i2X: A Common Electronic Health Record Format for Better Health Across Europe

The i2X – Intelligent Implementations of the European Electronic Health Record Exchange Format (EEHRxF) project, funded by the Digital Europe Programme, officially kicked off on April 1st! Coordinated by Henrique Martins, former eHealth Network co-chair, and all UpHill Team, i2X is a flagship initiative that contributes to the goals of the Digital Europe Programme, aligns with the Single Digital Market strategy, and supports the ambitions of the Digital Decade 2030. 

At the heart of this initiative lies the European Electronic Health Record Exchange Format (EEHRxF) – also known as the X-Format – a key component of the recently approved European Health Data Space Regulation. This format is crucial both for the primary use of health data (supporting individual care) and for secondary use (policymaking, research, innovation). i2X will showcase how the “intelligent” implementation of the X-Format, supported by tailored IT solutions and positive user experiences among health professionals, can drive real change in European healthcare systems. 

The project’s core goal is to demonstrate sustainable, real-world adoption of the X-Format across all five data priority categories, through more than 35   live demonstrators in 14 healthcare settings across 10 EU Member States, with the involvement of 38 partners and a growing number of others that may join very soon. These in-service demonstrators will prove that the EEHRxF can enhance health and care pathways without placing an additional burden on health professionals or systems. The project will generate practical insights and best practices to help accelerate adoption of the Format across Europe and promote interoperability amongst healthcare organizations and systems. 

i2X is a hands-on implementation project, experimenting in real clinical environments to explore improved methods for capturing, exchanging, and using health data. By deploying advanced digital tools that ease the everyday work of health professionals, i2X will deliver evidence, policy recommendations, and technical guidance, while promoting alignment with EU standards and creating opportunities for other organizations to join as early adopters. 

The project also plays a key role in advancing open innovation policies and in the implementation of MyHealth@EU services. Building on the foundations laid by previous and parallel EU initiatives—such as Xt-EHR, XpanDH, and xShare—i2X will also actively seek synergies with another key project starting today: myHealth@myHands. 

i2X is deeply committed to improving experiences for both health professionals and patients, by optimizing workflows and integrating cutting-edge technologies. It supports industry preparedness, offering a safe and structured space for the X-Format adoption in clinical settings—primarily in public or publicly oriented institutions. By bringing together numerous digital health companies, the project also fosters innovation and inclusivity, amplifying the voices of all key stakeholders, especially the overstretched health workforce. 

As an ambitious, highly impactful initiative, i2X will tackle significant challenges, including interoperability gaps and resistance to digital transition. The project will focus on demonstrating real-world benefits for patients and citizens, improving system efficiency, reducing costs, and providing actionable recommendations for successful EEHRxF implementation. 

Over the next four years, 12 EU Member States—including Belgium, Cyprus, Czech Republic, Finland, France, Germany, Greece, Ireland, Italy, Portugal, and Spain—will participate. Most will develop demonstrators, with some integrating AI-based technologies. At least 1,200 healthcare professionals are expected to engage in demonstrator sites, and more than 3 million European citizens will benefit from the project’s activities.