Data interoperability of health information systems in public hospitals in the Gauteng province of South Africa

The fragmentation of health systems remains one of the most persistent barriers to achieving integrated and coordinated healthcare delivery in South Africa. Many public hospitals continue to operate within silo-based systems, which hinder the delivery of comprehensive and efficient care. In this context, data interoperability emerges as a critical enabler for bridging these gaps. Despite the existence of national digital health strategies, there is a lack of frameworks to guide public hospitals in implementing interoperable systems. This study aimed to investigate the data interoperability of health information systems in public hospitals in the Gauteng Province of South Africa, with a view to proposing a framework that can serve as a reference for breaking down data silos and ensuring data sharing and collaboration between health facilities. A convergent mixed-methods design was employed, using questionnaires with 144 clinical and administrative staff and interviews with 16 managers, complemented by document analysis. Data were analysed thematically and descriptively. The findings revealed that existing national digital health strategies are perceived as inadequate due to weak infrastructure support, limited technical guidance, and insufficient stakeholder engagement. Participants recommended the inclusion of implementation roadmaps and timelines, regulatory compliance mechanisms, defined infrastructure requirements, and strong governance structures. The study proposes a framework to enhance cohesive, efficient, and patient-centred healthcare. The framework offers practical guidance for stakeholders and contributes to the theoretical advancement of data interoperability in developing countries. Achieving effective interoperability requires not only frameworks but also active stakeholder engagement, capacity building, sustained political commitment, and strategic infrastructure investments.