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Open contribution model

This architecture is developed as an open and transparent initiative. Cross-border interoperability requires alignment between many stakeholders across countries, disciplines, and organisations. By making all content publicly available and open to contribution, it enables broad participation and continuous improvement.

This architecture impacts a wide range of stakeholders—including clinicians, patients, policymakers, and technical experts—and therefore encourages contributions from all relevant perspectives. Openness supports trust, adoption, and alignment across the region.

Decision-making

At this stage, decisions are made by the maintainer, based on input from contributors.

As the initiative grows, governance is expected to evolve towards a more structured and representative governance model, involving regional stakeholders and organisations.

Constraints

The architecture operates within a number of important constraints:

  • Regulatory diversity: Different legal and policy frameworks across countries
  • Data sovereignty: Health data remains under national control
  • Heterogeneous IT landscapes: Varying levels of digital maturity and infrastructure
  • Resource limitations: Constraints in funding, capacity, and technical expertise
  • Digital inclusion: Need to support populations with varying levels of digital access and literacy
  • Trust and governance: Requirement for clear agreements on responsibilities, access, and data sharing
  • Diverse populations: Different languages and cultural backgrounds

Deliverables

The architecture will realise the following deliverables:

  • Architecture principles: This includes the descriptions, rationale and implications.

  • Reference Architecture: This includes the target architecture, definitions, building blocks, architecture decision records, and relevant initiatives.