The digitalization of healthcare in the Czech Republic and Slovakia is progressing, but it is hindered by complex system integration and fragmented projects. In the Czech Republic, a solution is already running in ten large hospitals, mostly university hospitals, where the sharing of health data across clinical systems is being tested. The EHDS is also entering the picture, aiming to help not only with cross-border care, but especially with local interoperability.
Integration in hospitals: from pilot to data sharing
In practice, hospitals encounter a multitude of different clinical applications—from the hospital information system to several laboratory solutions. Integrations are demanding, and without an integration platform, sharing data between departments or systems is cumbersome. An example is Fakultná nemocnica svätej Anny v Brne, where, after the pilot phase, the transition to production is underway, with the goal of introducing a unified integration layer for all key systems.
In Czechia, medical documentation is also shared within so-called affinity domains, that is, groups of providers clustered primarily geographically. This is not a single central exchange system, but rather multiple interconnected domains that enable secure and controlled sharing. Such a model lowers barriers to local innovation but requires strict discipline in standardizing formats and data semantics.
EHDS and standards: from primary to secondary data
The European Health Data Space (EHDS) targets two areas: the primary use of data in treatment and the secondary use for research or clinical trials. Cross-border access to information is intended to help in emergency situations, but the key benefit is support for domestic implementations and the harmonization of approaches. For systems to "understand" each other, format alone is not enough—semantics and the testability of entire scenarios are also needed.
Hence the emphasis on international standards and interoperability profiles, which enable joint testing by vendors and providers alike. The Czech side seeks to align with European developments and to change the data standards in use so that the market opens to a broader spectrum of solutions. If the standards can also be established at the national level, connecting hospitals, regions, and countries will become significantly simpler.
Slovakia versus Czechia: governance, priorities, and security
Slovakia was a pioneer in electronic prescribing and has also made progress in document exchange. In Czechia, the national e-health ecosystem is split among multiple administrators (for example, SÚKL, ÚZIS, and NCES), which complicates coordination and calls for reform. Clear prioritization and the smooth deployment of services—from citizen-visible ones (e-prescription) to clinical ones (document sharing)—with sufficient time for practice to adapt, are considered key.
Alongside interoperability, the importance of security and the use of artificial intelligence is growing. Healthcare professionals already use various tools, but the risks of data leaks and inaccurate outputs require firm rules and technical safeguards. Hospitals also face internal fragmentation: if they have three laboratory systems and multiple clinical applications, they must first consolidate data internally before they can share it externally in a meaningful way. It is precisely the linkage of integration platforms, unified standards, and security mechanisms that is a precondition for e-health to bring real benefits to both physicians and patients.
