Introduction: Ilam province, with over 430 km of shared border with Iraq and hosting the strategic Mehran crossing – through which millions of pilgrims and travelers pass annually – holds a unique geopolitical position. Cultural, linguistic, and religious affinities with neighboring Iraqi provinces position Ilam as a natural gateway for attracting health tourists from Iraq’s multi-billion-dollar market. Despite significant treatment potential and infrastructure, the province’s share of this lucrative market remains negligible. The core challenge lies not in shortages of medical equipment or specialists, but in distorted patient attraction and retention processes dominated by informal brokerage networks. These networks foster black markets, impose opaque pricing and exorbitant commissions, inflate final treatment costs, diminish service quality, erode foreign patient trust, and increase risks of no-shows or appointment cancellations. This study aims to transition from the current traditional, opaque model to a data-driven digital ecosystem that reduces information asymmetry and restores lost trust among Iraqi patients.

Methodology: This research employs a Design Science Research (DSR) approach. Following expert interviews and field needs assessment, a novel four-layer software architecture based on Service-Oriented Architecture (SOA) and microservices was proposed. This innovative architecture comprises: a multi-channel Presentation & Access Layer (bilingual mobile app for patients, web portal for physicians, and governance dashboard); an API Gateway & Security Layer; a Core Business Services Layer featuring an Intelligent Decision Support System, integrated logistics management, and an escrow-based financial clearing mechanism; and an Infrastructure & Deployment Layer leveraging Docker and Kubernetes for automatic scalability. The central component is a Clinical Registry System built on the HL7 FHIR standard, ensuring seamless interoperability with other medical centers. Model validation involved a descriptive-analytical survey of Iraqi health tourists at the Mehran border.

Findings: The proposed model (Ilam-HTR), utilizing artificial intelligence algorithms, delivers key innovations: 1) A Hybrid Recommender System that analyzes clinical match, language proficiency, reputation score, and availability to suggest suitable physicians with 84.5% accuracy, and 2) A No-Show prediction module employing the XGBoost algorithm to estimate cancellation risks. Simulation results show the platform sustains response times under 200 milliseconds at high traffic loads (up to 5000 concurrent users), vital for peak seasons like Arbaeen. Field data revealed a digital trust paradox: 90% of patients showed strong preference for an official app over brokers, yet only 39% were willing to make online advance payments, largely due to financial insecurity and absent shared banking infrastructure.

Conclusion/Implicatins: Developing an intelligent software infrastructure with the proposed novel architecture is a prerequisite for eliminating information asymmetry and reviving eroded trust among Iraqi patients. This study recommends that provincial policymakers establish a Regulatory Sandbox in the Mehran Free Zone to enable HealthTech startup operations, thereby completing the health tourism value chain and significantly enhancing the province’s foreign currency revenue potential.