35 views Aug 24, 2026 In-person video interviews"Interoperability isn't failing — it's underfunded." Herko Coomans on standards as public infrastructure.
Most interoperability conversations start with what's technically broken. This one starts by rejecting that framing. Herko Coomans argues that health data exchange is a wicked problem rather than an unsolved engineering task, that the real constraint is infrastructure funding and governance, and that the moment governments mandated standards, they took on a public accountability they haven't yet resourced. We cover the closing post-COVID funding window, what EHDS implementation actually looks like inside a country that has no national health data authority, why the EU started its data union with health, and where AI genuinely helps interoperability — and where it quietly doesn't.
GUEST
Herko Coomans — International Digital Health Coordinator, Ministry of Health, Welfare and Sport (VWS), the Netherlands; interoperability lead, Global Digital Health Partnership (GDHP)
Host: Tjaša Zajc
WHAT THE CONVERSATION COVERS
Why interoperability is a "wicked problem," not a failure — and why it was never all-or-nothing
Interoperability as an infrastructure funding crisis rather than a technical one
The closing post-pandemic window for digital health investment
Why healthcare executives are asking the ministry to be MORE directive on standards
What changes when standards become law: parliamentary questions about SNOMED CT and nursing terminology
Who funds SNOMED CT, HL7 FHIR and IHE for the next 20–50 years
The national FHIR profile problem: why a Dutch profile may not work in Germany
From product implementation to integration: national platforms as an emerging concept
GDHP explained: 44 countries, 40%+ of the world's population, no legal existence by design
The global stewardship gap after US and Argentine withdrawal from the WHO
The International Patient Summary in practice — Canada, Brazil, and QR-code patient summaries at the Hajj
EHDS implementation reality check: 2027, 2029, 2031 deadlines and national health data access bodies
Why the EU chose health as the first pillar of its data union — and what Brexit had to do with it
AI and interoperability: ambient scribes, ontology reasoning, and why a plausible SNOMED code isn't a correct one
The OECD's interoperability valuation: 2.7–6.6% of annual health expenditure
Shifting from project funding to sustainable public infrastructure funding for standards
CHAPTERS
00:00 Interoperability in 2026: what are we still not getting?
01:06 The pushback: a wicked problem, not a failure
05:50 Why interoperability is an infrastructure funding problem
10:25 Who owns integration? From product rollout to national platforms
16:32 When standards become law: parliament, nurses and SNOMED CT
19:01 National FHIR profiles and the interoperability they don't deliver
25:49 GDHP: 44 countries, 40% of the world, no legal existence
30:52 The Dutch chairmanship and the handover to Portugal
35:35 The International Patient Summary in Canada, Brazil and Mecca
39:52 EHDS reality check: European excitement, national scrambling
47:41 Why the EU started its data union with health
50:58 AI and interoperability: "not the magic, but the magician"
1:00:06 The OECD number: what interoperability is actually worth
MENTIONED
OECD, "Interoperability in healthcare: Towards an interconnected future" (Health Working Paper No. 197, July 2026)
International Patient Summary (IPS) — HL7 FHIR, CDA, ISO, SNOMED Global Patient Set, IHE
European Health Data Space (EHDS) • 21st Century Cures Act • My Health Record legislation (Australia) • Ayushman Bharat Digital Mission (India)
FACES OF DIGITAL HEALTH
Podcast: https://www.facesofdigitalhealth.com
Newsletter: https://fodh.substack.com
LinkedIn: / faces-of-digital-health
Apple Podcasts: https://podcasts.apple.com/us/podcast...#interoperability #EHDS #digitalhealth #healthdata #FHIR #SNOMEDCT #healthpolicy #healthIT #GDHP #healthcareAI #europeanhealthdataspace #InternationalPatientSummaryInteroperability Isn't Failing — It's Underfunded (Herko Coomans)
