Exploring Technological Solutions for Interoperability Between Patient Electronic Medical Records and Clinical Registries: Scoping Review

Abstract

Abstract Background The use of electronic medical records (EMRs) and clinical registries has transformed health care delivery by improving data management, care coordination, and research capacity. However, the full potential of these technologies can only be realized through effective interoperability, thereby reducing the burden of manual data entry and enhancing the use of real-world clinical data. Objective This review examines technologies that enable automated data extraction and transfer, which promote interoperability between EMRs and clinical registries. Methods A search of PubMed, CINAHL, Embase, and Web of Science, including studies published between January 2013 and April 2025, was registered with Open Science Framework a priori and involved three key concepts: (1) “registry,” (2) “electronic medical records,” and (3) “interoperability.” A 2-phase screen identified studies evaluating technologies that facilitate automated data extraction or interoperability. Automation was defined as fully automated, where data are extracted and transferred without human intervention, or semiautomated, where extraction or transfer is predominantly automated but may include manual validation. Only technologies supporting ongoing database integration were eligible for inclusion. Screening, data extraction, and synthesis were conducted by multiple independent reviewers. Technology experts provided extensive input and guidance throughout to ensure the accuracy and relevance of the extracted information. Results Overall, 36 studies met the inclusion criteria, representing 12 countries across 5 continents and addressing a wide range of acute and chronic health conditions. Epic was the most frequently reported EMR system, while the most common registry platforms were REDCap (Research Electronic Data Capture; Vanderbilt University), structured query language (SQL) server database, and EMR-embedded solutions. Most approaches centered around extracting data from structured formats (n=18), or a combination of both structured and unstructured formats (n=10), emphasizing the central role of structured EMR data in current automated extraction approaches. Conclusions This review advances understanding of interoperability between EMRs and clinical registries by uniquely examining automated and sustainable solutions for data exchange, extending beyond prior work that has largely focused on technologies designed for isolated systems or study-specific data extraction. A novel contribution of this review is the synthesis of context-specific considerations derived from reported implementations, providing a comprehensive overview of how technology selection and implementation are shaped by the context in which they are deployed. While these advancements have reduced reliance on inefficient, error-prone, and resource-intensive manual processes, ongoing challenges in data standardization, seamless integration, and long-term sustainability are compounded by poor and inconsistent reporting across studies. Future efforts should follow comprehensive reporting guidelines, adhere to robust governance principles, and incorporate implementation science frameworks, to not only enable meaningful comparison and synthesis in future research, but also to ensure that technologies can be effectively, feasibly, and sustainably integrated within health care contexts, while upholding the ethical and equitable use of health care data.