EHRxF - European Electronic Health Exchange Format

Contributing Projects

Contributing Projects

Projects contributing to European EHRxF

Projects that have contributed, or are currently contributing, to the development of the European EHRxF and its implementation.

X-eHealth

During the European Commission’s innovation project X-eHealth, a framework was developed meant for (international) exchange of health data. This common framework covered medical imaging, discharge letters, laboratory results and rare diseases. Furthermore, the framework was used to facilitate data exchange between health entities across EU Member States and individual patients. This resulted into the European EHRxF which laid the foundation for future EU projects and further innovation.

> x-ehealth.eu

XpanDH

The XpanDH project supports an expanding ecosystem of individuals and organizations that are developing, experimenting and adopting the European EHRxF providing the next step in development of the EHDS. Resulting in the first collection of relevant artefacts and the creation of the X-Bubbles, X-Bundles and X-Nets to be used in further development.

> xpandh-project.iscte-iul.pt

xShare

xShare envisions everyone sharing their health data in European EHRxF with a click-of-a-button. The xShare Yellow Button to be featured across health portals and patient apps and allow people to exercise their data portability rights under GDPR. Hence, the European EHRxF will be the driver for research and innovation in EHDS.

> xshare-project.eu

Xt-EHR

Xt‑EHR is a pan‑European initiative, funded under the EU4Health Programme and coordinated by the National eHealth Authority of Cyprus, spanning from November 1, 2023 to April 30, 2026. With over 50 partners across 25 countries, Xt‑EHR aims to build the technical and operational foundation for the European Health Data Space (EHDS) by defining implementation guidelines, technical specifications, and a conformity assessment framework for EHR systems aligned with the future European Electronic Health Record Exchange Format (EEHRxF). One of the driving factors of Xt-EHR is its attention for stakeholder engagement and consultation. Through regular consultations, feedback sessions, and workshops, stakeholders including healthcare providers, policymakers, software developers, and patient representatives will have the opportunity to contribute their expertise and insights. This collaborative approach will foster a sense of ownership and commitment among stakeholders towards achieving the objectives of the EHDS proposal. 

Xt‑EHR thus plays a significant role in operationalizing the European EHRxF by enabling Member States and health IT providers to align national EHR systems with a harmonized, secure, and interoperable European Health Record exchange format. 

> xt-ehr.eu

TEHDAS2

As a successor to the TEHDAS project, Joint Action 10 (JA10) or TEHDAS2 kick off was in May 2024. TEHDAS2 aims to develop, in active cooperation, guidelines and technical specifications for common use for the implementation of the EHDS for the secondary use of health data. The main objective of the joint action is to prepare implementation of common measures, enabling the secondary use as proposed in the EHDS. Given the ambitions of xShare to extend the use of the European EHRxF to secondary use, at least for select additional settings, discussions around possible collaboration are underway to facilitate bridges from EHRxF to secondary use in existing and future categories of health data.

> tehdas.eu

i2X

The i2X project – which stands for “Intelligent” Implementation of the European Electronic Health Record Exchange Format (EEHRxF) – will, for the first time, connect electronic health record systems across Europe. 

Over the next four years, the initiative will launch 35 pilot projects in five key areas: e-prescriptions, lab and test results, patient summaries, medical imaging, and discharge reports. A total of 12 EU Member States – including the Netherlands, Belgium, Cyprus, Czechia, Finland, France, Germany, Greece, Ireland, Italy, Portugal, and Spain– will participate. Most will run pilot projects, some incorporating Artificial Intelligence-based technologies.

> i2X – Connecting EU Health Data

XiA

The XiA project builds on the solid foundation established by XpanDH, which pioneered scalable training solutions in healthcare interoperability. By leveraging the networks and resources developed during XpanDH, XiA focuses on broadening educational frameworks and delivering practical, real-world applications. The project’s goal is to develop and disseminate high-quality training materials and courses, empowering healthcare professionals, IT providers, and digital health solution developers with the skills needed to embrace EHDS-related standards and promote a culture of interoperability.

> XiA – Xpanding Innovative Alliance

Other relevant projects related to the EHDS and EEHRxF

Specifically for the EHDS and EEHRxF two demonstrator projects have been selected and are currently in the process of drawing up grant agreements with the European Commission: