Interoperability in EU healthcare cooperation

Ten Member States have joined the eHealth Digital Service Infrastructure (eHDSI), built on TESTA.

Published on: 24/03/2022

The Trans European Services for Telematics between Administrations (TESTA) is the data communication network service lying at the digital core of the EU4Health Programme, and interoperability is the key tool that makes it work.


In the wake of the COVID-19 crisis, in 2021 the EU institutions launched the EU4Health Programme (2021-2027) via Regulation (EU) 2021/522. Based on an investment of EUR 5.3 billion, EU4Health aims to tackle the health crisis through enhanced cooperation at EU level,  and is articulated in 4 general goals:

  1. Improving and fostering health in the European Union;
  2. Protecting people in the European Union from serious cross-border threats to health;
  3. Improving medicinal products, medical devices & crisis-relevant products;
  4. Strengthening health systems at national level.

As part of Goal no. 4, the eHealth Digital Service Infrastructure (eHDSI) - partially financed by EU4Health - has been set up in order to assist the Member States with the cross-border exchange of health data by providing national eHealth systems with the necessary IT infrastructure and essential services (e.g. semantic and technical interoperability) which in turn connect national eHealth IT ecosystems via the “National Contact Points for eHealth (NCPeH)”. Overall, the eHDSI is “an infrastructure ensuring the continuity of care for European citizens while they are travelling abroad in the EU”, and its secure, efficient and interoperable services are branded “MyHealth @ EU”. 

The main products built on top of eHDSI are the two electronic cross-border health services: 

  • ePrescription and eDispensation, which allows for the online transfer of European citizens’ electronic prescription from their country of residence where they are affiliated, to their country of travel;
  • Patient Summaries, which aims to provide doctors with all necessary information and medical records of European citizens regardless of the EU country of reference, while translating such records in the local language to avoid burdensome linguistic barriers.

Both the electronic cross-border health services have been deployed following the guidelines released by the EU voluntary network of national authorities eHealth Network (i.e. eHealth Network guidelines on ePrescription and eHealth Network guidelines on Patient Summary). At the moment, 10 Member States are part of this effort, namely: Czech Republic, Croatia, Estonia, Finland, France, Luxembourg, Malta, Portugal, Spain and The Netherlands. However, the European Commission expects to deploy MyHealth @ EU to 25 Member States by 2025.

It goes without saying, interoperability lies at the foundation of this project. In fact, the eHealth Digital Service Infrastructure works on top of an underlying communication service called TESTA. Standing for Trans European Services for Telematics between Administrations, the TESTA network service is a secured communication infrastructure “meant for sensitive pan-European information exchange between public authorities requiring guaranteed service levels for network availability, performance and/or security (confidentiality, integrity, authentication, availability)”. Born on the thrust of Member States as part of the IDA Programme in 1996, it is now supported by Interoperable Europe

Overall, TESTA facilitates cross-border and cross-sectoral cooperation between public administrations in various policy areas, ranging from judicial cooperation and fundamental rights to migration and internal market (being such cross-border exchanges of health data part of the latter). Managed and controlled by the European Commission’s Directorate-General for Informatics (DG DIGIT), TESTA creates interoperability through shared generic solutions and consolidates existing parallel networks by providing a secure, reliable and flexible building block. In this, it lowers complexity as regards setup, infrastructure and service management for the Member States.