Black Book Research: openEHR Adoption Accelerates with Focus on Data Sovereignty and AI-Usable Longitudinal Records

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According to the report, health systems are facing structural challenges beyond mere interoperability, such as 'digital sovereignty' and ensuring that data outlives the application lifecycle. There is a shift away from traditional EHR deployments toward platforms that treat long-term clinical data as durable infrastructure. OpenEHR is positioned as a foundational architecture capable of avoiding vendor lock-in in national or multi-provider environments. The report highlights a pragmatic division of labor: HL7 FHIR handles transactional exchange and network interoperability via APIs, while openEHR ensures the persistence of long-term clinical records with structured, semantically governed consistency. This 'both/and' approach allows applications to be replaced while the core meaning and consistency of the longitudinal record remain intact. The report cites examples from regions like the UK and Spain for large-scale openEHR implementation. Furthermore, growth is linked not just to interoperability but also to policy drivers such as 'data sovereignty' and initiatives like EHDS (European Health Data Space). This trend is visible in South America, where modernization efforts are centering on openEHR. Health systems increasingly require durable longitudinal records, semantic consistency across multi-provider networks, and composable applications. OpenEHR is thus evaluated as foundational for future-proof flexibility and vendor neutrality.