Interoperability of Telemonitoring Data in Digital Health Solutions: A Scoping review

Diogo Martins ^1* Simon Lewerenz ¹ Anderson Carmo ¹ Henrique Martins ^1,2

• ¹ ISCTE Business School, University Institute of Lisbon, Lisbon, Lisboa, Portugal
• ² Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Castelo Branco, Portugal

Objectives: This scoping review explores the existing literature on the interoperability of telemonitoring systems in cross-border healthcare settings. It focuses on identifying technical standards, enablers, and barriers to effective telemonitoring data exchange across healthcare systems and geographies.Methods: A systematic search was conducted across databases (MEDLINE, PubMed, ISI Web of Knowledge, DBLP, and Scopus) from January 2000 to May 2023, using keywords such as "telemonitoring", "interoperability", "technical standards", and "crossborder data exchange". Eligibility criteria included peer-reviewed studies examining the interoperability of telemonitoring systems across healthcare providers and cross-border settings. A total of 861 studies were identified, and 25 met the inclusion criteria.The review identified diverse technical standards, including HL7 FHIR, ISO/IEEE 11073, and IHE profiles, used in telemonitoring systems. However, significant gaps were found in the literature regarding the operational challenges of telemonitoring systems, particularly in cross-border contexts. Many studies focused on technical aspects, with fewer addressing organizational and legal issues. Data transport types, such as Bluetooth and REST APIs, were mentioned, but no common standard for data exchange between devices was identified.: The findings highlight the need for further research on the deployment of telemonitoring systems, particularly in cross-border contexts. The lack of harmonization How this study might affect research, practice or policy:The study calls for the development of a robust and harmonised framework for telemonitoring interoperability, influencing future research, healthcare practices, and policymaking at the European level. It underscores the importance of standardised approaches to accelerate the transition from conceptual studies to practical applications, particularly under the European Health Data Space (EHDS).