"No hope for AI - yet" - Jordi Piera Jimenez on interoperability and open platform

In 2017, the Catalan Health Service launched one of Europe’s most ambitious health digitalisation strategies. After two decades of building links between separate regional systems, Catalonia would move to a single common data layer, structured with openEHR, and place every application on top of it. The aim was data that is consistently structured, and therefore usable beyond the system that first recorded it. Jordi Piera Jiménez, now Director of the Digital Health Strategy Office at the Catalan Health Service, led the strategy. Nine years on, it is still being implemented, and he says he would write it exactly the same way today.

At the end of October, I moderated a fireside chat with Jordi at the Campus Clínic Innova Summit 2026 in Barcelona. We discussed the right approach to healthcare data in 2026, the state of interoperability in Europe and what AI changes. We also asked a more basic question: does the sector know what to do with its data at all, when so much of it is unreliable? According to HIMSS’s 2026 AI and digital transformation landscape report for North America, only 47% of leaders are confident their data is accurate, and only 21% say it is fully leveraged for clinical and operational decision-making.

HAT THE CONVERSATION COVERS • Who does what: openEHR, SNOMED CT, LOINC and HL7 FHIR • Why AI models don't transfer between hospitals: semantics, not only populations • Catalonia's infrastructure-first digital health strategy and the open platform in healthcare • The platform economy analogy: iOS and Android versus BlackBerry • Patient identifiers, patient matching and the longitudinal health record • EHR data quality: copy-paste clinical notes, 400–600 data silos, unused data • "Right data, right time": why more clinical data is not the goal • AI scribes, patient-generated data and parallel health records • The 17-year adoption gap in healthcare and pressure from the consumer market • Clinicians using LLMs as "Dr Google 2.0", answer consistency and guardrails for CIOs • Digital health training in medical and nursing education • Vibe-coded clinician apps, regulation and owning your digital infrastructure • The WHO/ITU reference architecture for digital public infrastructure for health • Vendor lock-in versus a common data layer: Norway, Sweden, Finland and Asklepios CHAPTERS 03:00 Back from Sydney: standards bodies find common ground 04:40 "No hope for AI yet": openEHR, SNOMED, LOINC and FHIR explained 06:45 Infrastructure first: Catalonia's strategy and the COVID algorithm that couldn't travel 08:10 The open platform in healthcare: lessons from iOS, Android and BlackBerry 10:55 Would the strategy change today? Data silos and patient identifiers 12:05 EHR data quality: copy-paste notes, 400–600 silos, unused data 15:30 Do clinicians need all the data? Right data, right time 17:05 AI scribes, patient-generated data and the 17-year adoption gap 20:10 LLMs as "Dr Google 2.0": consistency, risk and guardrails 22:25 Training clinicians for digital health 24:35 Vibe-coded apps, vendor lock-in and owning your infrastructure 27:35 The WHO/ITU reference architecture for digital public infrastructure for health 28:40 The North Star: Nordic regions, Asklepios and the platform economy FACES OF DIGITAL HEALTH Website: https://www.facesofdigitalhealth.com Newsletter: https://fodh.substack.com LinkedIn: https://www.linkedin.com/company/faces-of-digital-health Spotify: https://open.spotify.com/show/4cElKJHrauyP6QJQaCkvdY Apple Podcasts: https://podcasts.apple.com/gb/podcast/faces-of-digital-health/id1194284040 #openEHR #interoperability #HL7FHIR #SNOMEDCT #digitalhealth #healthdata #Catalonia #healthcareAI #vendorlockin #digitalpublicinfrastructure #FacesOfDigitalHealth