Date of Award
4-2026
Document Type
Dissertation
Degree Name
Doctor of Education (EdD)
Department
Executive Leadership
First Supervisor
Dr. Guillermo Montes
Second Supervisor
Dr. Erika McBride
Abstract
Healthcare interoperability remains constrained not only by technical barriers but also by leadership, governance, and administrative fragmentation. The purpose of this quantitative cross-sectional study was to examine how leadership-related barriers to interoperability were reflected in patients’ and caregivers’ experiences with administrative clarity, system integration complexity, trust in leadership, satisfaction, and switching behavior. Guided by transformational leadership theory, data were collected through an online survey of 435 U.S. adults who managed healthcare administrative tasks for themselves or family members. Descriptive, subgroup, and multivariable analyses were conducted to address five research questions. Respondents reported moderate coverage clarity and billing ease, elevated billing stress, and substantial system integration complexity. They most often identified healthcare providers and hospitals as primarily responsible for improving interoperability, and they indicated that trust would increase most through patient-focused improvement and clear communication. Coverage clarity, system integration complexity, and leadership trust significantly predicted billing and platform satisfaction, while billing ease and system integration complexity were associated with switching behavior. Demographic differences were observed across age, caregiving role, billing involvement, and insurance type. The findings indicate that interoperability is experienced by patients and caregivers as a leadership and governance issue as well as a technical issue, and that leadership shapes how fragmentation is understood, navigated, and evaluated. Recommendations include strengthening cross organizational accountability, improving billing and coverage communication, and incorporating patient and caregiver input into interoperability planning.
Recommended Citation
Sher, Hoshiar J., "Leadership Challenges in Achieving Healthcare Interoperability: A Cross-sectional Survey of Patient Experiences" (2026). Education Doctoral. Paper 655.
https://fisherpub.sjf.edu/education_etd/655
Please note that the Recommended Citation provides general citation information and may not be appropriate for your discipline. To receive help in creating a citation based on your discipline, please visit http://libguides.sjfc.edu/citations.