Design and Implementation of a Scalable Clinical Data Warehouse for Resource-Constrained Healthcare Systems

Centralized electronic health record (EHR) repositories are critical for advancing disease surveillance, public health research, and evidence-based policymaking. However, developing countries face persistent challenges in achieving this due to fragmented healthcare data sources, inconsistent recordkeeping practices, and the absence of standardized patient identifiers. These issues hinder reliable record linkage, compromise data interoperability, and limit scalability-obstacles exacerbated by infrastructural constraints and privacy concerns. To address these barriers, this study proposes a scalable, privacy-preserving clinical data warehouse, NCDW, designed for heterogeneous EHR integration in resource-limited settings deployed on institutional servers and tested with 1.16 million clinical records. The framework incorporates a wrapper-based data acquisition layer for secure, automated ingestion of multisource health data and introduces a space-efficient Soundex algorithm to resolve patient…