Interoperability of Health Information Systems in Low and Middle-Income Countries (LMIC): Implementation of Cluster Care System.

Interoperability of Health Information Systems (HIS) is critical for improving healthcare delivery, decision-making, and resource management in Low- and Middle-Income Countries (LMICs). However, challenges such as fragmented systems, limited digital infrastructure, and the absence of standardized health records hinder progress. This study proposes the Cluster Care System (CCS), a modular, cluster-based framework designed to address these challenges. Its architecture includes local Cluster Information Systems, a Cluster Master Patient Index for unified patient identification, and a Cluster Enterprise Service Bus for secure, standardized data exchange. By integrating data from health facilities, national registries, and third-party providers, the system enhances accessibility, continuity of care, and reduces data redundancies. The study underscores the scalability, security, and adaptability of the model, while also addressing implementation barriers related to infrastructure, policy, and governance. Recommendations for scaling across LMICs emphasize investments in digital infrastructure, standardized policies, and collaborative efforts.