We are sharing the details of the recently awarded Scientific paper, which proposes a governance model to unify and standardize clinical information in a decentralized healthcare system like ours, facilitating its use both in clinical practice and in public health.

Every time a healthcare professional treats a patient and records health information, they are making a decision that goes far beyond that specific consultation. Properly structured and standardized, this data can serve to improve that same patient's care in another service, feed public health studies, or, in the near future, participate in research projects on a European scale. The problem is that, in a healthcare system as decentralized as Spain's, ensuring that this information travels seamlessly across 17 autonomous communities and two autonomous cities is a massive organizational challenge.

To address this challenge, a multidisciplinary team from the Ministry of Health, the Servei Català de la Salut, the Health Service of the Principality of Asturias, and Veratech for Health has published the scientific paper «From Bedside to Population Health: A Federated Governance Framework for Clinical Information Models in the Spanish National Health System». The paper proposes a federated governance framework for clinical information models that aims to resolve a tension well known to any professional in the sector: how to preserve regional autonomy while simultaneously achieving true semantic interoperability at the national level.

The model proposed in the paper

The proposal does not seek to impose a single technology on all autonomous communities. It stems from a more realistic premise: that effective standardization requires consensus, not imposition. To achieve this, it proposes a two-tiered collaboration structure.

At the national level, the CMDIC Observatory is led by the Ministry of Health in collaboration with all autonomous communities. It establishes common methodologies and strategic priorities, and clinically validates models to ensure they reflect real-world medical practice.

At the regional level, each region adapts and manages these guidelines according to its own needs. The paper details the experience of Catalonia, which has a permanent clinical modeling unit consisting of a balanced team of five clinical professionals (medicine, nursing, and pharmacy) and five engineers. This structure translates the needs of professionals into formal structured languages, which have already been applied successfully in areas such as radiotherapy and intensive care.

From a technical standpoint,, the framework uses openEHR archetypes as a conceptual foundation for modeling clinical knowledge, but allows them to be flexibly implemented in other widely used standards in the sector, such as HL7 FHIR or ISO 13606, while also ensuring their linkage to reference terminologies like SNOMED CT and LOINC. It is precisely the kind of standards-agnostic approach that Veratech has been advocating for years. It is not about choosing a single standard, but about building a model that allows different standards to communicate with one another.

Why it matters now

The paper does not present a purely technical solution, but rather an organizational one. And that is what makes it relevant. It demonstrates that it is possible to collaboratively build a public digital infrastructure in a decentralized system, something that for years has been considered difficult or downright unfeasible.

The timing could not be more opportune. With the arrival of the European Health Data Space (EHDS), having standardized, high-quality clinical data at the point of origin will not only be a competitive advantage, but a necessary condition for Spanish healthcare information to circulate securely and comprehensibly across autonomous communities and between European Union countries.

This recognition honors more than a decade of joint work between the public administration, healthcare professionals, and specialized companies. And it serves as a reminder that healthcare interoperability is not a technical problem with a technical solution, but a governance issue that requires will, method, and collaboration.