Using the European Electronic Health Record Exchange Format (EEHRxF) from Primary Systems to Public Health Dashboards

The European Health Data Space (EHDS) is driving Europe toward a harmonized framework for the exchange and secondary use of health data. Within this framework, the European project xShare explores the potential of the European Electronic Health Record Exchange Format (EEHRxF) to support public health dashboards that draw data directly from primary systems. This paper presents three integrated pilot initiatives-conducted by Charité (Germany), Monasterio (Italy), and Sciensano (Belgium)-that have been developed in the context of the European Project xShare. These pilots illustrate how health data from categories prioritized under the EHDS Regulation can be reused to monitor key public health indicators, and how the adoption of a single standard format could enable near-real-time visualization of such data. The pilots address topics such as healthcare-associated infections, influence-like illnesses, antimicrobial resistance, and the impact of circadian rhythm disruption in critical care. Together, they illustrate the opportunities and challenges of implementing interoperable dashboards for evidence-based public health across Europe. Preliminary work highlights both the promise of EEHRxF for reducing administrative burden and improving timely data access, as well as the ongoing legal, ethical, and technical barriers that must be overcome.