MyHealth@EU is the European digital infrastructure that enables the secure exchange of health data between Member States. Operational since 2019, it allows citizens to receive care in any EU country by making necessary clinical information available to authorized healthcare professionals, thereby fostering interoperability, continuity of care, and safe, integrated European mobility.
The free movement of people is one of the cornerstones of European integration. Every day, millions of citizens travel across the European Union for work, study, tourism, or simply to live in another Member State. While goods, capital, and people can now move across national borders with increasing ease, health data must inevitably follow the same path.
Over the past decades, Europe has built some of the most significant shared infrastructures in its history. The introduction of the euro created a common currency adopted by much of the Union; the GDPR established a harmonised framework for personal data protection; more recently, the European Digital Identity Wallet has laid the foundations for a digital identity recognised across the EU. Today, digital healthcare is taking another decisive step towards this shared vision through MyHealth@EU, the European infrastructure for the cross-border exchange of health data.
Operational since 2019, MyHealth@EU is the European Union's first digital infrastructure dedicated to the secure exchange of clinical information between Member States. Its objective is simple yet highly ambitious: to enable any European citizen to receive healthcare anywhere in the Union by allowing authorised healthcare professionals to access the clinical information they need, regardless of where that information was originally generated.
The first countries to join the initiative were genuine pioneers of European digital health, including Estonia, Portugal, Lithuania, Finland, the Czech Republic, and Croatia. Their early adoption made it possible to validate an interoperability model that is now gradually being extended across the European Union.
At present, participation in MyHealth@EU remains voluntary. Each Member State decides independently whether to join the infrastructure and which services to make available to its citizens. This landscape will change significantly with the entry into force of the European Health Data Space (EHDS), which will transform European health interoperability from an opportunity into a legal requirement. By March 2029, all Member States will be required to participate in the cross-border exchange of core health data according to common technical and organisational standards.
Today, the most widely deployed services focus on two essential documents: the Patient Summary and the ePrescription.
The Patient Summary provides healthcare professionals with a concise overview of a patient's essential clinical information—including allergies, medical conditions, current medications, and other data necessary to ensure safe treatment abroad.
The ePrescription, meanwhile, allows a prescription issued in one Member State to be dispensed in another participating country, removing many of the practical obstacles that European citizens have traditionally faced when requiring medication while travelling or staying abroad.
The European Health Data Space foresees a gradual expansion of the range of clinical documents available through the infrastructure. Laboratory reports, hospital discharge summaries, diagnostic images, radiology reports, and many other document types will progressively become part of the European ecosystem, making more comprehensive continuity of care possible and fostering genuine integration among national healthcare systems.
Behind this evolution lies not only a technological infrastructure but also a comprehensive framework of shared standards that enables healthcare information systems across Europe to "speak the same language." Within this framework, HL7 FHIR plays a central role as the common language for representing and exchanging clinical data, complemented by international clinical terminologies and shared semantic models.
The objective is not simply to transfer information from one system to another, but to ensure that the information is interpreted consistently by every organisation involved.
Interoperability, however, also depends on security and digital identity management. Before a healthcare professional can access a patient's clinical information, it must be possible to verify with certainty their identity, professional role, and authorisation level. Likewise, citizens must be able to identify themselves securely when requesting access to their health records or granting consent for their use.
In this context, the European Digital Identity Wallet is set to become a key enabler of cross-border digital healthcare. It is expected to become the primary European tool for digital identification, initially for citizens and progressively also for healthcare professionals.
The Wallet will allow users to prove their identity and present verifiable digital credentials in a standardised way throughout the European Union, strengthening security while making access to cross-border digital health services significantly simpler.
The potential applications of MyHealth@EU are considerable. Every year, millions of European citizens travel, work, study, or temporarily reside in another Member State. In all these situations, the need for healthcare may arise—often in emergency circumstances where immediate access to accurate clinical information can make a crucial difference to both patient safety and the quality of care.
It is therefore reasonable to expect that the volume of health data exchanged through the European infrastructure will continue to grow steadily over the coming years.
The impact of this transformation will extend well beyond public administrations and healthcare providers. The technological harmonisation introduced by the EHDS will also open up a much larger European market for companies developing digital health solutions. Today, many Electronic Health Record (EHR) systems are heavily tailored to the regulatory and organisational requirements of individual countries—or even individual regions. In the future, software vendors will increasingly be expected to develop platforms that comply with common European standards for interoperability, cybersecurity, and certification.
This means that an EHR system developed in one Member State will be able to reach other European markets far more easily, reducing market fragmentation and encouraging the emergence of truly European digital health solutions. Interoperability will no longer be simply a technical requirement; it will become a genuine competitive advantage for software companies developing solutions capable of operating seamlessly within a shared European digital ecosystem.
Lithuania’s experience: lessons learned from one of MyHealth@EU’s early adopters.
To conclude this article, we spoke with one of the Member States already operating within MyHealth@EU, Lithuania, to gain first-hand insights into the lessons learned and the challenges encountered during implementation.
Monika Būdvytienė, Senior Product Manager for Cross-Border Services, shared her experience. How long has Lithuania been operational within the MyHealth@EU infrastructure?
"Lithuania has been operational within MyHealth@EU since 2 May 2024. Since then, cross-border ePrescription and eDispensation services have been available through the Lithuanian National Contact Point for eHealth (NCPeH), which currently exchanges data with nine EU Member States.
Lithuania operates a centralised national digital health system connecting all healthcare providers across the country. At present, however, pharmacists access cross-border electronic prescriptions through the national eHealth portal rather than via direct integration with their local information systems.
As for the Patient Summary, deployment is planned for the fourth quarter of 2026. Initially, the service will be implemented using narrative-based documents before gradually evolving towards full compliance with the European Electronic Health Record Exchange Format (EEHRxF) and the HL7 FHIR standard."
Did you encounter any particular challenges during deployment or day-to-day operations?
"Yes. Both during implementation and during operational use, we encountered several challenges, although none had a significant impact on service continuity.
The first concerns the coexistence of different data models. Our national system already uses FHIR, whereas cross-border services were originally based on the CDA format. This required robust mechanisms for data transformation and validation.
A second challenge relates to semantic differences between Member States, particularly regarding medicines, packaging formats, and dispensing rules.
Finally, we observed an operational issue. Pharmacists access cross-border prescriptions through the national eHealth portal, where they can retrieve prescriptions issued abroad and dispense medicines to foreign citizens. In some cases, however, the dispensing process is not completed correctly within the system, meaning that the final 'dispense approved' event is not always recorded.
As a result, there is a noticeable discrepancy between the total number of cross-border prescription transactions and the number of dispensing operations successfully completed. This issue can be observed both from Lithuania's perspective as the issuing country and from that of the other Member States involved in the exchange."
What advice would you give to Member States, such as Italy, that are still preparing to implement MyHealth@EU?
"Based on Lithuania's experience, we would offer several practical recommendations. First, it is important to consider from the very beginning how the services will actually be used in daily clinical practice. For example, countries should decide whether to prioritise access through a national portal or develop direct integration with healthcare providers' information systems.
Second, it is essential to monitor not only technical performance indicators but also the quality of the overall operational process - for example, verifying that dispensing operations are completed correctly and that audit information remains consistent.
Finally, MyHealth@EU should be viewed as a long-term strategic infrastructure. It requires continuous investment, effective governance, and an ongoing commitment to technological evolution.