Paving the way to establishing the digital-friendly health and care information model in Kazakhstan

•Requirements on health data collection in Kazakhstan are fragmented.•Information modelling in key for advancing digital health interoperability.•Standardization of data elements and data structures are interconnected.•Tailored combination of international and national standards is showcased. Kazakhstan has made significant strides in digital health implementation since 2013, transitioning from paper-based systems to wide implementation of digital solutions. However, challenges persist, notably the misalignment between existing data collection requirements and ongoing digital transformations. To address this obstacle, the development of a new digital-friendly requirements for health data collection at provider levels was initiated. A comparative analysis of all existing requirements on health and care data collection set a foundation for further actions. A dedicated technical working group, established by the Ministry of Healthcare, oversaw this process, while several specialized expert groups participated in detailed discussions to ensure alignment with healthcare needs. We took as a basis the legislative act enforcing use of data forms inherited from pre-digital era. Data elements from most used forms were cataloged, checked for consistency, and standardized. ISO 13940 standard guided transformation of rigid paper-based forms into flexible digital-friendly data sets. Analysis of the healthcare legislation reveals significant optimization opportunities. We categorized 157 forms into four groups by their content and role and focusing on clinical and administrative records for transformation. Data elements’ analysis led to developing 209 standardized classifications with data values. 83 data sets, encompassing clinical and administrative domains, were developed to substitute 63 (out of 157) forms. Therefore, the foundation for better data and structure interoperability was set. The top-down approach to digital health standardization, combined with open market policies, results in inconsistent data collection practices. Developed data sets align with the goal of developing the national Electronic Health Records system as enabler for interoperability and adds a bottom-up perspective to digital health standardization. This effort addresses the lack of guidance for digital data model development, however additional efforts required to change the current practice and finalize the national legislation transformation into digital-friendly mode.