Study by ITACA-UPV and WHO Regional Office for Europe | ITACA Institute

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A study led by researchers from the ITACA-UPV Institute, in collaboration with the WHO Regional Office for Europe, has published an in-depth analysis of the implementation of electronic health record (EHR) systems in 53 countries across Europe and Central Asia.

The study, based on a survey conducted in 2022, provides a detailed overview of the digital health situation, identifying challenges and opportunities for advancing digital transformation in the health sector.

Published in the International Journal of Medical Informatics, the research was conducted by Roberto Tornero Costa, Antonio Martínez Millana and Vicente Traver Salcedo from the SABIEN-ITACA group, together with Keyrellous Adib, Nagui Salama, Stefania Davia and Karapet Davtyan, experts from WHO-Europe.

Context of the study

Electronic health records (EHRs) are essential tools for improving healthcare quaity, improving efficiency and ensuring secure access to patient information.

 In this context, WHO Europe conducted a survey in 2022 to evaluate the level of digitisation in its Member States. The survey aimed to identify barriers, opportunities for improvement, and best practices in the use and exchange of digital health data.

“Through its Global Strategy on Digital Health 2020-2025, WHO is committed to establishing global minimum standards for EHRs, promoting people-centred health systems through digital technologies”, highlights Vicente Traver, ITACA researcher and participant in the study.

Main conclusions

EHR implementation and national data exchange are at an advanced stage in the WHO European region, although achievements and challenges differ across sub-regions. The study highlights significant progress in interoperability, with 87% of countries now equipped with systems that enable national clinical data exchange.

“Since 2015, 18 new Member States have developed this capability, reflecting notable progress in healthcare digitisation across the region”, explians Antonio Martínez Millana, a researcher at ITACA.

Despite these advances, regional differences persist. Eastern, Western, and Southern Europe have predominantly adopted centralised systems, while Northern Europe and Asian sub-regions combine centralised and decentralised approaches tailored to their local contexts.

“However, significant barriers remain, such as a lack of funding, insufficient technical resources, and the absence of interoperability standards, particularly in Central Asia, the region facing the greatest challenges,” explains Roberto Tornero Costa.

From a regulatory perspective, although all states have implemented data protection laws, only 29 countries have enacted regulations requiring health systems to comply with national standards, which hinders regional harmonisation

Strategic recommendations

The report therefore urges Member States to develop national legislation to ensure the interoperability of local and regional systems, as well as to ensure sustainable funding for their maintenance.

It also emphasizes the importance of comprehensive strategies to drive the implementation of health data standards and actively involve patients and cross-sectoral stakeholders, prioritizing a people-centred approach.

Finally, the paper highlights that EHR systems have the potential to transform healthcare by enabling more efficient and secure access to information, ultimately improving clinical decision-making.

“In addition, stronger interoperability could pave the way for advanced technologies, such as artificial intelligence, to deliver faster diagnoses and personalized treatments, significantly enhancing the quality of healthcare,” the study concludes.

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