After electronic health record systems were slowly incorporated into health facilities and medical practices, and after data was already keyed in, doctors still relied on the standard hard copy with downloads and faxes to transmit data from one physician practice to another.  Since 2009 when the systems first were introduced and got underway, exchange of information was only a lofty goal and not reality.

The problem of interoperability has plagued healthcare for over seven years  but this is now changing.  National and regional governments play a critical role in advancing the adoption of Continua Design Guidelines for interoperable connected health, in a number of ways.

National electronic health record (EHR) systems can define the conditions and technical interfaces through which people can share their personal health data.  Government agencies as single-payer systems have the choice of which systems and products to purchase.


Unfortunately, most governments hesitate to take a stand.  Some wait for the marketplace to sort things out since  they manage public funds and the public trust and want to avoid any litigation.  Policymakers hear of other standards and guidelines in the field and are concerned about backing the wrong horse.  They hear the siren call of some companies that offer integrated solutions and ease of use, but as we have seen in many medical practices, that may trap them in vendors’ lock.  In most cases, government agencies require assurance that the Continua Design Guidelines are the answer to the persistent lack of interoperability.

The European Commission has issued  the eHealth European Interoperability Framework (published in 2013, later refined in 2015) that reference the Continua Design Guidelines and others, for guidance documents.  However, the Framework stops short of an endorsement or recommendation.  The eHealth Network, the instrument of the EU Member States to coordinate eHealth policies, has also hesitated to endorse standards; the project of a Joint SDO Platform to advise the eHealth Network on standards and interoperability appears stalled.

The June 2016 request from six governments to the eHealth Network to show more leadership on a telehealth framework remains is still being ignored. In their letter, health online pharmacy no prescriptions ministries and their agencies responsible for ICT systems endorsed the large scale deployment of telehealth systems, and acknowledged the Continua Design Guidelines as ‘the leading open framework for many technical interoperability aspects of personal connected health.’

Policymakers in the European Commission and the eHealth Network are risk averse, too.   A recent report from the GSMA could make a difference.  Digital Healthcare Interoperability: Assessment of existing standards and how they apply to mobile operator services, in order to provide global recommendations to increase their adoption, was just published in October and is available for download at  Prepared primarily for an audience of mobile operators, this is an excellent, state of the art overview of standards in mobile digital health from a recognised, impartial player.

Do you find yourself still stuck in the crunch between not liking your current EHR but hesitant to change and if so, which one would be better?  How do you make those decisions and what guidelines do you use to make your determination?

Some of these questions are answered in EMR Guide: Choosing without Losing…How to Choose the Best Medical Record System for our Practice.  This offers valuable advice for an important transition period and expert tips for moving towards e-Health.

Check it out at: