Challenges and Strategies for Interoperability as a Basis for Sustainable Health Policies: A Systematic Review

Abstract

Introduction: This study aims to identify the main barriers and strategies to strengthen systemic interoperability in public health services and to support the development of sustainable policies. Methods: A systematic literature review was conducted based on PRISMA 2020 guidelines. Searches were performed in Scopus, Web of Science, MEDLINE/PubMed, and the Brazilian Digital Library of Theses and Dissertations (BDTD), focusing on openaccess studies published between 2014 and 2025. Eligibility criteria included full-text studies addressing interoperability, public health, and process management. Data were analyzed qualitatively and thematically categorized. Results: Of the 61 records, 18 met the inclusion criteria. The challenges identified were grouped into technical, organizational, governance, and data related. The proposed strategies included the adoption of international standards, semantic web technologies, federated platforms, investment in training and infrastructure, process management approaches, and patient-centered care models. Overcoming interoperability barriers requires a combination of technological solutions, robust governance, strategic planning, and organizational process redesign. The Brazilian context still faces structural and political challenges that hinder large-scale implementation. Conclusion: Advancing interoperability demands a sociotechnical approach aligned with long-term public policy. It involves investing in infrastructure, digital maturity, regulatory frameworks, and organizational change, recognizing interoperability as a strategic pillar for achieving a resilient and equitable health system.

Ähnliche Arbeiten