Public Reporting Systems in Health Care and the Underconceptualized Technical Substrate, a Core Information Systems Dimension: Scoping Review.

Background: Public reporting systems (PRSs) in health care are defined as digital platforms that make comparative health care performance data available to the public (eg, Hospital Compare in the United States, NHS Choices in the United Kingdom, national quality registries in Europe, and MyHospital in Australia). These systems aim to improve transparency, accountability, and patient choice. While these systems have been widely studied from policy and clinical perspectives, the information system (IS) foundations that enable their operation, including architecture, interoperability, data governance, APIs, usability, and technical performance, remain underexplored. Objective: This study aims to map the extent and nature of the published literature addressing the technological foundations of PRSs in health care and to identify persistent gaps in IS scholarship. Methods: This scoping review followed the Joanna Briggs Institute guidelines and was reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). Seven databases were searched: PubMed, Web of Science, Scopus, IEEE (Institute of Electrical and Electronics Engineers), ACM (Association for Computing Machinery), AIS (Association for Information Systems) eLibrary, and Cochrane. The search covered articles published between 2000 and 2026. Eligible articles included peer-reviewed journal articles and conference papers on PRSs in health care. Data were charted according to study characteristics, including 6 IS-specific coding dimensions: architecture, interoperability, data governance, APIs, usability, and technical performance. Descriptive statistics were used to summarize the findings, and a narrative synthesis was conducted to identify thematic trends and research gaps. Results: A total of 1882 records were identified across 7 databases. After deduplication, 1127 records were screened, and 233 studies were included in the review. Most of the included studies originated from the United States (n=157, 67.4%), followed by Europe (n=43, 18.4%). Of the 233 included studies analyzed, 60.5% (n=141) used quantitative methods, whereas 24.0% (n=56) used qualitative methods and 15.5% (n=36) used mixed methods. Applying a structured IS coding framework to all 233 studies revealed that the technical substrate of PRSs remains underexplored. Conclusions: Despite the centrality of IS infrastructure to public reporting, existing scholarship predominantly frames these systems as policy or social tools while neglecting their technical underpinnings. This oversight has practical implications, including poor system usability, weak interoperability, and noncompliance with data regulations, which can undermine patient trust and system effectiveness. Addressing this gap requires interdisciplinary approaches that integrate IS frameworks, sociotechnical analysis, and usability evaluation to ensure that PRSs are effective, equitable, and technically robust.