Health research governance of data access: a black-box challenge.

This article addresses organisational governance, including perceived reputational concerns, by health data custodians as the principal barrier to timely and transparent research. Although existing literature primarily addresses ethics reviews and site-specific research approvals, our experience with a Local Hospital Network uncovered additional active barriers within this complex health system. We position these experiences in relation to literature that has documented inefficiencies in health research governance processes that lead to lost knowledge capital and opportunities for significant advancements in health systems research.