Table 1. Clustering of barriers and facilitators to harmonized health data collection, sharing and linkage.

Barriers		Facilitators
Cluster	Sub-cluster	Cluster	Sub-cluster
Ethical	Privacy	Ethico-Legal	Ethical approval by REC/IRB
	Respect for Autonomy		Health Data Anonymization
	Other		Informed Consent
Legal	Data Protection Regulations		Patient data access rights
	Divergence in National Legislations for Data Security and Privacy		Confidentiality measures
	Other		Clarity of legislation for health data collection/sharing/linkage
			Official/legal approval of project
			Study according to International laws and regulations
			Legislation allows project without consent or REC approval
			Legislation requires mandatory reporting
			Other
Technical	Lack of Data Standards (data structure and semantics)	Technical	Data harmonization techniques
	Data Quality Issues		Data Linkage techniques
	Limited Technical Capabilities
	Other		Other
Financial	Lack of Funding	Financial	Securing funding
	Other		Public-Private partnership
			Other
Political	Mistrust between stakeholders	Political	Data Sharing Agreement
	Data Ownership		Building and maintaining stakeholder trust
	Institutional/constitutional organization issues		Data access control
	Other		Health System Structure
			Other
Motivational	Lack of research incentives	Motivational	Monetary Incentive
	Stakeholder restricts access for re-use of data as deemed unfit for secondary use		Easing workload through improvement of data collection
	Stakeholder competing interests		Memorandum of understanding to ensure collaboration until end of study
	Other		Other
Sociocultural	Cultural clash for data collection/sharing/linkage	Sociocultural	Participant data access control
	Other		Other