Healthcare Big Data Platform for Linking National Databases in Korea: System Development and Research Applications

Public healthcare databases in South Korea have been distributed across disparate government agencies, requiring researchers to navigate multiple, separate institutional approval processes for data linkage. To address the systemic inefficiency, the Healthcare Big Data Linkage Platform (HCDL), jointly administered by NECA and KHIS, was established to integrate 13 databases from 10 public institutions through a Trusted Third Party (TTP)-based linkage methodology and a centralized one-stop review process. Of 311 projects submitted between 2022 and 2025, 190 (61.1%) were approved with annual applications increasing 2.4-fold over the study period. The average number of databases per project exceeded three, reflecting a surging demand for integrated clinical data. Nationwide healthcare data from HIRA and NHIS were the most frequently requested databases (93.2% and 82.1% of approved projects, respectively), and co-occurrence pattern analysis further confirmed that both formed the core of the research ecosystem in combination with vital status, lifestyle, and cancer diagnosis data. By consolidating multi-institutional review and enabling equitable data access, the HCDL has emerged as a core infrastructure for data-driven and precision medicine research in South Korea.

Background

Public healthcare databases in South Korea have been managed in a fragmented manner across disparate government agencies, requiring researchers to contact each institution individually and complete separate approval processes. This structural inefficiency significantly prolonged the time from data request to use and constrained research to datasets available within a researcher’s own institutional network.

Objective

This study describes the system design and governance structure of the Healthcare Big Data Linkage Platform (HCDL) and examines data utilization trends from 2022 to 2025 to evaluate the platform’s impact on the domestic healthcare research environment.

Methods

The HCDL, jointly administered by the National Evidence-based Healthcare Collaborating Agency (NECA) and the Korea Health Information Service (KHIS), integrates 13 databases from 10 public institutions. The platform employs a Trusted Third Party (TTP)-based linkage methodology and a centralized Research Evaluation Committee (REC) for one-stop review. Data on application submissions, approvals, database usage patterns, and inter-database co-occurrence networks across 311 submitted projects were analyzed.

Results

A total of 311 projects were submitted between 2022 and 2025, of which 190 (61.1%) were approved. Annual applications increased approximately 2.4-fold, from 44 in 2022 to 105 in 2025, with approval rates remaining stable between 51.7% and 66.7%. CLAIMS and SCREEN were the most frequently requested databases (93.2% and 82.1% of approved projects, respectively), suggesting strong and consistent demand for nationwide healthcare data as the analytical foundation for research. Co-occurrence pattern analysis further revealed that the CLAIMS-SCREEN pairing formed the core of the research ecosystem in combination with vital status, lifestyle, and cancer diagnosis data.

Conclusions

The HCDL has substantially reduced administrative burden and expanded data accessibility by consolidating multi-institutional review and linkage into a single integrated process. By enabling equitable access to public health, the platform has emerged as a core infrastructure supporting the growth of data-driven and precision medicine research in South Korea. Further development priorities include expanding analytical capacity, incorporating clinical data sources such as electronic medical records, and establishing a standardized metadata framework to enhance interoperability.