System interoperability

The full benefit of digital health solutions cannot be obtained without system interoperability. Establishing this faces some challenges:

1. Fragmented information systems: The pace of creating patients’ health data is increasing every day because of the popularity of  digital health devices and mobile applications. However, this data is often collected under different standards, which cannot be merged meaningfully. For example, according to a survey by Healthcare Information and Management Systems Society (HIMSS) [1] in 2018, each hospital in the survey used 16 different EHR systems to collect patients’ data.

2. Lack of awareness: some stakeholders do not fully understand the importance of interoperability for digital health solutions:
  • Health decision-makers: many are unaware of the impact of using different standards in healthcare and overlook the value of      interoperability.
  • Digital Health solution developers: many digital health companies (especially the small companies with limited resources) are unaware of or unable to invest in necessary data standards.
  • Patients and the public can play an important role in demanding the adoption of proper data standards if they understand the importance of interoperability.
      3. Lack of pressure and incentives: there is a paucity of incentives or pressure on healthcare organisations or healthcare providers to adopt interoperability [2].

      There are a few initiatives worldwide and in the EU to address interoperability issues. Robust and transparent standards on data protection (such as the General Data Protection Regulation in the EU) may help incentivise healthcare organisations and digital technology developers to standardise the developed and procured solutions [3].

      Enabling citizens to securely access and share their health data across borders is one of the priorities of the EC. The General Data Protection Regulation (GDPR) underlines that citizens have the right to access their personal data, including health data and contains rules for facilitating the access to safe and high-quality cross-border healthcare.

      The European Commission has adopted a Recommendation on a European Electronic Health Record Exchange Format (EEHRxF) [4] to enable the flow of health data across borders. The development of the EEHRxF can be another step to unify the fragmented health data space in Europe.



      [1] Healthcare Information and Management Systems Society (HIMSS).
      [2] Digital Health Europe. What are the barriers to interoperability in healthcare? Accessed June 26, 2022.
      [3] Digital Health Europe. Which factors can promote interoperability in healthcare? Accessed June 26, 2022. 
      [4] Recommendation on a European electronic health record exchange format.