Background

Clinical Quality Registries (CQRs) monitor the quality of health care and outcomes for defined conditions, treatments or procedures. Registry data are often linked with administrative datasets to support follow‑up and evaluation, but linkage readiness varies. As part of the Population Health Research Network CROSS‑Link project, we surveyed Australian registries to assess technical readiness and inform national recommendations and dataflow pathways.

Methods

An online structured survey captured linkage history; use of person identifiers; storage practices (identifier separation); and governance/consent models, noting likely response bias towards more linkage‑ready registries. Responses from 33 registries were analysed descriptively and thematically and synthesised into technical recommendations (UWA HREC 2025/ET000960).

Results

Most respondents had prior linkage experience, using a mix of national and jurisdictional linkage services. Core linkage variables were commonly collected, but practices for capturing and storing identifiers varied, including manual and mixed entry. Reported challenges included unclear data‑sharing governance, inconsistent separation of identifiers from clinical/outcomes data, and linkage settings did not always match to the intended purpose (for example, follow‑up or return‑to‑provider reporting).

Where captured, hospital medical record numbers can improve within‑jurisdiction linkage efficiency and reduce reliance on name‑based matching. The survey also identified opportunities to strengthen privacy through identifier separation and access controls.

Conclusion

To improve national linkage readiness, registries would benefit from minimum technical requirements and clearer consent and governance guidelines. Recommendations include reducing repeated handling of identifiers (e.g., a master linkage key or jurisdictional linkage maps) and standardised capture, validation and stewardship of identifiers to improve linkage quality and comparability.