Increasing proportions of patient data are held in sophisticated electronic health records. This can facilitate the communication of medical summary information within and across national borders when a patient needs urgent care. Large scale population health data can also be analysed to improve clinical outcomes and to accelerate clinical research.

The Connecting Europe Facility is funding an infrastructure and services to support cross-border information flows across Europe, including eHealth services for prescriptions and an unplanned care summary. Europe has also funded major multi-national projects to develop societally acceptable and scalable approaches to reusing health data for research. The EHR4CR project has established a trustworthy mechanism for remotely querying electronic health records to calculate the number of patients who match the eligibility criteria for a clinical trial protocol. The EMIF project has developed a platform and tools to enable researchers to remotely query multiple data sources for big data research.

Whether the technical approach is to centralise data in multiple connected hubs, or to federate access for distributed querying, Europe has found that the main challenges are the same. The most important is data protection: ensuring that the privacy of patients is always assured when the data are communicated or reused for non-care purposes. Clinical data quality must be improved, and EHR systems must be more interoperable through better adoption of standards. The approaches being taken to these challenges will be presented.