New international rankings spotlight 30 urban health hubs across 57 countries eliminating medical data silos, optimizing electronic records, and setting the pace for cross-sector interoperability
NEW YORK CITY, NEW YORK / ACCESS Newswire / May 19, 2025 / A sixteen month global study by Black Book Research, drawing from more than 52,000 verified survey responses from health IT leaders, clinicians, and digital infrastructure administrators in 57 countries, has revealed the world's leading cities in achieving seamless health record exchange and EHR optimization. While a growing number of urban health systems are pushing forward with national digital transformation initiatives, only a small elite tier of cities have successfully eliminated clinical data silos and made real-time patient record interoperability a functional reality.
Based on global survey responses collected throughout calendar year 2024 and the first half of 2025, Black Book's new international rankings distinguish cities that have not only implemented advanced health IT platforms but have also ensured provider-to-provider EHR connectivity, enabled cross-sector data exchange, and embraced semantic standards like HL7 FHIR and SNOMED CT at scale.
Top 20 Global Cities (Non-U.S.) with the Highest EHR Interoperability Ratings
1. Tallinn, Estonia
Tallinn tops the global rankings due to Estonia's fully unified EHR environment, supported by the X-Road national data exchange platform and blockchain-secured patient records. Every provider across Estonia participates in the system, enabling real-time access and updating of health records across care settings. Black Book survey respondents gave Tallinn a 94% top-tier rating, with 91% citing the system's ability to eliminate data silos entirely.
2. Helsinki, Finland
Finland's Kanta Services platform enables every hospital, clinic, and pharmacy in Helsinki to retrieve and contribute to patient records instantly. The platform integrates social care data and offers full patient visibility across the continuum of care. 95% of surveyed Finnish users rated Kanta's accessibility and completeness as excellent, and 90% cited strong satisfaction with reduced duplication of tests.
3. Copenhagen, Denmark
Copenhagen leverages Sundhed.dk, a patient and provider portal integrated with MedCom's structured HL7v2 messaging standards. These allow universal access across all levels of care, including municipal services. 87% of Danish survey participants credited Copenhagen's infrastructure for enabling instant cross-sector health record exchange.
4. Stockholm, Sweden
With the NPÖ (National Patient Overview) platform, Stockholm providers access records from across Sweden in real time. High levels of compliance with semantic standards (SNOMED CT) and strong regional governance have enabled 84% of respondents to report broad interoperability beyond their organizations.
5. Oslo, Norway
Oslo's Core Journal and Helsenorge platform allow secure and universal access to medical records across hospitals, GPs, and emergency services. Black Book data show 92% satisfaction with cross-institutional EHR sharing, with over 80% of users citing improved care coordination as a result.
6. Vienna, Austria
Vienna's ELGA system (Elektronische Gesundheitsakte) enforces provider participation and connects hospitals, pharmacies, and clinics under a unified national system. 90% of survey respondents said patient records were accessible within 30 seconds, and 88% cited ELGA as a catalyst for improved discharge and follow-up processes.
7. Seoul, South Korea
Seoul demonstrates strong private sector EHR adoption, complemented by government efforts through the Health Information Highway and MyData program. 86% of users report successful data exchange between large hospital groups, and 81% predict Seoul will be among the first global megacities to achieve true universal interoperability.
8. Barcelona, Spain
Barcelona benefits from Catalonia's HC3 initiative, which integrates health, social, and mental health records region-wide. 88% of respondents in Catalonia use shared records daily, and 93% report seamless lab, imaging, and specialist data exchange.
9. Singapore, Singapore
The NEHR platform enables national-scale EHR integration, while HealthHub ensures patients and providers can view, update, and coordinate care records. 91% of survey respondents across Singapore confirmed end-to-end visibility across clinical settings, and 89% rated the city's privacy and security protocols as top-tier.
10. Tel Aviv, Israel
Israel's vertically integrated health maintenance organizations (HMOs), particularly Clalit and Maccabi, drive interoperability in Tel Aviv. 95% of Israeli respondents reported consistent access to full patient histories across institutions, and 90% credited real-time integration for improved chronic disease management.
11. London, UK
London leverages NHS Spine and OneLondon programs to unify patient data across hospitals, GPs, and mental health services. 86% of local users rated London's infrastructure as "effective or better," citing Spine's ability to support real-time medication and allergy histories.
12. Bristol, UK
Bristol's Connecting Care platform integrates NHS data with social and community care providers. 90% of respondents in the region confirmed cross-sector interoperability, especially in care transitions for vulnerable populations.
13. Sydney, Australia
Sydney's Local Health Districts have integrated their systems with the My Health Record platform, enabling provider access to a national repository. 77% of respondents in New South Wales reported routine access to external records, a dramatic improvement from just 39% in 2021.
14. Tokyo, Japan
Tokyo's interoperability is rapidly improving with national mandates for digital health IDs and government-funded Cloud Health Record pilots. 74% of respondents noted access to shared records within their provider network, with high expectations for broader interoperability by 2027.
15. Toronto, Canada
Toronto benefits from provincial systems such as OLIS and the Drug Information System. 81% of Ontario-based users reported high satisfaction with regional record sharing, and 78% cited digital viewers and APIs as key interoperability enablers.
16. Buenos Aires, Argentina
Through its city-wide Historia Clínica Electrónica, Buenos Aires has unified all public health institutions under one system. 88% of surveyed clinicians confirm seamless record access across hospitals and clinics, significantly improving chronic care workflows.
17. Riyadh, Saudi Arabia
The NPHIES platform enables real-time data exchange among Riyadh's hospitals and payers. 79% of respondents reported improved clinical documentation exchange, and 84% foresee full cross-sector participation by year-end 2025.
18. Abu Dhabi, UAE
Malaffi connects more than 500 facilities across Abu Dhabi. 87% of users indicated enhanced discharge and imaging coordination, and 91% said the system improved diagnostic accuracy.
19. Doha, Qatar
Doha's national Cerner deployment connects its entire public system, allowing shared patient summaries and lab access. 83% of respondents cited improved coordination across inpatient and outpatient settings.
20. Amsterdam, Netherlands
With LSP and MedMij driving national standards, Amsterdam has achieved secure record-sharing across pharmacies, hospitals, and GPs. 72% of Dutch users say interoperability is reliable and consistent, while 80% support the patient-access features of MedMij.
10 Global Cities with the Fastest EHR Implementation and Optimization Momentum
21. Berlin, Germany
Berlin's Gematik-led ePA rollout and FHIR adoption position the city for rapid convergence. 67% of respondents confirmed improved interoperability since 2023, particularly among public hospitals.
22. Paris, France
Paris has accelerated integration via the Mon Espace Santé platform, aligning hospital and pharmacy records. 71% of users in the capital reported increased use of standardized interfaces and shared documents.
23. São Paulo, Brazil
São Paulo's public hospital EHRs are rapidly integrating under the SUS program. 60% of providers noted expanded regional access and support for outpatient record exchange.
24. New Delhi, India
Under India's ABDM, New Delhi has become a hub for digital health ID issuance and EHR pilots. 58% of providers now participate in some form of shared data initiative, nearly doubling since 2022.
25. Bangkok, Thailand
Bangkok's Health Link project connects top hospitals and public health facilities. 71% of users cited better referral coordination and improved access to patient summaries.
26. Rome, Italy
Rome is benefiting from regional FSE enhancements and hospital system consolidation. 61% of users reported interoperability improvements in 2024, especially in public tertiary centers.
27. Shanghai, China
Shanghai is piloting regional cloud EHRs for public hospitals, and 64% of local users report functional record sharing within the same administrative health cluster.
28. Cape Town, South Africa
Cape Town's Western Cape HIE connects community clinics and hospitals. 51% of surveyed users report reliable access to shared care records in outpatient settings.
29. Kuala Lumpur, Malaysia
Kuala Lumpur hospitals using MyHIX pilot systems show growing adoption. 58% of respondents cited enhanced interoperability across major public facilities.
30. Mexico City, Mexico
Smart hospital initiatives and federal health IT mandates have improved EHR integration. 54% of Mexico City users report partial record exchange across major public hospitals.
About Black Book
Black Book Research conducted surveys from January 2024 through May 2025 across 57 countries. Respondents include clinicians, IT executives, digital transformation leaders, administrators, and government health officials. All data was collected independently without vendor or consultant sponsorship or influence. Visit www.blackbookmarketresearch.com for country reports, dashboards, and digital health performance benchmarks. The entire 2025 600 page resource directory "The 2025 Black Book of Global Healthcare Information Technology" is available for gratis download to industry stakeholders at https://blackbookmarketresearch.com/register-for-the-black-book-of-global-healthcare-it-2025-report . Published in December 2024, the landing page also includes a May 2025 update including 20 additional pages of up-to-date surveying and outcomes achieved in the first 4 months of 2025 globally.
Black Book Research Methodology and Statistical Confidence
To determine statistical significance and confidence levels in assessing the top-performing cities globally, Black Book narrowed the population to the world's 30 largest cities (by population and health system size) that currently operate functioning EHR ecosystems. Based on global healthcare market intelligence, these 30 urban regions collectively represent a universe of approximately 120,000 potential qualified EHR users in leadership roles. Reaching 52,000 respondents within this group yields a margin of error of less than 1.2% at a confidence level exceeding 99%, ensuring robust credibility for identifying cities with the highest satisfaction scores in interoperability, data accessibility, and record-sharing capabilities. All data was collected independently without vendor influence, promotional consideration, subscriptions,, or consultant sponsorship for IT vendor performance improvement. Visit www.blackbookmarketresearch.com for country reports, dashboards, and digital health performance benchmarks.
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SOURCE: Black Book Research
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