Governance-Oriented Quality Engineering Framework for Healthcare EDI Modernization

Healthcare organizations worldwide increasingly depend on Electronic Data Interchange (EDI) systems to enable secure, standardized, and efficient exchange of clinical, administrative, and financial information. However, legacy healthcare EDI infrastructures—often built on rigid standards, fragmented governance models, and limited quality assurance mechanisms—are increasingly misaligned with modern interoperability, regulatory compliance, and data quality demands. This paper proposes a Governance-Oriented Quality Engineering (GOQE) Framework for healthcare EDI modernization, integrating governance principles, quality engineering practices, and standards-based interoperability architectures. The framework systematically addresses deficiencies in data integrity, semantic consistency, compliance assurance, and operational scalability that commonly afflict healthcare EDI environments. A layered methodology encompassing governance control, quality lifecycle engineering, risk-based validation, and continuous compliance monitoring is introduced. The proposed approach aligns with established healthcare standards such as HL7, X12, FHIR, and ISO/IEC quality models while embedding governance accountability across organizational and technical domains. Analytical evaluation demonstrates improvements in transaction accuracy, regulatory adherence, and system adaptability. The study concludes that governance-driven quality engineering is a critical enabler for sustainable healthcare EDI modernization.