Interoperability Challenges in Integrating Mobile Health Applications with Electronic Health Records for Health System Sustainability: A Scoping Review

Abstract

Introduction: Mobile health (mHealth) applications generate massive volumes of patient-generated health data; however, their isolation from hospital Electronic Health Records (EHR) severely limits their clinical utility. Seamless interoperability is a critical prerequisite for achieving health system sustainability and resilience. This scoping review aimed to systematically investigate the technical, organizational, and regulatory challenges hindering the effective integration of mHealth interventions with national EHR systems. Methods: A Scoping Review was conducted in accordance with the PRISMA-ScR framework. The study protocol was registered in Zenodo [Registration Code: 10.5281/zenodo.XXXXXXX]. A comprehensive literature search was executed in PubMed, Scopus, and Web of Science databases for articles published up to 2026. Standardized extraction forms were used to categorize barriers based on the socio-technical systems theory. Descriptive statistics and thematic analysis were utilized for data synthesis. Large language models (AI) were employed exclusively for English language editing and structural refinement of this abstract. Results: The search strategy identified 52 relevant peer-reviewed studies published globally. The analysis revealed that the most prominent barriers were technical, primarily the lack of universally adopted data exchange standards, such as HL7 FHIR, across commercial mHealth platforms (48%). Organizational challenges, including ambiguous clinical workflows and increased physician burnout due to data overload, constituted 34% of the reported barriers. Furthermore, regulatory ambiguities concerning patient data ownership, privacy, and dynamic consent models formed major obstacles (18%). Despite these challenges, pilot studies demonstrated that semantic interoperability could reduce redundant clinical testing by up to 30%, significantly enhancing resource allocation. Conclusion: The lack of mHealth-EHR interoperability remains a critical bottleneck threatening the sustainability of digital health ecosystems. Developing standardized APIs, establishing robust data governance frameworks, and aligning integration strategies with clinical workflows are essential steps toward building a resilient healthcare infrastructure.