Modernising public health surveillance in an EHDS-enabled Europe: building a coordinated European public health intelligence ecosystem
- 1Global Digital Health and International Affairs Unit, SPMS - Shared Services of the Ministry of Health, E. P. E.
Abstract
Background: Public health surveillance in Europe is facing increasingly complex cross-border threats. Although digital health investments and EU-level initiatives have expanded the amount of health data available for surveillance purposes, the generation of timely and actionable public health intelligence remains constrained by disease-specific reporting systems and systemic technical and governance barriers. The European Health Data Space (EHDS) Regulation provides a new opportunity for the use and exchange of routinely electronic health data to improve public health surveillance and emergency preparedness, but its effective contribution remains insufficiently explored.
Objective: Through a scoping literature review and regulatory analysis, this study examines the role of the EHDS in strengthening public health surveillance and emergency preparedness in Europe.
Methods: This review followed the PRISMA-ScR guidelines. Multiple bibliographic databases were searched for studies published between 2016 and 2026, complemented by an analysis of grey regulatory literature. Eligible studies included publications addressing the EHDS or secondary use of health data and public health surveillance or emergency preparedness.
Results: The scoping review included 35 scientific studies and six grey literature documents. Our findings suggest that health system digitalisation, Electronic Health Records (EHR) implementation and the COVID-19 pandemic have reshaped surveillance and preparedness needs in Europe, which remain limited by fragmented infrastructures, distributed health data, limited interoperability, and unclear legal and governance mechanisms. Our regulatory analysis indicates that the EHDS could help address several of these challenges by establishing common governance rules, secure processing conditions, and federated access mechanisms. We further propose a conceptual European public health intelligence ecosystem, positioning the EHDS as an enabling layer for converting distributed health data into actionable intelligence. Three non-exclusive governance options illustrate how this model could be operationalised across national and European levels.
Conclusions: This study establishes the EHDS as an important enabling framework for modernising public health surveillance in Europe. The conceptual framework proposed in this study establishes a foundation for future research on the development of an EHDS-enabled European public health intelligence ecosystem to strengthen surveillance, preparedness, and coordinated emergency response. Future EU initiatives and implementation pilots will be essential to test, validate, and translate this vision into practice.
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BibTeX
@article{ferreirapinto2026modernising,
title = {{Modernising public health surveillance in an EHDS-enabled Europe: building a coordinated European public health intelligence ecosystem}},
author = {Miguel Ferreira-Pinto and Nuno P. Silva and Sara Silva Marques and Nuno Cruz and Eva Gouveia Anjo and Cátia S. Pinto},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1974886},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1974886/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Modernising public health surveillance in an EHDS-enabled Europe: building a coordinated European public health intelligence ecosystem
AU - Miguel Ferreira-Pinto
AU - Nuno P. Silva
AU - Sara Silva Marques
AU - Nuno Cruz
AU - Eva Gouveia Anjo
AU - Cátia S. Pinto
PY - 2026
DA - 2026/10/19
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1974886
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1974886/full
AB - Background: Public health surveillance in Europe is facing increasingly complex cross-border threats. Although digital health investments and EU-level initiatives have expanded the amount of health data available for surveillance purposes, the generation of timely and actionable public health intelligence remains constrained by disease-specific reporting systems and systemic technical and governance barriers. The European Health Data Space (EHDS) Regulation provides a new opportunity for the use and exchange of routinely electronic health data to improve public health surveillance and emergency preparedness, but its effective contribution remains insufficiently explored. Objective: Through a scoping literature review and regulatory analysis, this study examines the role of the EHDS in strengthening public health surveillance and emergency preparedness in Europe. Methods: This review followed the PRISMA-ScR guidelines. Multiple bibliographic databases were searched for studies published between 2016 and 2026, complemented by an analysis of grey regulatory literature. Eligible studies included publications addressing the EHDS or secondary use of health data and public health surveillance or emergency preparedness. Results: The scoping review included 35 scientific studies and six grey literature documents. Our findings suggest that health system digitalisation, Electronic Health Records (EHR) implementation and the COVID-19 pandemic have reshaped surveillance and preparedness needs in Europe, which remain limited by fragmented infrastructures, distributed health data, limited interoperability, and unclear legal and governance mechanisms. Our regulatory analysis indicates that the EHDS could help address several of these challenges by establishing common governance rules, secure processing conditions, and federated access mechanisms. We further propose a conceptual European public health intelligence ecosystem, positioning the EHDS as an enabling layer for converting distributed health data into actionable intelligence. Three non-exclusive governance options illustrate how this model could be operationalised across national and European levels. Conclusions: This study establishes the EHDS as an important enabling framework for modernising public health surveillance in Europe. The conceptual framework proposed in this study establishes a foundation for future research on the development of an EHDS-enabled European public health intelligence ecosystem to strengthen surveillance, preparedness, and coordinated emergency response. Future EU initiatives and implementation pilots will be essential to test, validate, and translate this vision into practice.
SN - 2296-2565
ER -