Interview summary

Jordi, Director of Digital Health for the Catalonian Health Service, describes a region that has been a pioneer in digital health since the early 2000s - with full EMR deployment by 2000, electronic prescribing by 2002, and a shared longitudinal EHR by 2007. 

Despite this head start, Catalonia has reached a clear conclusion: what they built, however impressive relative to neighbours, is not good enough. The architecture rests on messaging-based interoperability that transfers only around 20% of clinical information between different vendor systems - what Jordi calls "an agreement to the dumbest." 

The result is a system built on referrals rather than shared care, where patients move between professionals like a tennis ball, and where innovation developed in one hospital cannot be transferred to the next.

The response is an open platform built around a vendor-neutral Clinical Data Repository using openEHR and standard terminologies, with the shared EHR already migrated into it and new solutions being built natively on top. 

The next step is opening that platform to third-party developers - publishing interfaces, documentation, and support so that an ecosystem can build on citizen health data, governed by explicit security rules and citizen consent. 

Jordi closes with three direct pieces of advice for others facing the same choices: avoid big monolithic vendor systems that create lock-in and kill local ecosystems; do not mistake messaging interoperability for a destination; and be brave enough to take the harder path, because continuing with the status quo is the real risk.

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