Why it matters
No single project can deliver European interoperability
European health data exchange requires more than a consortium. It depends on the clinicians who rely on health records, the vendors who build the systems, the standards communities that shape the format, and the health authorities that set the rules —most of whom sit outside any single project.
That is the purpose of the i2X Ecosystem: to be the open side of i2X. It provides a structured way to bring all stakeholders in the European Electronic Health Record Exchange Format into the same conversation, and to make sure engagement aligns with the technical and implementation work, not running in parallel to it.
Outreach
Reaching the right people
The first step is visibility. Outreach makes sure that the organisations which will shape —or be shaped by— the EEHRxF know about the work, understand its relevance, and have a clear path to engage.
Concertation
Dialogue with purpose
Awareness is not enough on its own. Concertation is where stakeholders, including those from connected projects, bring expectations and constraints to the table. It is where i2X listens, tests its assumptions and adjusts course.
Who can get involved
Three roles. One conversation.
The ecosystem is shaped by three groups whose perspectives are equally essential. Participation is open; follow the path that fits your role.
Healthcare providers & professionals
Bring clinical reality into the work
Clinicians, hospital teams and primary care organisations understand what a healthcare record needs to do in practice. Your operational experience helps us determine whether an interoperability solution will actually succeed in real-world settings.
What you get
- A seat in workshops and co-creation sessions
- Hands-on time with services in real clinical workflows
- Direct connection to the Healthcare Providers SIG
- Early visibility on findings from demonstration sites
Industry & technology providers
Test, align and get ahead of the curve
EHR vendors, digital health companies, and system integrators working toward EEHRxF and EHDS readiness. A space to validate your approach, compare notes with peers, and help shape the technical guidance you will be expected to follow.
What you get
- A place at testing events and online sessions
- Practical implementation guidance and shared profiles
- Membership in the Industry SIG
- Access to the Integrated Technical Team (IT2)
Policy, standards & EU initiatives
Anchor decisions in real evidence
National authorities, regulators, EU bodies, standards communities, and related EU-funded projects. The ecosystem channels live implementation experience directly to the people writing the rules and shaping the standards.
What you get
- Joint sessions with related EU initiatives
- Dialogue with the External Advisory Board
- Evidence to inform EHDS and EEHRxF policy
- A direct line into the i2X-FORMAT roadmap
What we do together
Where the ecosystem meets
Engagement is built around three standing structures — two Special Interest Groups and one technical team — that sustain the long-term conversation, plus a series of recurring activities where that conversation takes shape.
Standing structures
SIG · Industry
Industry SIG
For EHR vendors, integrators & digital health companies
The industry's standing forum for alignment on the EEHRxF. A space to surface implementation challenges and help shape the technical guidance that will affect every vendor in the market. Open to participants beyond the consortium.
CadenceQuarterly
Open toIndustry & vendors
SIG · Healthcare Providers
Healthcare Providers SIG
For clinicians, hospitals & care organisations
The standing forum for the clinical perspective. Hospitals and care organisations bring operational reality into the project — what works in practice, what does not, and what adoption really looks like. Open to participants beyond the consortium.
CadenceQuarterly
Open toClinical organisations
IT2 · Integrated Technical Team
Integrated Technical Team
For developers & technical leads
The technical engine room. The IT2 is where day-to-day implementation work happens — profiles, conformance, testing — and where developers from inside and outside the consortium collaborate directly on engineering.
CadenceOngoing
Open toTechnical leads & developers
Recurring engagement
Testing: Plugathons & Projectathons
A continuous testing programme for systems in progress. It spans IHE testing events, dedicated initiatives such as the i2Xathon linked to Hospitals on FHIR, and online sessions held between major events — so progress does not stall between conferences.
Cross-initiative collaboration
The EEHRxF evolves within a wider European effort. i2X works in concert with related EU initiatives and standards communities so that implementation experience flows both directions — outward to the wider ecosystem and back into the project.
Conferences, thematic sessions & workshops
Open events to connect, learn and contribute: conferences that bring together the wider ecosystem, focused sessions on the priority areas, and hands-on co-creation workshops where stakeholders work alongside the project teams.
How to join
Getting started takes three steps
1
Register your interest for the SIG that matches your role.
2
We confirm your registration by email and add you to the relevant mailing list.
3
You receive updates on upcoming meetings, testing events and collaboration opportunities.
Get involved
Three ways to engage with i2X
Each pathway maps to one of i2X's standing structures. Choose the one that fits your role.
For clinicians & care organisations
Join the Healthcare Providers SIG
Bring the clinical perspective into the room. Help validate use cases, shape workflows that fit real practice, and tackle shared challenges with peers across Europe.
Express interest→
For vendors, integrators & developers
Join the Industry SIG or the IT2
Two entry points for industry: the Industry SIG for strategic alignment and peer exchange; the Integrated Technical Team (IT2) for hands-on engineering. Both are open beyond the consortium.
Register interest→
For policymakers & related initiatives
Connect your programme
National authorities, EU bodies and related projects — link your work to the implementation network and feed live evidence into the i2X-FORMAT roadmap.
Get in touch→
How engagement is structured
The i2X-PHASES framework
Engagement unfolds across four phases: from mapping the landscape and working with it, to learning from real implementations and feeding that learning back into policy. The phases overlap: they describe a way of working, not a calendar.
01Phase
Phase 1
Contextualisation & ecosystem alignment
Before anything else, we map the ground. Who matters in each country, which organisations are already working on adjacent problems, where the gaps and dependencies lie. Without this picture, engagement is guesswork.
- Mapping the digital health ecosystem
- Identifying the right stakeholders
- Understanding local, national and EU context
02Phase
Phase 2
Engagement & co-creation
Mapping shifts into dialogue. Stakeholders join workshops, consultations, and co-creation sessions, to help shape the project's approach to readiness and implementation — including the methodology behind the EEHRxF Readiness Model.
- Workshops and consultations
- Co-creation around readiness and implementation
- Early feedback on emerging approaches
03Phase
Phase 3
In-service demonstration & cross-initiative collaboration
Specifications meet reality. Services run in live environments, stakeholders interact with them, and interoperability claims are tested in practice. In parallel, the work is aligned with related European initiatives and standards communities, so what i2X builds does not develop in isolation.
- Demonstrating services and use cases
- Validating interoperability in real settings
- Aligning with EU initiatives and standards bodies
04Phase
Phase 4
Perceptions, validation & scaling
Closing the loop. We gather perceptions, measure acceptance, and identify early signals about what is ready to scale beyond pilot sites, and what still needs work — so the lessons feed directly into policy and future practice.
- Capturing stakeholder perceptions
- Measuring real-world acceptance
- Surfacing signals for scaling and policy
The four phases feed the i2X-FORMAT roadmap — an evolving picture of how the EEHRxF can work across very different contexts, shaped by what stakeholders actually tell us.
