement, curation, and data ownership.

While the literature confirms that there is overall support for data sharing in medical and scientific research, there remain significant barriers to its uptake. These include concerns about privacy, consent, information security, and data ownership.

Availability of data and materials

All data generated or analysed during this study are included in this published article.

Abbreviations

Bioresource Research Impact Factor/Framework

Collective benefit, authority to control, responsibility, and ethics

Citation of BioResources in journal Articles

Findable, accessible, interoperable, and reusable

Global Indigenous Data Alliance

Human immunodeficiency virus/acquired immunodeficiency

International Council of Medical Journal Editors

Multiple sclerosis

Surveillance, Epidemiology, and End Results

Tuberculosis

The Cancer Genome Atlas

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Acknowledgements

The authors would like to thank Ms. Ngaire Pettit-Young, Information First, Sydney, NSW, Australia, for her assistance in developing the search strategy.

This project was supported by the Sydney Vital, Translational Cancer Research, through a Cancer Institute NSW competitive grant. The views expressed herein are those of the authors and are not necessarily those of the Cancer Institute NSW. FB is supported in her academic role by the Friends of the Mater Foundation.

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EH, PB, and FB were responsible for developing the study concept and the development of the protocol. EH and ML were responsible for the data extraction and data analysis. FB and PB supervised this research. All authors participated in interpreting the findings and contributed the intellectual content of the manuscript. All authors have read and approved the manuscript.

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Hutchings, E., Loomes, M., Butow, P. et al. A systematic literature review of researchers’ and healthcare professionals’ attitudes towards the secondary use and sharing of health administrative and clinical trial data. Syst Rev 9 , 240 (2020). https://doi.org/10.1186/s13643-020-01485-5

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DOI : https://doi.org/10.1186/s13643-020-01485-5

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Implementing evidence into practice requires nurses to identify, critically appraise and synthesise research. This may require a comprehensive literature review: this article aims to outline the approaches and stages required and provides a working example of a published review.

Are there different approaches to undertaking a literature review?

What stages are required to undertake a literature review.

The rationale for the review should be established; consider why the review is important and relevant to patient care/safety or service delivery. For example, Noble et al 's 4 review sought to understand and make recommendations for practice and research in relation to dialysis refusal and withdrawal in patients with end-stage renal disease, an area of care previously poorly described. If appropriate, highlight relevant policies and theoretical perspectives that might guide the review. Once the key issues related to the topic, including the challenges encountered in clinical practice, have been identified formulate a clear question, and/or develop an aim and specific objectives. The type of review undertaken is influenced by the purpose of the review and resources available. However, the stages or methods used to undertake a review are similar across approaches and include:

Formulating clear inclusion and exclusion criteria, for example, patient groups, ages, conditions/treatments, sources of evidence/research designs;

Justifying data bases and years searched, and whether strategies including hand searching of journals, conference proceedings and research not indexed in data bases (grey literature) will be undertaken;

Developing search terms, the PICU (P: patient, problem or population; I: intervention; C: comparison; O: outcome) framework is a useful guide when developing search terms;

Developing search skills (eg, understanding Boolean Operators, in particular the use of AND/OR) and knowledge of how data bases index topics (eg, MeSH headings). Working with a librarian experienced in undertaking health searches is invaluable when developing a search.

Once studies are selected, the quality of the research/evidence requires evaluation. Using a quality appraisal tool, such as the Critical Appraisal Skills Programme (CASP) tools, 5 results in a structured approach to assessing the rigour of studies being reviewed. 3 Approaches to data synthesis for quantitative studies may include a meta-analysis (statistical analysis of data from multiple studies of similar designs that have addressed the same question), or findings can be reported descriptively. 6 Methods applicable for synthesising qualitative studies include meta-ethnography (themes and concepts from different studies are explored and brought together using approaches similar to qualitative data analysis methods), narrative summary, thematic analysis and content analysis. 7 Table 1 outlines the stages undertaken for a published review that summarised research about parents’ experiences of living with a child with a long-term condition. 8

View inline

An example of rapid evidence assessment review

In summary, the type of literature review depends on the review purpose. For the novice reviewer undertaking a review can be a daunting and complex process; by following the stages outlined and being systematic a robust review is achievable. The importance of literature reviews should not be underestimated—they help summarise and make sense of an increasingly vast body of research promoting best evidence-based practice.

↵ Centre for Reviews and Dissemination . Guidance for undertaking reviews in health care . 3rd edn . York : CRD, York University , 2009 .
↵ Canadian Best Practices Portal. http://cbpp-pcpe.phac-aspc.gc.ca/interventions/selected-systematic-review-sites / ( accessed 7.8.2015 ).
Bridges J , et al
↵ Critical Appraisal Skills Programme (CASP). http://www.casp-uk.net / ( accessed 7.8.2015 ).
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A systematic literature review of health information systems for healthcare.

1. Introduction

2. material and method, 3. discussion, 3.1. the evolution of health information systems, 3.2. his structural deployment, 3.3. health information systems benefits, 3.4. information system and knowledge management in the healthcare arena, 3.4.1. information system, 3.4.2. knowledge management, 4. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, conflicts of interest.

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Source: Authors	Core Enabling HIS Components	Benefits
Malaquias and Filho [ ]	Health ER eHealth mHealth	Ease of access to patient and medical information from records; Cost reduction; Enhance efficiency in patients’ data recovery and management; Enable stakeholders’ health information centralization and remote access.
Ammenwerth, Duftschmid [ ]	eHealth	Upsurge in care efficacy and quality and condensed costs for clinical services; Lessen the health care system’s administrative costs; Facilitates novel models of health care delivery.
Tummers, Tobi [ ]	HIS	Patient information management; Enable communication within the healthcare arena; Afford high-quality and efficient care.
Steil, Finas [ ]	HIS	Enable inter- and multidisciplinary collaboration between humans and machines; Afford autonomous and intelligent decision capabilities for health care applications.
Nyangena, Rajgopal [ ]	HIS	Enable seamless information exchange within the healthcare arena.
Sik, Aydinoglu [ ]	HIS	Support precision medicine approaches and decision support.

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Share and Cite

Epizitone, A.; Moyane, S.P.; Agbehadji, I.E. A Systematic Literature Review of Health Information Systems for Healthcare. Healthcare 2023 , 11 , 959. https://doi.org/10.3390/healthcare11070959

Epizitone A, Moyane SP, Agbehadji IE. A Systematic Literature Review of Health Information Systems for Healthcare. Healthcare . 2023; 11(7):959. https://doi.org/10.3390/healthcare11070959

Epizitone, Ayogeboh, Smangele Pretty Moyane, and Israel Edem Agbehadji. 2023. "A Systematic Literature Review of Health Information Systems for Healthcare" Healthcare 11, no. 7: 959. https://doi.org/10.3390/healthcare11070959

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JBI Manual for Evidence Synthesis JBI (Joanna Briggs Institute) is an international evidence-based healthcare research organization. The JBI Manual for Evidence Synthesis is meant to provide authors with a comprehensive guide to conducting JBI systematic reviews. Types of systematic reviews covered in manual include: systematic reviews of qualitative evidence, systematic reviews of effectiveness, mixed methods systematics reviews and scoping reviews, among others.
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Systematic Reviews: CRD's Guidance for Undertaking Reviews in Health Care [PDF, 1.6MB] Published by the Centre for Reviews and Dissemination, University of York, this guide outlines the methods and steps necessary to conduct a systematic review. It also addresses issues associated with reviews in specific areas, such as clinical tests, public health interventions, harm/adverse effects, economic evaluations, and how and why interventions work. Opens as PDF.
Finding What Works in Health Care: Standards for Systematic Reviews This ebook, produced by the Institute of Medicine (2011), contains chapters on the following topics: Standards for initiating a systematic review -- Standards for finding and assessing individual studies -- Standards for synthesizing the body of evidence -- Standards for reporting systematic reviews -- Improving the quality of systematic reviews
Methods for the Thematic Synthesis of Qualitative Research in Systematic Reviews Article abstract: There is a growing recognition of the value of synthesising qualitative research in the evidence base in order to facilitate effective and appropriate health care. In response to this, methods for undertaking these syntheses are currently being developed. Thematic analysis is a method that is often used to analyse data in primary qualitative research. This paper reports on the use of this type of analysis in systematic reviews to bring together and integrate the findings of multiple qualitative studies.
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Systematic Reviews and Meta-Analysis This ebook, written by Littell, Corcoran, and Pillai (2008) and published by Oxford University Press, contains chapters on the following topics: Formulating a topic and developing a protocol -- Locating and screening studies -- Data extraction and study quality assessment -- Effect size metrics and pooling methods -- Assessing bias and variations in effects
Systematic Reviews in the Social Sciences: A Practical Guide This ebook, written by Petticrew and Roberts (2006), contains chapters on the following topics: Why do we need systematic reviews? -- Starting the review : refining the question and defining the boundaries -- What sorts of studies do I include in the review? : deciding on the review's inclusion/exclusion criteria -- How to find the studies : the literature search -- How to appraise the studies : an introduction to assessing study quality -- Synthesizing the evidence -- Exploring heterogeneity and publication bias -- Disseminating the review -- Systematic reviews : urban myths and fairy tales
Finding and Evaluating Evidence: Systematic Reviews and Evidence-Based Practice Part of the Pocket Guide to Social Work Research Method series, this ebook, written by Bronson and Davis (2012) and published by Oxford University Press, contains chapters on the following topics: Systematic reviews, evidence-based practice, and social work -- Asking the right questions, preparing a protocol, and finding the relevant research -- Critically appraising the quality and credibility of quantitative research for systematic reviews -- The art and science of managing and summarizing the available research -- Systematic reviews of qualitative research -- Assessing the quality of systematic reviews

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PROSPERO PROSPERO is an international database of prospectively registered systematic reviews in health and social care, welfare, public health, education, crime, justice, and international development, where there is a health related outcome. It aims to provide a comprehensive listing of systematic reviews, registered at inception, to help avoid duplication and reduce opportunity for reporting bias by enabling comparison completed review with what was planned in the protocol.
OSF Registries Use the OSF (Open Science Framework) platform to preregister the protocol for your knowledge synthesis. OSF if a useful alternative to PROSPERO if you are not publishing a systematic review or a review of interventions with health-related outcomes. OSF is commonly used to register protocols for scoping reviews.

Publishing a Protocol

Many journals will publish a protocol for research, including systematic reviews. See the 'Information for Authors' or 'Submissions' sections of journal's websites to determine what kind of articles they publish.

Examples of Journals that Publish Protocols

BMC Journals Many journals in BioMed Central's portfolio publish protocols for evidence syntheses. In particular, check out the journal 'Systematic Reviews'.
JBI Evidence Synthesis The journal JBI Evidence Synthesis accepts manuscripts for evidence synthesis protocols, including systematic reviews of effects, reviews of qualitative evidence, scoping reviews and mix methods systematic reviews
JMIR Research Protocols JMIR Research Protocols publishes protocols for systematic reviews and scoping reviews.

McGill Library. (2022). Guides: Systematic Reviews, Scoping Reviews, and Other Knowledge Syntheses: Developing the protocol . Retrieved February 4, 2022, from https://libraryguides.mcgill.ca/knowledge-syntheses/protocol

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Last Updated: Jun 11, 2024 2:15 PM
URL: https://guides.nyu.edu/healthcaremanagement

Research Topics & Ideas: Healthcare

100+ Healthcare Research Topic Ideas To Fast-Track Your Project

Healthcare-related research topics and ideas

Finding and choosing a strong research topic is the critical first step when it comes to crafting a high-quality dissertation, thesis or research project. If you’ve landed on this post, chances are you’re looking for a healthcare-related research topic , but aren’t sure where to start. Here, we’ll explore a variety of healthcare-related research ideas and topic thought-starters across a range of healthcare fields, including allopathic and alternative medicine, dentistry, physical therapy, optometry, pharmacology and public health.

NB – This is just the start…

The topic ideation and evaluation process has multiple steps . In this post, we’ll kickstart the process by sharing some research topic ideas within the healthcare domain. This is the starting point, but to develop a well-defined research topic, you’ll need to identify a clear and convincing research gap , along with a well-justified plan of action to fill that gap.

If you’re new to the oftentimes perplexing world of research, or if this is your first time undertaking a formal academic research project, be sure to check out our free dissertation mini-course. In it, we cover the process of writing a dissertation or thesis from start to end. Be sure to also sign up for our free webinar that explores how to find a high-quality research topic.

Overview: Healthcare Research Topics

Allopathic medicine
Alternative /complementary medicine
Veterinary medicine
Physical therapy/ rehab
Optometry and ophthalmology
Pharmacy and pharmacology
Public health
Examples of healthcare-related dissertations

Allopathic (Conventional) Medicine

The effectiveness of telemedicine in remote elderly patient care
The impact of stress on the immune system of cancer patients
The effects of a plant-based diet on chronic diseases such as diabetes
The use of AI in early cancer diagnosis and treatment
The role of the gut microbiome in mental health conditions such as depression and anxiety
The efficacy of mindfulness meditation in reducing chronic pain: A systematic review
The benefits and drawbacks of electronic health records in a developing country
The effects of environmental pollution on breast milk quality
The use of personalized medicine in treating genetic disorders
The impact of social determinants of health on chronic diseases in Asia
The role of high-intensity interval training in improving cardiovascular health
The efficacy of using probiotics for gut health in pregnant women
The impact of poor sleep on the treatment of chronic illnesses
The role of inflammation in the development of chronic diseases such as lupus
The effectiveness of physiotherapy in pain control post-surgery

Topics & Ideas: Alternative Medicine

The benefits of herbal medicine in treating young asthma patients
The use of acupuncture in treating infertility in women over 40 years of age
The effectiveness of homoeopathy in treating mental health disorders: A systematic review
The role of aromatherapy in reducing stress and anxiety post-surgery
The impact of mindfulness meditation on reducing high blood pressure
The use of chiropractic therapy in treating back pain of pregnant women
The efficacy of traditional Chinese medicine such as Shun-Qi-Tong-Xie (SQTX) in treating digestive disorders in China
The impact of yoga on physical and mental health in adolescents
The benefits of hydrotherapy in treating musculoskeletal disorders such as tendinitis
The role of Reiki in promoting healing and relaxation post birth
The effectiveness of naturopathy in treating skin conditions such as eczema
The use of deep tissue massage therapy in reducing chronic pain in amputees
The impact of tai chi on the treatment of anxiety and depression
The benefits of reflexology in treating stress, anxiety and chronic fatigue
The role of acupuncture in the prophylactic management of headaches and migraines

Topics & Ideas: Dentistry

The impact of sugar consumption on the oral health of infants
The use of digital dentistry in improving patient care: A systematic review
The efficacy of orthodontic treatments in correcting bite problems in adults
The role of dental hygiene in preventing gum disease in patients with dental bridges
The impact of smoking on oral health and tobacco cessation support from UK dentists
The benefits of dental implants in restoring missing teeth in adolescents
The use of lasers in dental procedures such as root canals
The efficacy of root canal treatment using high-frequency electric pulses in saving infected teeth
The role of fluoride in promoting remineralization and slowing down demineralization
The impact of stress-induced reflux on oral health
The benefits of dental crowns in restoring damaged teeth in elderly patients
The use of sedation dentistry in managing dental anxiety in children
The efficacy of teeth whitening treatments in improving dental aesthetics in patients with braces
The role of orthodontic appliances in improving well-being
The impact of periodontal disease on overall health and chronic illnesses

Free Webinar: How To Find A Dissertation Research Topic

Tops & Ideas: Veterinary Medicine

The impact of nutrition on broiler chicken production
The role of vaccines in disease prevention in horses
The importance of parasite control in animal health in piggeries
The impact of animal behaviour on welfare in the dairy industry
The effects of environmental pollution on the health of cattle
The role of veterinary technology such as MRI in animal care
The importance of pain management in post-surgery health outcomes
The impact of genetics on animal health and disease in layer chickens
The effectiveness of alternative therapies in veterinary medicine: A systematic review
The role of veterinary medicine in public health: A case study of the COVID-19 pandemic
The impact of climate change on animal health and infectious diseases in animals
The importance of animal welfare in veterinary medicine and sustainable agriculture
The effects of the human-animal bond on canine health
The role of veterinary medicine in conservation efforts: A case study of Rhinoceros poaching in Africa
The impact of veterinary research of new vaccines on animal health

Topics & Ideas: Physical Therapy/Rehab

The efficacy of aquatic therapy in improving joint mobility and strength in polio patients
The impact of telerehabilitation on patient outcomes in Germany
The effect of kinesiotaping on reducing knee pain and improving function in individuals with chronic pain
A comparison of manual therapy and yoga exercise therapy in the management of low back pain
The use of wearable technology in physical rehabilitation and the impact on patient adherence to a rehabilitation plan
The impact of mindfulness-based interventions in physical therapy in adolescents
The effects of resistance training on individuals with Parkinson’s disease
The role of hydrotherapy in the management of fibromyalgia
The impact of cognitive-behavioural therapy in physical rehabilitation for individuals with chronic pain
The use of virtual reality in physical rehabilitation of sports injuries
The effects of electrical stimulation on muscle function and strength in athletes
The role of physical therapy in the management of stroke recovery: A systematic review
The impact of pilates on mental health in individuals with depression
The use of thermal modalities in physical therapy and its effectiveness in reducing pain and inflammation
The effect of strength training on balance and gait in elderly patients

Topics & Ideas: Optometry & Opthalmology

The impact of screen time on the vision and ocular health of children under the age of 5
The effects of blue light exposure from digital devices on ocular health
The role of dietary interventions, such as the intake of whole grains, in the management of age-related macular degeneration
The use of telemedicine in optometry and ophthalmology in the UK
The impact of myopia control interventions on African American children’s vision
The use of contact lenses in the management of dry eye syndrome: different treatment options
The effects of visual rehabilitation in individuals with traumatic brain injury
The role of low vision rehabilitation in individuals with age-related vision loss: challenges and solutions
The impact of environmental air pollution on ocular health
The effectiveness of orthokeratology in myopia control compared to contact lenses
The role of dietary supplements, such as omega-3 fatty acids, in ocular health
The effects of ultraviolet radiation exposure from tanning beds on ocular health
The impact of computer vision syndrome on long-term visual function
The use of novel diagnostic tools in optometry and ophthalmology in developing countries
The effects of virtual reality on visual perception and ocular health: an examination of dry eye syndrome and neurologic symptoms

Topics & Ideas: Pharmacy & Pharmacology

The impact of medication adherence on patient outcomes in cystic fibrosis
The use of personalized medicine in the management of chronic diseases such as Alzheimer’s disease
The effects of pharmacogenomics on drug response and toxicity in cancer patients
The role of pharmacists in the management of chronic pain in primary care
The impact of drug-drug interactions on patient mental health outcomes
The use of telepharmacy in healthcare: Present status and future potential
The effects of herbal and dietary supplements on drug efficacy and toxicity
The role of pharmacists in the management of type 1 diabetes
The impact of medication errors on patient outcomes and satisfaction
The use of technology in medication management in the USA
The effects of smoking on drug metabolism and pharmacokinetics: A case study of clozapine
Leveraging the role of pharmacists in preventing and managing opioid use disorder
The impact of the opioid epidemic on public health in a developing country
The use of biosimilars in the management of the skin condition psoriasis
The effects of the Affordable Care Act on medication utilization and patient outcomes in African Americans

Topics & Ideas: Public Health

The impact of the built environment and urbanisation on physical activity and obesity
The effects of food insecurity on health outcomes in Zimbabwe
The role of community-based participatory research in addressing health disparities
The impact of social determinants of health, such as racism, on population health
The effects of heat waves on public health
The role of telehealth in addressing healthcare access and equity in South America
The impact of gun violence on public health in South Africa
The effects of chlorofluorocarbons air pollution on respiratory health
The role of public health interventions in reducing health disparities in the USA
The impact of the United States Affordable Care Act on access to healthcare and health outcomes
The effects of water insecurity on health outcomes in the Middle East
The role of community health workers in addressing healthcare access and equity in low-income countries
The impact of mass incarceration on public health and behavioural health of a community
The effects of floods on public health and healthcare systems
The role of social media in public health communication and behaviour change in adolescents

Examples: Healthcare Dissertation & Theses

While the ideas we’ve presented above are a decent starting point for finding a healthcare-related research topic, they are fairly generic and non-specific. So, it helps to look at actual dissertations and theses to see how this all comes together.

Below, we’ve included a selection of research projects from various healthcare-related degree programs to help refine your thinking. These are actual dissertations and theses, written as part of Master’s and PhD-level programs, so they can provide some useful insight as to what a research topic looks like in practice.

Improving Follow-Up Care for Homeless Populations in North County San Diego (Sanchez, 2021)
On the Incentives of Medicare’s Hospital Reimbursement and an Examination of Exchangeability (Elzinga, 2016)
Managing the healthcare crisis: the career narratives of nurses (Krueger, 2021)
Methods for preventing central line-associated bloodstream infection in pediatric haematology-oncology patients: A systematic literature review (Balkan, 2020)
Farms in Healthcare: Enhancing Knowledge, Sharing, and Collaboration (Garramone, 2019)
When machine learning meets healthcare: towards knowledge incorporation in multimodal healthcare analytics (Yuan, 2020)
Integrated behavioural healthcare: The future of rural mental health (Fox, 2019)
Healthcare service use patterns among autistic adults: A systematic review with narrative synthesis (Gilmore, 2021)
Mindfulness-Based Interventions: Combatting Burnout and Compassionate Fatigue among Mental Health Caregivers (Lundquist, 2022)
Transgender and gender-diverse people’s perceptions of gender-inclusive healthcare access and associated hope for the future (Wille, 2021)
Efficient Neural Network Synthesis and Its Application in Smart Healthcare (Hassantabar, 2022)
The Experience of Female Veterans and Health-Seeking Behaviors (Switzer, 2022)
Machine learning applications towards risk prediction and cost forecasting in healthcare (Singh, 2022)
Does Variation in the Nursing Home Inspection Process Explain Disparity in Regulatory Outcomes? (Fox, 2020)

Looking at these titles, you can probably pick up that the research topics here are quite specific and narrowly-focused , compared to the generic ones presented earlier. This is an important thing to keep in mind as you develop your own research topic. That is to say, to create a top-notch research topic, you must be precise and target a specific context with specific variables of interest . In other words, you need to identify a clear, well-justified research gap.

Need more help?

If you’re still feeling a bit unsure about how to find a research topic for your healthcare dissertation or thesis, check out Topic Kickstarter service below.

Research Topic Kickstarter - Need Help Finding A Research Topic?

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16 Comments

I need topics that will match the Msc program am running in healthcare research please

Hello Mabel,

I can help you with a good topic, kindly provide your email let’s have a good discussion on this.

Can you provide some research topics and ideas on Immunology?

Thank you to create new knowledge on research problem verse research topic

Help on problem statement on teen pregnancy

This post might be useful: https://gradcoach.com/research-problem-statement/

can you provide me with a research topic on healthcare related topics to a qqi level 5 student

Please can someone help me with research topics in public health ?

Hello I have requirement of Health related latest research issue/topics for my social media speeches. If possible pls share health issues , diagnosis, treatment.

I would like a topic thought around first-line support for Gender-Based Violence for survivors or one related to prevention of Gender-Based Violence

Please can I be helped with a master’s research topic in either chemical pathology or hematology or immunology? thanks

Can u please provide me with a research topic on occupational health and safety at the health sector

Good day kindly help provide me with Ph.D. Public health topics on Reproductive and Maternal Health, interventional studies on Health Education

may you assist me with a good easy healthcare administration study topic

May you assist me in finding a research topic on nutrition,physical activity and obesity. On the impact on children

I have been racking my brain for a while on what topic will be suitable for my PhD in health informatics. I want a qualitative topic as this is my strong area.

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PMC10094672

A Systematic Literature Review of Health Information Systems for Healthcare

Ayogeboh epizitone.

1 ICT and Society Research Group, Durban University of Technology, Durban 4001, South Africa

Smangele Pretty Moyane

2 Department of Information and Corporate Management, Durban University of Technology, Durban 4001, South Africa

Israel Edem Agbehadji

3 Centre for Transformative Agricultural and Food Systems, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg 3209, South Africa

Associated Data

Not applicable.

Health information system deployment has been driven by the transformation and digitalization currently confronting healthcare. The need and potential of these systems within healthcare have been tremendously driven by the global instability that has affected several interrelated sectors. Accordingly, many research studies have reported on the inadequacies of these systems within the healthcare arena, which have distorted their potential and offerings to revolutionize healthcare. Thus, through a comprehensive review of the extant literature, this study presents a critique of the health information system for healthcare to supplement the gap created as a result of the lack of an in-depth outlook of the current health information system from a holistic slant. From the studies, the health information system was ascertained to be crucial and fundament in the drive of information and knowledge management for healthcare. Additionally, it was asserted to have transformed and shaped healthcare from its conception despite its flaws. Moreover, research has envisioned that the appraisal of the current health information system would influence its adoption and solidify its enactment within the global healthcare space, which is highly demanded.

1. Introduction

Health information systems (HIS) are critical systems deployed to help organizations and all stakeholders within the healthcare arena eradicate disjointed information and modernize health processes by integrating different health functions and departments across the healthcare arena for better healthcare delivery [ 1 , 2 , 3 , 4 , 5 , 6 ]. Over time, the HIS has transformed significantly amidst several players such as political, economic, socio-technical, and technological actors that influence the ability to afford quality healthcare services [ 7 ]. The unification of health-related processes and information systems in the healthcare arena has been realized by HIS. HIS has often been contextualized as a system that improves healthcare services’ quality by supporting management and operation processes to afford vital information and a unified process, technology, and people [ 7 , 8 ]. Several authors assert this disposition of HIS, alluding to its remarkable capabilities in affording seamless healthcare [ 9 ]. Haux [ 10 ] modestly chronicled HIS as a system that handles data to convey knowledge and insights in the healthcare environment. Almunawar and Anshari [ 7 ] incorporated this construed method to describe HIS to be any system within the healthcare arena that processes data and affords information and knowledge. Malaquias and Filho [ 11 ] accentuated the importance of HIS in the same light, highlighting its emergence to tackle the need to store, process, and extract information from the system data for the optimization of processes, enhancing services provided and supporting decision making.

HIS’s definition was popularized by Lippeveld [ 12 ], and reported to be an “integrated effort to collect, process, report and use health information and knowledge to influence policy-making, programme action and research”. Over the course of time, this definition has been adopted and contextualized countlessly by many authors and the World Health Organization (WHO) [ 3 , 8 , 13 , 14 , 15 ]. Although Haule, Muhanga [ 8 ] claimed the definition of HIS varies globally, in actuality, the definition has never changed from its inception, but on the contrary, it has been conceptualized over various contexts. Malaquias and Filho [ 11 ] reiterated this definition in the extant literature. These scholars affirmed HIS as “a set of interrelated components that collect, process, store and distribute information to support the decision-making process and assist in the control of health organizations” [ 11 ]. The same definition is adopted in this paper, and HIS is construed as “a system of interrelated constituents that collect, process, store and distribute data and information to support the decision-making process, assist in the control of health organizations and enhance healthcare applications”. However, it is paramount to note that HIS is broad. In many instances, the definition is of minimal relevance due to its associated incorporation with external applications related to health developments and policy making [ 16 ]. Hence, emphasis should not be placed on the definition but on its contribution to all facets of health development.

The current state of HIS is considered to be inadequate despite its numerus deployment of HIS that has been driven by its potential benefit to uplift healthcare and revolutionize its processes [ 17 , 18 ]. The persistence of many constraints and resistance to technology has resulted to the incapacitation of HIS in the attainment of its objectives. The extant literature reveals several challenges in different categories, such as the inadequacy of human resources and technological convergence within the healthcare [ 18 ], highlighting the evidence of limitations of HIS that restrict their utilization and deployment within the healthcare. Although several authors identified the unique disposition of HIS in integrating care and unifying the health process, these perspectives seems to be marred by the presence of barriers [ 17 , 19 ]. Garcia, De la Vega [ 17 ] alleged that the current HIS deployment is characterized by fragmentation, update instability, and lack of standardization that limit its potential to aid healthcare. Congruently, several authors associated the lack of awareness of HIS potential, the underuse HIS, inadequate communication network, and security and confidentiality concerns among the barriers limiting HIS [ 20 ]. Thus, the need for this paper is set forth: to uncover current and pertinent insights on HIS deployment as a concerted effort to strengthen it and augment its healthcare delivery capabilities. This paper comprehensively explores the extant literature systematically with respect to the overarching objective: to ascertain value insights pertaining to HIS holistically from literature synthesis. To achieve this goal, the following research questions are investigated: What has been the development of the HIS since its conception? How has HIS been deployed? Finally, how does HIS enable information and knowledge management in healthcare?

In this paper, an overview HIS from the extant literature in relation to the health sector is presented with associated related work. It is essential to point out that in spite of the surplus of research work conducted on health information systems, there are still many challenges confronting it within the healthcare area that necessitate the need for this study [ 5 ]. Therefore, the extant literature is explored in this paper systematically to uncover current and pertinent insights surrounding the deployment of the HIS, an integrated information system (IS) for healthcare. This paper is structured into five sections. The paper commences with an introductory background that presents the contextualization of HIS for healthcare, followed by a methodology that details the method and material used in this study. The next section, which is the discussion, presents the discourse of HIS evolution that highlights its progress to date, its structural deployment, and the information system and knowledge management within the healthcare arena as mediated by HIS. The last part of this study focuses on the conclusion that summarizes the discussion presented in this paper.

2. Material and Method

In this paper, a systematic review is conducted to synthesize the extant literature and analyze the content to ascertain the value disposition of HIS in relation to healthcare delivery. Preceding this review, the used of search engines was employed to retrieve related research publications that fit the study scope and contexts. The main database used was the Web of Science . Other databases such as SCOPUS and Google Scholar were also used to obtain additional relevant work associated with the context. For inclusion criteria, only articles containing references to the keywords HIS, information, healthcare, and related healthcare systems were analyzed scrupulously. Research work that did not have these references, did not constitute a journal or conference-proceeding work, and were not written in the English language were excluded. Figure 1 , the PRISMA flow statement, illustrates the methodological phases of this research along with the exclusion and inclusion criteria that were implemented for the study synthesis.

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Prisma flow Statement.

3. Discussion

3.1. the evolution of health information systems.

The concept of enhancing healthcare applications has always been the foundation of HIS, which posits that the intercession of information systems with business processes affords better healthcare services [ 7 , 21 ]. According to Almunawar and Anshari [ 7 ], many determinants, such as technological, political, social and economic, have enormously influenced the nature of the healthcare industry. The technological determinant, particularly the computerized component, is thought to be deeply ingrained in the enactment and functioning of HIS. According to Panerai [ 16 ], this single attribute can be held solely responsible for HIS letdowns rather than its accomplishment.

The ownership of HIS has been contested in the literature, with some authors claiming that HIS belongs to the IT industries [ 22 ]. While IT has enabled many developments in various industries, it has also resulted in many dissatisfactions. Recently, there has been an insurgence from many industries, particularly the healthcare industries, who acknowledge the role of IT in optimizing and enhancing health initiatives but want appropriation of their integrated IS. However, according to the definition of HIS, it is presented as “a set of interconnected components that collect, process, store, and distribute information to support decision-making and aid in the control of health organizations”; thus, the disposition of HIS was established. Without bias, the development of HIS was conceived due to unavoidable changes and transformations within the global space.

A good representation and consolidation of this dispute are within the realization that there is a co-existence of different related and non-related components in a system. In this case, the HIS is an entrenched system with several features, including technologies. Panerai [ 16 ] supported this notion and theorized HIS to be broad, stating that the relevance of its definition is contextual. In the study, HIS was reiterated as any kind of “structured repository of data, information, or knowledge” that can be used to support health care delivery or promote health development [ 16 ]. Thus, maintaining a rigid definition is of minimal practical use because many HIS instances are not directly associated with health development, such as the financial and human resource modules. Moreover, several different HIS examples are categorized according to the functions they are dedicated to serving within the healthcare arena. They highlight the instances of the existence of outliers that are not regarded as the normal HIS even though they contain health determinants data, such as socioeconomic and environmental, which can be used to formulate health policies.

The development of HIS over the years has led many to believe they are solely computer technology. This notion has contributed dramatically to the misconception of the origin of HIS and the lack of peculiarity between the HIS conceptual structure and implemented HIS technology. The literature dates back the origin of HIS, which can be associated with the first record of mortality in the 18th century, revealing their existence to be 200 years or older than the invention of computers [ 16 ]. This demonstrates the emergence of digitalized HIS from the availability of commercialized episodes of “electronic medical records” EMR records in the 1970s [ 23 ]. Namageyo-Funa, Aketch [ 24 ] commended the advancement of technologies in the healthcare arena, recounting the implementation of digitalized HIS that significantly revolutionized the recording and accessing of health information. A study by Lindberg, Venkateswaran [ 25 ] highlighted an instance of HIS transition from paper based to digitally based, revealing a streamlined workflow that revolutionized health care applications in the healthcare arena. This HIS transition over the course of time has led to increased adoption of it within the health care arena. Tummers, Tekinerdogan [ 26 ] highlighted the landmark of HIS from its transition to digitalization and reported a current trend in healthcare that has now been extended with the inclusion of block chain technology within the healthcare arena. Malik, Kazi [ 27 ] assessed HIS adoption in terms of technological, organizational, human, and environmental determinants and reported a variation of different degrees of utilization. Despite these facts, the extant literature maintains the need for a resilient and sustainable HIS for health care applications within the healthcare arena at all levels [ 18 , 27 , 28 ].

Figure 2 illustrates the successful adoption of HIS amidst the significant determinants of its effectiveness. From the Figure 2 , the technological, organizational, human, and environmental determinants are the defining concepts along with individual sub-determinants in each domain that influence HIS adoption. At the technological level, the need for digitalization drives HIS adoption, especially for stakeholders such as clinicians and decision makers. The administrative, management, and planning functions are the driving actors within the organization level that endorse the implementation of HIS. The environmental and human determinants are more concerned with the socio-technical components that have been regarded as complex drivers for HIS adoptions. Perceptions, literacy, and usability are known forces within these categories that necessitate the adoption of HIS in many healthcare arenas.

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Effective health information system associations with the driving adoption determinants. Source: [ 27 ].

3.2. HIS Structural Deployment

HIS’s unified front is geared toward assimilating and disseminating health gen to enhance healthcare delivery. HIS consists of different sub-systems that serve several actors within the healthcare arena [ 29 ]. These sub-systems are dedicated to specific tasks that perform various functions such as civil registrations, disease surveillance, outbreak notices, interventions, and health information sharing within the healthcare arena. It also supports and links many functions and activities within the healthcare environment, such as recording various data and information for stakeholders, scheduling, billing, and managing. Stakeholders are furnished with health information from diverse HIS scenarios. These include but are not limited to information systems for hospitals and patients, health institution systems, and Internet information systems. Sligo, Gauld [ 30 ] regarded HIS as a panacea within the healthcare ground that improves health care applications. Despite all the limitless capabilities of HIS, it has been reported to be asymmetrical, lacking interactions within subsystems [ 1 , 18 ]. Many decision making methods and policies rely on good health information [ 31 ]. According to Suresh and Singh [ 32 ], the HIS enables stakeholders such as the government and all other players in the healthcare arena to have access to health information, which influences the delivery of healthcare. The sundry literature further reveals accurate health information to be the foundation of decision making and highlights the decisive role of the human constituent [ 29 , 31 , 33 , 34 ].

Furthermore, HIS can be classified into two cogs in today’s era: the computer-related constituent that employs ICT-related tools and the non-computer component, which both operate at different levels. These levels include strategic, tactical, and operational. The deployment of HIS at the strategic level offers intelligence functions such as intelligent decision support, financial estimation, performance assessment, and simulation systems [ 3 , 35 ]. At the tactical level, managerial functions are performed within the system, while at the operational level, functions including recording, invoicing, scheduling, administrative, procurement, automation, and even payroll are carried out. Figure 3 shows the three levels within the healthcare system where HIS deployment is utilized.

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Levels of HIS deployment: source authors.

3.3. Health Information Systems Benefits

HIS, as an interrelated system, houses several core processes and branches in the healthcare arena, affording many benefits. Among these are the ease of access to patients and medical records, reduction of costs and time, and evidence-based health policies and interventions [ 8 , 21 , 36 , 37 , 38 ]. Several authors revealed the benefits of HIS to be widely known and influential within the healthcare domain [ 38 ]. Furthermore, many health organizations are drawn to HIS because of these numerous advantages [ 22 , 39 ]. Moreover, investment in HIS has enabled effective decision making, real-time comprehensive health information for quality health care applications, effective policies in the healthcare arena, scaled-up monitoring and evaluation, health innovations, resource allocations, surveillance services, and enhanced governance and accountability [ 36 , 40 , 41 , 42 ]. Ideally, HIS is pertinent for data, information, and broad knowledge sharing in the healthcare environment. HIS critical features are now cherished due to their incorporation with diverse technology [ 16 , 43 ]. The extant literature reveals the role of HIS to extend beyond its reimbursement. Table 1 presents a summarized extract of various HIS benefits as captured in the literature and some of its core enabling components or instances.

HIS core enabling components and its benefits.

Source: Authors	Core Enabling HIS Components	Benefits
Malaquias and Filho [ ]	Health ER eHealth mHealth	Ease of access to patient and medical information from records; Cost reduction; Enhance efficiency in patients’ data recovery and management; Enable stakeholders’ health information centralization and remote access.
Ammenwerth, Duftschmid [ ]	eHealth	Upsurge in care efficacy and quality and condensed costs for clinical services; Lessen the health care system’s administrative costs; Facilitates novel models of health care delivery.
Tummers, Tobi [ ]	HIS	Patient information management; Enable communication within the healthcare arena; Afford high-quality and efficient care.
Steil, Finas [ ]	HIS	Enable inter- and multidisciplinary collaboration between humans and machines; Afford autonomous and intelligent decision capabilities for health care applications.
Nyangena, Rajgopal [ ]	HIS	Enable seamless information exchange within the healthcare arena.
Sik, Aydinoglu [ ]	HIS	Support precision medicine approaches and decision support.

3.4. Information System and Knowledge Management in the Healthcare Arena

The presence of modernized information systems (IS) in the healthcare arena is alleged by scholars to be a congested domain that seldom fosters stakeholders’ multifaceted and disputed relationships [ 48 ]. On the other hand, it is believed that a significant amount of newly acquired knowledge in the field of healthcare is required for the improvement of health care [ 49 ]. Ascertaining and establishing the role of IS and knowledge management is an important step in the development of HIS for healthcare. Flora, Margaret [ 5 ] posited that efficient IS and data usage are crucial for an effective healthcare system. Bernardi [ 50 ] alleged that the underpinning inkling of a “robust and efficient” HIS enables healthcare stakeholders such as managers and providers to leverage health information to commendably plan and regulate healthcare, which could result in enhanced survival rates. As a result, it is imperative to ground these ideas within the context of the healthcare industry to provide a foundation for developing a robust and sustainable HIS for use in the context of health care applications.

3.4.1. Information System

The assimilation and dissimilation of health information and data within the healthcare system is an important task that influences healthcare outcome. Within the healthcare setting, IS plays a significant role in the assimilation and dissimilation of health information needed by healthcare stakeholders. Many continents endorse the deployment of IS mainly to consolidate mutable information from different sources within the systems. The primary objective for these systems’ deployment has been centered on bringing together unique and different components such as institutions, people, processes, and technology in the system under one umbrella [ 5 , 51 ]. An overview of the extant literature reveals that this has rarely been easy, as integration within this system has always been difficult in many contexts. In the context of HIS, many reported the integration phenomena to be problematic, attributing this to the global transformation within the healthcare arena [ 52 , 53 ]. This revolution, coupled with the advancement of the healthcare arena, has resulted in the need for robust allied health IS systems that incorporates different IS and information technology [ 5 , 22 ]. These allied health information systems are necessary to consolidate independent information systems within their healthcare arena use to enhance healthcare applications [ 54 , 55 ]. Organizations in the healthcare arena expect these systems to be sustainable and resilient; however, in order to satisfy these requirements, an integrated information system is needed to unify all independent, agile, and flexible health IS to mitigate challenges for HIS [ 56 ].

An aligned HIS that is allied is essential, as it supports health information networks (HIN) that subsequently enhance and improve healthcare applications [ 44 , 57 ]. Thus, many organizations within the healthcare settings are fine-tuning their HIS to be resilient and sustainable. However, the realization of a robust information system within the healthcare arena is challenging and depends on the flow of information as a crucial constituent for suave and efficient functioning [ 58 , 59 ].

3.4.2. Knowledge Management

The process of constructing value and generating a maintainable edge for an industry with capitalization on building, communicating, and knowledge applications procedures to realize set aspirations is denoted as knowledge management [ 60 ]. The literature reveals knowledge management as an important contributor to organizational performance through its knowledge-sharing capabilities [ 61 ]. In the healthcare industry, there is a high demand for knowledge to enhance healthcare applications [ 49 , 62 ]. Several studies reported that the deployment of knowledge management in the healthcare arena is set to enhance healthcare treatment effectiveness [ 49 , 58 , 61 ]. Many stakeholders such as governments, World Health Organization (WHO), and healthcare workers rely on the management of healthcare knowledge to complement healthcare applications. According to Kim, Newby-Bennett [ 61 ], the focus of knowledge management is to efficaciously expedite knowledge sharing. However, integrating knowledge from different sources is challenging and requires an enabler [ 61 ].

The HIS is an indispensable enabler of health knowledge generated from amalgamated health information within the healthcare arena [ 63 , 64 , 65 ]. Dixon, McGowan [ 66 ] asserted that efficacious modifications in the healthcare arena are made possible by knowledge codification and collaboration from information technologies. Similarly, some authors have pinpointed information and communication technologies within the healthcare arena to be a major determinant in the attainment of a sustainable health system development [ 58 ]. The knowledge management relationship with HIS is considered complementary and balanced, as it enables the availability of knowledge that can be shared. The importance of knowledge management is relevant for the realization of an enhanced healthcare application via HIS. Soltysik-Piorunkiewicz and Morawiec [ 58 ] claimed that the information society effectively uses HIS as an information system for management, patient knowledge, health knowledge, healthcare unit knowledge, and drug knowledge. The authors herein demonstrated how HIS facilitates knowledge management in the healthcare sector to improve healthcare applications.

The role of HIS as an integrated IS and key enabler of healthcare knowledge management highlights its potential within the healthcare arena. From the conception of HIS and the records of its evolution, significant achievements have been attained that are demonstrated at different levels of its structural deployment. HIS deployment in several settings of healthcare have positively influenced clinical processes and patients’ outcomes [ 17 ]. Globally, the need for HIS within the healthcare system is critical in the enhancement of healthcare. Many healthcare actions are dependent on the use of HIS [ 67 , 68 , 69 ]. This demand is substantiated by the offerings of HIS in tackling the transformation and digitalization confronting the healthcare system. However, despite the need for HIS and its potential within healthcare, several barriers limit its optimization. Some authors posited the role and involvement of healthcare professionals such as physicians to be important measure that is paramount to decreasing the technical and personal barriers sabotaging HIS deployment [ 20 ]. Nonetheless, the design of HIS is accentuated on augmenting health and is considered to be lagging behind in attaining quality healthcare [ 70 ].

Although there are equal blessings as well as challenges with HIS deployment, this study appraisal of HIS highlights its capabilities and attributes that enhance healthcare in many ways. From its conception, HIS has evolved significantly to enable the digitalization of many healthcare processes. Its deployment structurally has facilitated many healthcare applications at all levels within the health system where it has been implemented. Many benefits such as ease of access to medical records, cost reduction, data and information management, precision medicine, and autonomous and intelligent decisions have been enabled by HIS deployment. Primarily, HIS is the core enabler of the healthcare information system and knowledge management within the healthcare arena. Ascertaining the attributes and development of HIS is a paramount to driving its implementation and realizing its potential. Many deployments of HIS can be anchored on this study as a reference for planning and executing HIS implementation. The extant literature points out the need for the role of technology such HIS to be ascertained, as little is known in this regard, which as a result has adversely influenced healthcare coordination [ 19 ]. Additionally, among the barriers of HIS, the presence of inadequate planning that fails to cater to the needs of those adopting it hinders the optimization of these systems within the healthcare arena [ 71 ]. Cawthon, Mion [ 72 ] associated the lack of health literacy incorporation in deployed HIS to increased cost and poorer health outcomes. Hence, the insight from this study can be incorporated and associated with HIS initiatives to mitigate these issues. Thus, the findings of this study can be employed to strategize HIS deployment and plans as well as augment its potential to enhance healthcare. Furthermore, the competency of healthcare stakeholders such as patients can be enhanced with the findings of this study that accentuate the holistic representation of HIS in the dissimilation and assimilation of health data and information.

4. Conclusions

In the healthcare information and knowledge arena, assimilation and dissemination is a facet that influences healthcare delivery. The conception and evolution of HIS has positioned this system within the healthcare arena to arbitrate information interchange for its stakeholders. HIS deployment within healthcare has not only enabled information and knowledge management, but it has also enabled and driven many healthcare agendas and continues to maintain a solidified presence within the healthcare space. However, its deployment and enactment globally has been marred and plagued with several challenges that hinder its optimization and defeat its purpose. Phenomena such as the occurrences of pandemics such as COVID-19, which are uncertain, and the advancement of technology that cannot be controlled have caused disputed gradients regarding the positioning of HIS. These phenomena have not only influenced the adoption of HIS but have also limited its ability to be fully utilized. Although much research on HIS has been conducted, the presence of these phenomena and many other inherent challenges such as fragmentation and cost still maintain a constant, prominent presence, which has led to the need for this study.

Consequently, the starting point for this study was to provide insight and expertise regarding the discourse of HIS for healthcare applications. This paper presents current and pertinent insights regarding the deployment of the HIS that, when adopted, can positively aid its employment. This paper investigated the existing HIS literature to accomplish the objective set forth in the introduction. This study’s synthesis derived key insights relevant to the holistic view of HIS through a thorough systematic review of the various extant literature on HIS and healthcare. According to the study’s findings, HIS are critical and foundational in the drive of information and knowledge management for healthcare. The contribution of HIS to healthcare has been and continues to be groundbreaking since its conception and through its consequent evolution. Nevertheless, despite the presence of some limitations that are external and inherent, it is claimed to have transformed and changed healthcare from the start. Similarly, the evaluation of the current HIS is expected to impact its adoption and strengthen its implementation within the global healthcare space, which is greatly desired. These findings are of great importance to the healthcare stakeholders that directly and indirect interact with HIS. Additionally, scholars and healthcare researchers can benefit from this study by incorporating the findings in future works that plan HIS for healthcare.

Funding Statement

This research received no external funding.

Author Contributions

Conceptualization, A.E.; methodology, A.E.; software, A.E.; validation, A.E.; formal analysis, A.E.; investigation, A.E.; resources, A.E.; data curation, A.E.; writing—original draft preparation, A.E.; writing—review and editing, A.E.; visualization, A.E.; supervision, S.P.M. and I.E.A.; project administration, A.E., S.P.M. and I.E.A.; funding acquisition, A.E., S.P.M. and I.E.A. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

Informed consent statement, data availability statement, conflicts of interest.

The authors declare there are no conflict of interest.

Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

A Systematic Literature Review of Health Information Systems for Healthcare

Healthcare 11(7):959

Durban University of Technology

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A Systematic Literature Review of Health Information Systems for Healthcare
literature maintains the need for a resilient and sustainable HIS for health care applications within the healthcare arena at all levels [ 18 , 27 , 28 ]. Healthcare 2023 , 11 , 959 5 of 13

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