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Orchestration and Small World Governance in the European Health Data Space
Simon Lewerenz1, Henrique Martins1,2
1ISCTE - Instituto Universitário de Lisboa, Lisbon, Portugal.
Studies in Health Technology and Informatics
|May 23, 2026
Summary
The European Health Data Space (EHDS) uses a hybrid governance model, combining legal authority with networked coordination. This "orchestrated small world" aims to facilitate secure health data sharing across the EU.
Area of Science:
- Digital Health Governance
- Network Science in Policy
- European Health Policy
Background:
- The European Health Data Space (EHDS) establishes a legal framework for EU health data sharing.
- EHDS effectiveness relies on both regulatory control and inter-state/stakeholder coordination.
- Existing governance models may not fully capture the EHDS's hybrid nature.
Purpose of the Study:
- To interpret the EHDS governance through orchestration theory and network science.
- To propose the EHDS as an 'orchestrated small world' model.
- To offer a conceptual mapping for analyzing EU digital health governance using network concepts.
Main Methods:
- Conceptual-analytical approach.
- Application of network science concepts (clustering, path length, modularity, centrality).
- Mapping of EHDS governance bodies onto a multi-level network structure.
Main Results:
- The EHDS is conceptualized as a hybrid system blending legal authority with distributed agency.
- The European Commission acts as an orchestrator within a networked ecosystem, not a central hierarchy.
- Intermediaries are hypothesized to connect national/sectoral clusters, enhancing data diffusion and system resilience.
Conclusions:
- The EHDS governance can be effectively analyzed using network science principles.
- The 'orchestrated small world' model provides a novel lens for understanding EU digital health governance.
- Quantitative validation by the biomedical-informatics community is invited.
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