Interoperability Isn't Failing — It's Underfunded (Herko Coomans)

35 views Aug 24, 2026 In-person video interviews"Interoperability isn't failing — it's underfunded." Herko Coomans on standards as public infrastructure.

Most interoperability conversations start with what's technically broken. This one starts by rejecting that framing. Herko Coomans argues that health data exchange is a wicked problem rather than an unsolved engineering task, that the real constraint is infrastructure funding and governance, and that the moment governments mandated standards, they took on a public accountability they haven't yet resourced. We cover the closing post-COVID funding window, what EHDS implementation actually looks like inside a country that has no national health data authority, why the EU started its data union with health, and where AI genuinely helps interoperability — and where it quietly doesn't.

GUEST

Herko Coomans — International Digital Health Coordinator, Ministry of Health, Welfare and Sport (VWS), the Netherlands; interoperability lead, Global Digital Health Partnership (GDHP)

Host: Tjaša Zajc

WHAT THE CONVERSATION COVERS

Why interoperability is a "wicked problem," not a failure — and why it was never all-or-nothing

Interoperability as an infrastructure funding crisis rather than a technical one

The closing post-pandemic window for digital health investment

Why healthcare executives are asking the ministry to be MORE directive on standards

What changes when standards become law: parliamentary questions about SNOMED CT and nursing terminology

Who funds SNOMED CT, HL7 FHIR and IHE for the next 20–50 years

The national FHIR profile problem: why a Dutch profile may not work in Germany

From product implementation to integration: national platforms as an emerging concept

GDHP explained: 44 countries, 40%+ of the world's population, no legal existence by design

The global stewardship gap after US and Argentine withdrawal from the WHO

The International Patient Summary in practice — Canada, Brazil, and QR-code patient summaries at the Hajj

EHDS implementation reality check: 2027, 2029, 2031 deadlines and national health data access bodies

Why the EU chose health as the first pillar of its data union — and what Brexit had to do with it

AI and interoperability: ambient scribes, ontology reasoning, and why a plausible SNOMED code isn't a correct one

The OECD's interoperability valuation: 2.7–6.6% of annual health expenditure

Shifting from project funding to sustainable public infrastructure funding for standards

CHAPTERS

00:00 Interoperability in 2026: what are we still not getting? 01:06 The pushback: a wicked problem, not a failure 05:50 Why interoperability is an infrastructure funding problem 10:25 Who owns integration? From product rollout to national platforms 16:32 When standards become law: parliament, nurses and SNOMED CT 19:01 National FHIR profiles and the interoperability they don't deliver 25:49 GDHP: 44 countries, 40% of the world, no legal existence 30:52 The Dutch chairmanship and the handover to Portugal 35:35 The International Patient Summary in Canada, Brazil and Mecca 39:52 EHDS reality check: European excitement, national scrambling 47:41 Why the EU started its data union with health 50:58 AI and interoperability: "not the magic, but the magician" 1:00:06 The OECD number: what interoperability is actually worth

MENTIONED

OECD, "Interoperability in healthcare: Towards an interconnected future" (Health Working Paper No. 197, July 2026)

International Patient Summary (IPS) — HL7 FHIR, CDA, ISO, SNOMED Global Patient Set, IHE

European Health Data Space (EHDS) • 21st Century Cures Act • My Health Record legislation (Australia) • Ayushman Bharat Digital Mission (India)

FACES OF DIGITAL HEALTH

Podcast: https://www.facesofdigitalhealth.com Newsletter: https://fodh.substack.com LinkedIn: / faces-of-digital-health Apple Podcasts: https://podcasts.apple.com/us/podcast...#interoperability #EHDS #digitalhealth #healthdata #FHIR #SNOMEDCT #healthp