Abstract

Indonesia continues to face challenges in health data fragmentation and disconnected systems, limiting timely clinical decisions and continuity of care. Although the SATUSEHAT platform adopts HL7 FHIR to promote interoperability, real-time, bidirectional data exchange remains limited due to incomplete electronic health record (EHR) integration. This paper presents a Design Science Research (DSR) case study to develop and evaluate a federated Health Information Exchange (HIE) architecture enabling real-time data sharing across EHRs, regional HIEs, and the national platform. Piloted in Jakarta and East Java, the solution reflects a scalable, standards-based model aligned with national priorities. The study begins with a literature review and case analysis of HIE implementations in diverse settings to extract key architectural and governance strategies. The proposed architecture spans point-of-service, regional, and national levels and includes registry services, business services, and interoperability layers. Design activities involve iterative modeling, prototyping, and scenario-based testing in a controlled environment. The resulting artifact offers a replicable model for HIE advancement in low- and middle-income countries.

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