Towards a universal patient-centric health record sharing platform

•Existing health record sharing platforms can be categorized into 4 groups based on their governing authority (governmental or commercial) and their compatibility (platform-independent, or multi-organizational).•We compared these four groups against our conceptual system-level record sharing (SLRS) platform based on our evaluation criteria - derived from quadruple aim and canadian institute for health information metrics.•Technology-independent systems are the most effective systems in terms of satisfying data interoperability, providing the right level of details and timely information, being compliant with the contextual health privacy regulations and are also more cost-efficient.•Context and process interoperability requirements, as well as providing evidence-based information across an entire health system is a challenge.•Commercial platforms in this study need to improve their governance structure and employ a consistent ontology that can be adopted by all EHR applications across a health system. This paper provides a practical approach to evaluate health record sharing platforms in terms of their ability to deliver interoperable healthcare of quality at a systems level. We use our previously published interoperability evaluation framework to evaluate our proposed System-level Record Sharing (SLRS) platform against four other common categories of health record sharing platforms in Canada, the United States, and Norway. In this paper, we compare the SLRS platform architecture that we previously developed against 4 health record sharing platform categories. We conducted this comparative evaluation of 5 categories of healthcare platforms: SLRS, Commercial-Multi (CM), Commercial-Independent (CI), Governmental-Multi (GM), and Governmental-Independent (GI) using our proposed evaluation framework that is built upon quadruple aim, triple aim and Canadian Institute for Health Information (CIHI) health platform evaluation frameworks. SLRS and platforms managed by government organizations that provide a technology-independent or compatible platform were the most effective in terms of satisfying data interoperability, providing meaningful and effective information exchange, being compliant with health privacy regulations across a range of contexts, and having many of the costs paid for at a central level. All platforms struggled with context and process interoperability requirements, as well as providing evidence-based information across an entire health system.