Healthcare Technology

The future of interoperability in Dutch healthcare

How open standards such as FHIR and HL7 are laying the foundation for an integrated healthcare landscape. An analysis of Wegiz, EHDS and the role of the CareHub ecosystem.

By Niels Roest 7 min read
The challenge

The fragmented healthcare landscape

Dutch healthcare ranks among the best in the world, but behind the scenes the sector is grappling with a fundamental problem: more than 1,000 different software systems that barely communicate with each other. From electronic client records (ECRs) and GP information systems to pharmacy software and imaging platforms – each system operates as a standalone island.

The consequences are felt at every level. Patients must share their medical history anew with each care provider. GPs have no visibility into medication prescribed by a specialist. Nurses manually enter the same data into multiple systems. This fragmentation leads not only to frustration, but also to medical risks: information that is not available in time can lead to incorrect diagnoses or unnecessary duplicate examinations.

The Nictiz Monitor Digital Care shows that 70% of healthcare organisations are actively seeking solutions for better data exchange. There is a growing recognition that interoperability – the ability of systems to seamlessly exchange and interpret data – is no longer a luxury, but an absolute necessity for future-proof care.

The question is no longer whether interoperability will come, but how we accelerate the transition to an integrated healthcare landscape. In this article, we analyse the legislative, technical and practical dimensions of this transformation.

70%

Seeking interoperability

Source: Nictiz e-health Monitor, 2024

1000+

Healthcare software systems

Source: Nictiz/VWS, 2024

40%

Time saved through integration

Source: CareHub case studies

Wegiz and EHDS: legislation as a catalyst

The government has recognised the urgency of interoperability and translated it into concrete legislation. The Wet elektronische gegevensuitwisseling in de zorg (Wegiz), adopted by the Dutch Senate, mandates care providers to exchange patient data electronically. This is a historic step: for the first time, digital data exchange is no longer voluntary, but legally required.

Wegiz: national mandate

Wegiz introduces phased requirements for electronic data exchange. The first tranche makes medication transfer and nursing handover mandatory in digital form. Subsequent tranches will extend this to laboratory results, imaging reports and referral letters. Software vendors must demonstrate that their systems comply with the stipulated interoperability standards.

EHDS: European framework

At the European level, the European Health Data Space (EHDS) creates a uniform framework for health data. This framework enables a Dutch patient who requires care in Germany or Spain to access their medical records. The EHDS additionally encourages the secondary use of anonymised data for research and policymaking.

IZA: ambitions for 2026

The Integraal Zorgakkoord (IZA) translates this legislation into concrete ambitions. The objective for 2026 is that all relevant care providers can exchange data digitally in accordance with established standards. This requires investment in infrastructure, training and cultural change within healthcare organisations.

This legislative triangle – Wegiz, EHDS and IZA – forms an unprecedented catalyst for standardisation. Healthcare organisations that invest in interoperable systems now are not only positioning themselves in compliance with the law, but are also building a competitive advantage that will prove crucial in the years ahead.

Technical standards

FHIR and HL7: the technical standards

Behind every successful data exchange in healthcare lie technical standards that determine how systems communicate with each other. Two standards form the backbone: HL7 and FHIR.

01

HL7: the established standard

HL7 (Health Level Seven) has been the international standard for exchanging medical messages for decades. The protocol defines how clinical and administrative data is structured and transmitted between systems. Much of the existing healthcare software in the Netherlands is built on HL7 v2 messages, providing a solid yet sometimes rigid foundation for data exchange.

02

FHIR: the modern API standard

FHIR (Fast Healthcare Interoperability Resources) is the successor that is revolutionising the healthcare sector. Unlike traditional message exchange, FHIR works with modern RESTful APIs – the same technology that powers applications such as iDEAL and DigiD. Data is structured in “resources” (e.g. Patient, Observation, MedicationRequest) that can be queried and shared in real time. This makes FHIR exceptionally well-suited for mobile applications, patient portals and integrations across different care domains.

03

NEN7510: security as a foundation

Interoperability without security is irresponsible. NEN7510 is the Dutch standard for information security in healthcare and forms the security foundation on which all data exchange rests. In combination with GDPR, NEN7510 ensures that patient data is not only integrated, but also exchanged securely. Every FHIR or HL7 implementation must comply with this security standard.

FHIR R4 as the Dutch standard

Nictiz has designated FHIR R4 as the standard for new health information exchanges in the Netherlands, with the aim of creating a uniform and future-proof digital healthcare landscape.

The role of the CareHub ecosystem

Legislation and standards create the framework, but the real transformation takes place in practice. This is where the CareHub ecosystem of PCD CareHub comes into play: a concrete answer to the interoperability challenge.

25 complementary companies

CareHub connects 25 complementary healthcare technology companies, each serving a specific part of the care chain. From ECR systems and scheduling software to medication safety and patient communication – all solutions are designed to work seamlessly together via open standards.

Open standards as a foundation

Within CareHub, interoperability is not an afterthought, but the architectural principle. All connected companies implement FHIR interfaces and HL7 connections, enabling data to flow in real time between systems without manual intervention or duplicate data entry.

What distinguishes CareHub from standalone integrations is the ecosystem approach. Instead of point-to-point connections – which grow exponentially in complexity – CareHub offers a shared integration layer. When a new healthtech company joins, it is immediately connected to all existing participants. This drastically reduces integration costs and shortens implementation time from months to weeks.

PCD CareHub selects and supports healthtech companies that demonstrably contribute to the interoperability ambition. By providing shared services in the areas of compliance, governance and technical architecture, PCD ensures that all ecosystem participants comply with Wegiz requirements, NEN7510 standards and FHIR specifications.

The result: interoperability that does not remain theoretical on whitepapers, but functions daily in the practice of healthcare organisations throughout the Netherlands.

What does this mean for healthcare organisations?

For healthcare organisations, interoperability translates into tangible benefits that improve both the quality of care and operational efficiency.

Concrete benefits of interoperability:

  • One patient overview: all relevant medical information available on a single screen, regardless of which source system holds the data. No more switching tabs or calling colleagues for missing information.
  • Less duplicate data entry: data recorded in one system is automatically available in connected systems. This saves professionals up to 40% of their administrative time.
  • Better care coordination: during handover moments – from hospital to GP, from mental healthcare to community team – information flows automatically. This prevents information loss and accelerates the care process.
  • Future-proof: by building on open standards such as FHIR, your organisation avoids vendor lock-in. New applications and modules can be added easily without disrupting the existing landscape.

The transition to interoperable systems is an investment that pays for itself. Organisations that act now not only benefit from operational efficiency, but also proactively comply with the Wegiz mandates that will come into effect in the coming years.

The CareHub ecosystem offers healthcare organisations a proven path to interoperability: not lengthy, high-risk migration programmes, but a modular approach in which existing systems are connected step by step via open standards.

Interoperability is the key to future-proof healthcare

The combination of legislation, open standards and the CareHub ecosystem is making integrated care in the Netherlands a reality. PCD CareHub builds the bridge between ambition and practice.

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