If health data increasingly needs to move between systems, organizations and countries, should it remain tied to the applications where it was originally created?
This is where EHDS becomes more than a compliance exercise. It is an opportunity to consider the data foundations on which tomorrow's healthcare services will be built.
From regulation to clinical reality
One of the main aims of EHDS is to make it easier for health data to follow the patient.
Imagine a Finnish citizen who needs emergency care in Spain. The clinician does not need the patient's entire lifelong record. But access to trusted information about medications, allergies, major diagnoses and previous procedures could make an important difference.
This type of cross-border exchange is already happening through MyHealth@EU, the existing European infrastructure that EHDS builds on for the primary use of health data. Under EHDS, its role will expand, as the ability to exchange certain health data will become a requirement for all healthcare providers. Patient summaries and electronic prescriptions are among the first priority data categories, followed by laboratory results, medical imaging and discharge reports.
For healthcare providers and EHR vendors, this means being able to make defined health information available electronically and exchange it according to common European requirements. But moving information from A to B is only part of the challenge.
Lessons from Finland: interoperability need to work in practice
Finland has been building the foundations for health data sharing for decades.
National legislation, terminology services, electronic prescriptions, citizen access and the Kanta Patient Data Repository have gradually created a national infrastructure for sharing health information. Cross-border electronic prescription services went into production in 2019.
Today, local EHR systems connect to Kanta, which in turn enables cross-border services through MyHealth@EU. Tieto’s Lifecare EHR is part of this national ecosystem.
Finland’s experience shows that interoperability depends on more than connecting systems. Information must be shared within a clear framework for access and responsibility and be available to clinicians in a way they can interpret and use.
The final kilometer is particularly important. Information may successfully cross a border, but its value is limited if the clinician has to search for it in a separate portal, cannot understand its meaning or cannot trust where it came from. Interoperability creates real value when trusted information reaches healthcare professionals in a form they understand and within their existing workflow. The result can be less searching, fewer duplicate questions and examinations, better continuity and ultimately safer care.
FHIR, openEHR and EHDS: different pieces of the puzzle
Discussions about EHDS can quickly become confusing because FHIR, openEHR and European exchange formats are often mentioned together.
FHIR helps healthcare systems exchange information through standardized resources and APIs.
openEHR provides a standardized way to model and store clinical information, helping preserve and govern its meaning independently of individual applications.
EHDS provides the European rules and framework for making health data accessible and interoperable.
These standards and frameworks address different parts of the challenge: how clinical information is modelled, how systems exchange it, and how it can be accessed across Europe. They can work together, but none alone delivers interoperability in practice.
Importantly, a healthcare provider does not need openEHR simply to comply with EHDS. An existing EHR can potentially meet the requirements by mapping its internal information to the European Electronic Health Record Exchange Format (EEHRxF). But is compliance the only goal?
From EHDS compliance to reusable health data
Healthcare organizations could approach EHDS as another integration requirement: identify the required data, create the necessary mappings and interfaces, and connect existing systems to national and European infrastructure.
But the same clinical information is increasingly needed for much more: direct care, information sharing, new clinical applications, AI, analytics and research.
Instead of repeatedly unlocking information from individual applications for every new use case, healthcare providers can create a common clinical data foundation where information is structured and governed independently of the applications using it.
This is where openEHR becomes particularly relevant.
It enables clinical information to be maintained in a vendor-neutral, clinically governed model, while standards such as FHIR can make that information available to other systems.
Put simply:
openEHR helps preserve the structure and clinical meaning of the data. FHIR provides a standardized way to exchange health information between systems. EEHRxF defines the common European format for exchanging priority health data under EHDS. EHDS provides the regulatory framework that requires this health data to become accessible and interoperable across healthcare organizations and national borders. Together, this creates an opportunity to move from solving individual interoperability requirements towards building a reusable health data foundation.
A foundation for stepwise modernization
This is also where the discussion moves beyond EHDS.
If clinical data can exist independently of a particular EHR application, modernization no longer must mean replacing everything at once.
Existing clinical information can be brought into a common data platform. New applications can use the same data. Existing systems can remain where they still provide value. Capabilities can then be introduced or modernized step by step.
This is the architectural idea behind Lifecare Clinical Suite.
Tieto chose openEHR and FHIR as key architectural pillars for our clinical solutions around ten years ago. Lifecare Clinical Suite combines an openEHR-based clinical data foundation with applications and capabilities designed to work on top of it.
The goal is not simply to provide another way to exchange data. It is to help healthcare organizations make clinical data independent of individual applications, so the same trusted information can support existing workflows, new applications and future use cases.
That can also change the modernization journey. Instead of a single large EHR replacement, organizations can gradually establish a common data foundation, make existing information accessible and introduce new capabilities over time.
EHDS becomes one use case for that foundation, rather than the reason for building it.
Think beyond the next requirement
EHDS will put interoperability higher on the agenda for every European healthcare organization. Finland's experience shows that making it work requires more than technical connectivity. Clinical meaning needs to be preserved, governance and trust need to be established, and information needs to reach professionals in a way that supports everyday care.
For healthcare providers preparing for EHDS, the immediate question is naturally: What do we need to do to comply?
But there is a more strategic question worth asking: If we are going to make our health data interoperable, how can we make it reusable too?
Because the bigger opportunity is not simply to exchange information across borders. It is to create a health data foundation that can support better care, new applications, AI and continued modernization without having to unlock the same data again every time requirements or technology change.
