Emerging digital health ecosystems

The vision of EHR environments, located within multiple adaptive digital health ecosystems, provided the foundation for this road map. Planning and implementing desired strategic directions and implementation strategy are described. This includes a list of top-down and bottom-up responsibilities. The current state and enabling environment is summarised to provide a foundation for future directions. Each of the many interdependent ecosystem components requires strong leadership, a commitment to collaborative cross-sectoral practices, and niche expertise. Key ecosystem architectural components to be standardised are open platform architecture, data types, terminology, concept representation and definitions, unique identifiers, and governance and domain information models. This may need a new coordinating standards body charged with the global responsibility to create a coherent set of health standards that will support a fully functional global digital health ecosystem. A successful digital health ecosystem needs to be built using a solid engineering methodology, compliant with scientific evidence, and underpinned by extensive implementation experience by a capable workforce.