Why does Epic keep losing European tenders?
Not on clinical capability, which is genuinely strong. On reimplementation cost.
Billing codes differ by country and are frequently the mechanism by which a hospital is funded at all. E-prescription runs on national infrastructure with its own connectors and certification. Mandatory reporting to national registries has country-specific formats and deadlines. None of that is configuration.
An American system therefore has to be reimplemented into each national regime, at a cost several European health systems have judged unaffordable against a vendor already built into it. Where Epic has won in Europe it has usually been at large academic centres with the budget to absorb that.
How do you choose between these?
By care setting and country first, because that eliminates most of the list immediately. Acute hospital care in the Netherlands points to ChipSoft; a Nordic region points to Cambio; long-term care points to Nedap; ambulatory practice in Germany points to CompuGroup.
Then by what the vendor is actually certified and connected to in your country. Being present in a market is not the same as being connected to its prescription infrastructure, and that difference is the implementation.
Only then by features, which in this category vary less between serious vendors than the national fit does.
What does the GDPR require for health data?
Health data is special category data under Article 9, which prohibits processing unless a specific condition applies — such as provision of health care under an obligation of professional secrecy. That is a stricter starting position than ordinary personal data.
Member states may add conditions, and many have: certified health data hosting in France, the Telematikinfrastruktur in Germany, national security requirements in Nordic regional procurement. A general-purpose cloud vendor cannot simply assert compliance; the hosting itself must meet a national certification.
The European Health Data Space adds a further layer around secondary use and cross-border exchange. This is a summary rather than legal advice.
