SYSTEMATIC REVIEW article
Front. Digit. Health
Sec. Health Informatics
Architecture Patterns for Health Information Systems: A Systematic Review
Provisionally accepted
- 1National University of Colombia, Medellin, Medellin, Colombia
- 2Ph.D. Candidate, Medellín, Colombia
- 3Universidad Nacional de Colombia - Sede Medellin, Medellín, Colombia
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Background: Health information systems (HIS) are critical for digital health transformation, yet fragmentation and poor interoperability adoption remain major challenges. Objectives:This study aims to systematically review architectural patterns applied in HIS and evaluates their alignment with ecosystem-level requirements. Methods: A systematic literature review was conducted following PRISMA 2020 guidelines across Scopus, IEEE Xplore, PubMed, and Web of Science (2020 to 2025). Eligible studies described, evaluated, or proposed HIS solutions. Results: From an initial set of 304 records, 89 met the inclusion criteria. Services-based and Decentralized/Distributed Ledger architectures were predominant, with emerging models integrating edge computing and modular design. FHIR-based contracts are found as stabilizers of interfaces, enabling validation and reducing integration costs. However, gaps persist in cross-border care, sustainability and artificial intelligence integration. Conclusion: Microservices dominate current HIS architectures, but achieving resilient, interoperable ecosystems requires greater architectural diversity and intersectoral collaboration.
Keywords: Digital health ecosystems, software architecture, interoperability, Microservices, Blockchain, HL7 FHIR, Systematic review
Received: 28 Aug 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 Casanova, Villa Garzón and Branch Bedoya. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Rene Casanova, rcasanovay@unal.edu.co
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.