Faces of Digital Health

Nearly €200m, twenty years of EU health data projects. Henrique Martins on what they built and what EHDS needs next.

Before the European Health Data Space became law, the EU had already funded two decades of cross-border interoperability work: epSOS, EXPAND, Trillium Bridge, JAseHN, eHAction and more. Henrique Martins has worked on most of them. In this conversation he explains how those projects became MyHealth@EU, why the European EHR exchange format matters for every hospital and IT vendor, what digital health authorities and health data access bodies will do from 2027, and how far patient control of health data can realistically go. He also argues that Europe is not behind on cross-border exchange, that slow national progress is ultimately a political choice made by voters, and that 2027 will show whether the EHDS implementing acts can actually be applied.

GUEST

Henrique Martins — Associate Professor, ISCTE – University Institute of Lisbon; coordinator, i2X (Intelligent Implementations of the European EHR Exchange Format); former President of SPMS, Portugal's national digital health agency; former Member States co-chair, EU eHealth Network

Host: Tjaša Zajc

WHAT THE CONVERSATION COVERS

What nearly €200m in EU interoperability funding bought over twenty years

How epSOS, EXPAND and OpenNCP became MyHealth@EU

Cross-border ePrescription and patient summary: who exchanges data today

The European EHR exchange format (EEHRxF) and why discharge reports still don't travel

Transformation layers: wrapping HL7 v2 messages in FHIR

AI and natural language processing to structure clinical data at the point of care

Trillium Bridge: EU–US patient data exchange, and why it couldn't be funded today

Xt-EHR and how joint actions shape the EHDS implementing acts

Digital health authorities vs health data access bodies: why one versus many

Patient rights under EHDS: access, download, correction and upload

Health data activism and patient health literacy

The xShare Yellow Button, MyHealth@MyHands and the EU Digital Identity Wallet

i2X: 35 pilots, 12 member states and 3 million citizens — and everyone else

Is Europe slow? Cross-border exchange compared with North America

The EHDS test for 2027: implementing acts and demonstration sites

CHAPTERS

03:00 Fifteen years of European interoperability projects
03:36 €200m over twenty years: what EU funding built
06:38 FHIR, implementation guides and the European exchange format
10:10 From drop-down menus to AI: structuring health data
10:48 epSOS, eHAction and the projects that shaped EU digital health
14:02 Trillium Bridge: when the EU and US exchanged health data
15:58 Xt-EHR and why joint actions shape the implementing acts
18:58 Digital health authorities and health data access bodies explained
23:13 Patients and EHDS: access, correction and health data activism
29:04 Is Europe too slow? 3 million in pilots, 400 million waiting
39:08 The best case for 2027: implementing acts that work

Recent FODH episodes on interoperability and EHDS:
Herko Coomans on interoperability [ • Interoperability Isn't Failing — It's Unde... ]
• Nils Hellrung on openEHR and EHDS [ • Just Connecting systems isn't interoperabi... ] • Karlien Hollanders, The Agentic Patient [ • "I stopped letting AI read my daughter's m... ]

FACES OF DIGITAL HEALTH

Website: https://www.facesofdigitalhealth.com
Newsletter: https://fodh.substack.com
LinkedIn: / faces-of-digital-health
Spotify: https://open.spotify.com/show/4cElKJH...
Apple Podcasts: https://podcasts.apple.com/gb/podcast...#EHDS #EuropeanHealthDataSpace #interoperability #digitalhealth #healthdata #MyHealthEU #FHIR #ePrescription #healthpolicy #EEHRxF #patientdata #FacesOfDigitalHealth

One ultrasound tech, four scanning rooms. NVIDIA's David Niewolny on what "augmented autonomy" asks of clinicians.

NVIDIA is best known for GPUs, but its healthcare strategy is a full stack: compute to train models, compute to run them at the point of care, and simulation to generate the data that medical robotics lacks. In this interview, David Niewolny explains how that stack underpins autonomous X-ray and ultrasound with GE HealthCare, surgical robotics simulation with Johnson & Johnson MedTech, and the Open-H surgical robotics dataset. He argues that open models are a regulatory necessity in healthcare, that software-defined medical devices will shrink innovation cycles from years to months, and that the path to autonomy in surgery will follow the one taken by autonomous vehicles, one level at a time. We also press on the parts that remain unsettled: whether AI efficiency turns into clinician burnout, whether synthetic data reflects real patient populations, and what could still stall adoption.

GUEST

David Niewolny — Senior Director and Global Head of Business Development, Healthcare & Medical, NVIDIA

Host: Tjaša Zajc

WHAT THE CONVERSATION COVERS

- NVIDIA's healthcare strategy: training, simulation and edge deployment for medical AI

- Why open models and open datasets matter in regulated healthcare

- Autonomous X-ray and ultrasound with GE HealthCare: one technician, multiple rooms

- "Augmented autonomy": keeping a clinician in the loop

- AI efficiency, cognitive load and the risk of a new wave of clinician burnout

- Ambient clinical documentation as the clearest efficiency case

- Surgical robotics and the autonomous-vehicle model of stepwise autonomy

- Why robotics costs are falling, and what it means for hospital ROI

- Synthetic data for healthcare robotics: Cosmos-H, Isaac for Healthcare and the Open-H dataset

- Can simulated data reflect a local patient population?

- Model drift, verification and validation, and governance of AI agents in healthcare

- Is healthcare worried about superintelligence?

- Software-defined medical devices and the FDA's predetermined change control plan (PCCP)

- How regulators are adapting to AI-enabled devices

- Change management and ROI as the real barriers to adoption

CHAPTERS

02:00 NVIDIA in healthcare: more than GPUs

03:03 The full stack: training, simulation and edge deployment

08:46 Why open models matter in regulated healthcare

10:51 Autonomous X-ray and ultrasound: one technician, four rooms

14:49 AI augmentation and clinician burnout

18:16 What NVIDIA looks for in a partner, and the surgical robotics bet

23:38 Cheaper robots, more competition, clearer ROI

27:37 Synthetic data, Cosmos-H and the Open-H surgical dataset

31:43 Does simulated data reflect the real world?

34:37 Model drift and governing AI agents in healthcare

38:03 Superintelligence, change management and the autonomous-vehicle analogy

43:10 Software-defined medical devices, the FDA's PCCP and regulators

49:54 A golden age for medtech? What could still slow it down

MENTIONED

NVIDIA Isaac for Healthcare • Cosmos-H • Open-H-Embodiment dataset • NVIDIA Nemotron • BioNeMo Agent Toolkit

GE HealthCare • Johnson & Johnson MedTech (MONARCH platform) • Abridge • Aidoc • OpenEvidence • Sword Health

FDA Predetermined Change Control Plan (PCCP)

FACES OF DIGITAL HEALTH

Website: https://www.facesofdigitalhealth.com

Newsletter: https://fodh.substack.com

LinkedIn: https://www.linkedin.com/company/faces-of-digital-health

Spotify: https://open.spotify.com/show/4cElKJHrauyP6QJQaCkvdY

Apple Podcasts: https://podcasts.apple.com/gb/podcast/faces-of-digital-health/id1194284040

#NVIDIA #healthcareAI #medtech #surgicalrobotics #physicalAI #digitalhealth #medicalimaging #syntheticdata #openmodels #FDA #medicaldevices #healthcarerobotics

Most interoperability debates focus on exchange formats. In this discussion with Dr Nils Hellrung, medical informatician and CEO Strategy & Operations at vitagroup, Nils focuses on the need for shaping hospital IT with governance and financing.

Linking proprietary systems through standards, he says, will always lose meaning, which is why he backs openEHR as a vendor-neutral clinical data core, with FHIR used for exchange. vitagroup in providing the data platform for Catalonia, and just signed a contract with a large hospital group in France. The discussion touches different market approaches to interoperability and challenges of markets such as Germany, where each federal state has its own authority to regulate and implement as they please. Tjasa Zajc and Nils Hellrung talk about what "AI-native" data integration means in practice, why 95% accuracy of AI is not good enough in healthcare, and whether Europe ends up with monolithic US EHRs or open platforms.

This episode is supported by vitagroup.

GUEST

Dr Nils Hellrung — CEO Strategy & Operations, vitagroup; medical informatician; co-author, "Health Information Systems: Architectures and Strategies"

Host: Tjaša Zajc

WHAT THE CONVERSATION COVERS

Why hospital IT architecture reflects governance, trust and financing: three professors, three PACS

Billing versus therapy: why German hospital and ambulatory systems don't talk to each other

AI in healthcare: the widening gap between what is possible and what happens in practice

Why Europe doesn't have to be slower than the US in digital health

Data availability as the main barrier to digital health implementation

openEHR vs FHIR: clinical data repository vs communication standard

FHIR version changes and national profiles: the semantic interoperability problem

Is European Health Data Space (EHDS) interoperability achievable, or only for a core data set?

Catalonia's single patient record on openEHR: 18 months to go-live and the next step to an open health platform

Why Catalonia's single health system makes adoption easier

Germany: 16 federal states, 17 data protection authorities, and a 20-year-old electronic patient record (ePA) programme

Alliance SIH in France: competitors agreeing on a shared health data layer

AI as a translator between clinical data and clinicians

AI-native vs AI-enabled software, and why data pipelines must stay deterministic

Deskilling risk: clinicians who stop thinking because AI seems to have the answer

Epic at Charité, monolithic EHRs vs open platforms, and European digital sovereignty in healthcare

Europe's health IT ecosystem in 2036: best, worst and realistic scenarios

CHAPTERS

02:30 From textbook to practice: 15 years of health information systems
03:00 Why hospital IT looks the way it does: three professors, three PACS
06:50 Is AI speeding up healthcare? The gap between possible and real
10:39 EHDS and data availability: the biggest barrier to digital health
14:00 openEHR vs FHIR: how health data normalisation works in practice
16:40 Is European interoperability achievable? The semantic problem
20:00 Catalonia: why a single health system makes adoption possible
26:48 Germany: 16 states, 17 data protection authorities
30:45 France: Alliance SIH and a shared data layer
32:14 The data layer as Europe's AI advantage
35:38 AI in data integration: why "convincing" is dangerous
41:48 Agentic AI, guardrails and the risk of deskilling
45:00 Europe in 2036: Epic, open platforms and a "very nineties decision"

FACES OF DIGITAL HEALTH

Website: https://www.facesofdigitalhealth.com
Newsletter: https://fodh.substack.com
Spotify: https://open.spotify.com/show/4cElKJH...
Apple Podcasts: https://podcasts.apple.com/gb/podcast...
LinkedIn: / faces-of-digital-health #openEHR #EHDS #interoperability #digitalhealth #healthdata #FHIR #healthIT #healthcareAI #EuropeanHealthDataSpace #Catalonia #vitagroup #FacesOfDigitalHealth

She has 408 of her daughter's medical documents. She stopped letting AI read them — here's why.

Karlien Hollanders is a pharmacist who became her daughter's medical record. When her firstborn went into complete renal failure at two months old and was diagnosed with primary hyperoxaluria type 1, she spent three years moving between Belgian specialist hospitals that could not exchange data with each other. Eleven years later, 408 documents sit on a national platform that can be filtered by doctor, hospital and date — and nothing else. This episode of The Agentic Patient is about what happens when you actually try to put AI to work on a real, fragmented, non-anonymised medical history: what it organised, what it got wrong, and the reason she has stopped.

GUEST

Karlien Hollanders — Patient expert and caregiver; consultant to the Belgian federal health service; pharmacist by training

Host: Tjaša Zajc

THE AGENTIC PATIENT

A Faces of Digital Health series on how patients and caregivers actually use AI — which tools, which prompts, which guardrails — and what that does to the clinical relationship.

Series hub: https://www.facesofdigitalhealth.com/agentic-patient

WHAT THE CONVERSATION COVERS

- Being your child's "walking medical record" across five specialist hospitals

- Why case management exists for cancer and diabetes but not for rare disease

- 408 PDFs, three filters: the missing-metadata problem in national health data platforms

- Federated health data explained — and why you still download your records one click at a time

- What AI document tools did well: organising records by organ and producing specialty-specific summaries

- The timeline AI could not build, and why copy-pasted clinical letters break text-layer summarisation

- Why internists and orthopaedic surgeons need the same records and completely different queries

- The 15-minute consultation and the unprepared specialist

- Local bulk de-identification: the tool that does not exist, and the vendors who could not supply it

- A child's medical data on third-party AI platforms, twenty years forward

- Patient summaries and cross-border care: what an emergency room in another country actually needs

- EHDS versus AI extraction — structuring data at the point of documentation instead of after it

- SNOMED CT and structured entry that clinicians do not know they are doing

- ZAS Antwerp's AI-generated patient-friendly discharge letters, already in production

- Why a shared medication scheme can be five years out of date in a country with electronic prescribing

- Personal health vaults, EU wallets and itsme: identity is not the same as data portability

- Practical advice: how to assemble your own records before letting AI near them

CHAPTERS

03:00 A caregiver's view of patients using AI

04:28 Renal failure at two months: primary hyperoxaluria type 1

10:43 Ten years on: what has changed in Belgian health data sharing

13:04 408 documents, three filters: the metadata problem

15:03 Downloading a federated health record one PDF at a time

17:20 What AI document tools organised — and the timeline they couldn't build

22:27 Same records, different questions: internists vs orthopaedic surgeons

26:38 Not a technology problem: incentives and the missing business case

30:18 AI as a better Google — and where that gets dangerous

32:30 The anonymisation gap: why she stopped feeding AI real data

36:10 Patient summaries, EHDS and structuring data at the source

41:46 ZAS Antwerp's AI-written patient letters, already in production

47:49 Preparing for a specialist visit when your records are scattered

MENTIONED

European Health Data Space (EHDS) — Regulation (EU) 2025/327

ZAS (Ziekenhuis aan de Stroom), Antwerp — AI-generated patient-friendly letters

FACES OF DIGITAL HEALTH

Website: https://www.facesofdigitalhealth.com

Newsletter: https://fodh.substack.com

LinkedIn: https://www.linkedin.com/company/faces-of-digital-health

Spotify: https://open.spotify.com/show/4cElKJHrauyP6QJQaCkvdY

Apple Podcasts: https://podcasts.apple.com/gb/podcast/faces-of-digital-health/id1194284040

#TheAgenticPatient #digitalhealth #healthdata #EHDS #patientdata #caregiver #healthAI #rarediseases #interoperability #healthtech #patientempowerment #medicalrecords

35 views Aug 24, 2026 In-person video interviews"Interoperability isn't failing — it's underfunded." Herko Coomans on standards as public infrastructure.

Most interoperability conversations start with what's technically broken. This one starts by rejecting that framing. Herko Coomans argues that health data exchange is a wicked problem rather than an unsolved engineering task, that the real constraint is infrastructure funding and governance, and that the moment governments mandated standards, they took on a public accountability they haven't yet resourced. We cover the closing post-COVID funding window, what EHDS implementation actually looks like inside a country that has no national health data authority, why the EU started its data union with health, and where AI genuinely helps interoperability — and where it quietly doesn't.

GUEST

Herko Coomans — International Digital Health Coordinator, Ministry of Health, Welfare and Sport (VWS), the Netherlands; interoperability lead, Global Digital Health Partnership (GDHP)

Host: Tjaša Zajc

WHAT THE CONVERSATION COVERS

Why interoperability is a "wicked problem," not a failure — and why it was never all-or-nothing

Interoperability as an infrastructure funding crisis rather than a technical one

The closing post-pandemic window for digital health investment

Why healthcare executives are asking the ministry to be MORE directive on standards

What changes when standards become law: parliamentary questions about SNOMED CT and nursing terminology

Who funds SNOMED CT, HL7 FHIR and IHE for the next 20–50 years

The national FHIR profile problem: why a Dutch profile may not work in Germany

From product implementation to integration: national platforms as an emerging concept

GDHP explained: 44 countries, 40%+ of the world's population, no legal existence by design

The global stewardship gap after US and Argentine withdrawal from the WHO

The International Patient Summary in practice — Canada, Brazil, and QR-code patient summaries at the Hajj

EHDS implementation reality check: 2027, 2029, 2031 deadlines and national health data access bodies

Why the EU chose health as the first pillar of its data union — and what Brexit had to do with it

AI and interoperability: ambient scribes, ontology reasoning, and why a plausible SNOMED code isn't a correct one

The OECD's interoperability valuation: 2.7–6.6% of annual health expenditure

Shifting from project funding to sustainable public infrastructure funding for standards

CHAPTERS

00:00 Interoperability in 2026: what are we still not getting?
01:06 The pushback: a wicked problem, not a failure
05:50 Why interoperability is an infrastructure funding problem
10:25 Who owns integration? From product rollout to national platforms
16:32 When standards become law: parliament, nurses and SNOMED CT
19:01 National FHIR profiles and the interoperability they don't deliver
25:49 GDHP: 44 countries, 40% of the world, no legal existence
30:52 The Dutch chairmanship and the handover to Portugal
35:35 The International Patient Summary in Canada, Brazil and Mecca
39:52 EHDS reality check: European excitement, national scrambling
47:41 Why the EU started its data union with health
50:58 AI and interoperability: "not the magic, but the magician"
1:00:06 The OECD number: what interoperability is actually worth

MENTIONED

OECD, "Interoperability in healthcare: Towards an interconnected future" (Health Working Paper No. 197, July 2026)

International Patient Summary (IPS) — HL7 FHIR, CDA, ISO, SNOMED Global Patient Set, IHE

European Health Data Space (EHDS) • 21st Century Cures Act • My Health Record legislation (Australia) • Ayushman Bharat Digital Mission (India)

FACES OF DIGITAL HEALTH

Podcast: https://www.facesofdigitalhealth.com
Newsletter: https://fodh.substack.com
LinkedIn: / faces-of-digital-health
Apple Podcasts: https://podcasts.apple.com/us/podcast...#interoperability #EHDS #digitalhealth #healthdata #FHIR #SNOMEDCT #healthpolicy #healthIT #GDHP #healthcareAI #europeanhealthdataspace #InternationalPatientSummaryInteroperability Isn't Failing — It's Underfunded (Herko Coomans)