The Swiss Health Data Space: Status, Progress, and Future Direction

Introduction

Switzerland has been discussing digital health and data interoperability for many years, but progress has often been slow and fragmented. Health information is distributed across cantonal systems, hospitals, private practices, laboratories, insurers and research institutions, with limited coordination between them. This fragmentation affects not only continuity of care but also the ability to conduct research, plan the health system, or monitor public health trends in a timely way.

Against this background, the Federal Council launched the national programme DigiSanté that created the project Swiss Health Data Space (SwissHDS). The goal is to develop a secure, interoperable, and decentralised infrastructure that will enable the exchange and responsible reuse of health data across Switzerland, and to reshape the country’s digital health landscape.

SwissHDS envisions building a decentralized “data-mesh” architecture, where data remain where they originate (e.g., hospitals, labs), but are found and queried via standardized interfaces and shared services. This will ensure that data ownership stays local, but the benefits of data sharing (care continuity, health-system efficiency, research) become broadly available. In addition, SwissHDS aims to simplify and harmonize administrative, billing, and regulatory processes across cantons; reduce duplication; and enable efficient secondary use (e.g., public health analysis, real-world data research) in a secure, governed environment.

Development timeline and early steps

The idea of SwissHDS is rooted in two longstanding issues. First, Switzerland lacks a unified national health information infrastructure. The cantonal structure of the healthcare system and the diversity of IT systems have resulted in poor standardisation. Second, previous national initiatives, such as the electronic patient record (EPR/EPD) or the Swiss Personalized Health Network (SPHN), progressed but in separate domains (clinical care and research) without creating a unified system.

The SwissHDS initiative intends to bridge these gaps by creating a common “data space” where different actors can contribute and access data under clear rules, without centralising the data themselves. In other words, the aim is to build a coordinated network based on interoperability standards, shared services, and strong governance.

SwissHDS formally started in 2025, but the foundational architecture study was completed between June and September 2024. According to its public page, the project duration is planned for 2025–2034.

In late 2025 key steps have already been taken. On 18 November 2025 the first meeting of the SwissHDS commission took place. The commission brings together 45 organisations from across the Swiss health sector (representing federal agencies, cantons, providers, insurers, and research) tasked with guiding the project roadmap, prioritizing services and pilot projects, and refining the vision for SwissHDS. At this meeting, the architecture vision and major strategic directions were presented and discussed, and a planning framework for 2026 was defined.

Accordingly, by late 2025 the project has moved from conceptual design to the “initialisation phase”, preparing key building blocks.

What is SwissHDS today — present status (late 2025)

• Governance structure started: The SwissHDS Commission has been formed and had its first session. This marks the official kick-off of strategic oversight, prioritization, and planning for pilot services and infrastructure rollout.
• Architecture and vision defined: The national architecture study is completed; the design follows a decentralized, federated “data-mesh” model.
• First technical service under preparation: In October 2025 the project announced work on the first base service: a national FHIR-based “terminology server.” This server will provide semantic interoperability, offering value sets, classification codes (e.g., SNOMED-CT), validation services and FHIR-standard operations. The timeline targets a Minimum Viable Product (MVP) by the second quarter of 2026.
• Engagement of stakeholders across the health ecosystem: Through DigiSanté, SwissHDS involves federal agencies, cantons, care providers, insurers, research institutions and vendors. A first public “roundtable” for primary system producers (e.g. hospital information system vendors, EPR vendors) will be announced in December 2025, indicating efforts to align stakeholders and prepare for technical integration.
• Connection with other national initiatives: SwissHDS builds upon or integrates with existing initiatives such as the Swiss Personalized Health Network (SPHN), which already has established national standards for research-grade data, secure processing environments, and data coordination for secondary use.

Architecture and operating principles

SwissHDS is designed as a federated, decentralised ecosystem. This means that hospitals, practices, laboratories, and other actors retain their own data, but make them findable and usable through a set of shared services and common standards.

Key elements include:

• A common Health Information Model that provides the structural and semantic framework for data exchange.
• Base services such as the terminology server, metadata catalogues, access control and authentication.
• A governance system defining responsibilities, compliance rules, security requirements and auditing.
• A “data mesh” approach: instead of moving all data into a national repository, SwissHDS connects existing data sources through standard interfaces, allowing authorised users to access or reuse data when permitted.

This model is intended to balance data protection, data control and usability, which is essential in a federal country where health responsibilities are shared between the Confederation and the cantons.

What still needs to happen

Beyond the purely technical steps, legal and regulatory alignment will likely proceed in parallel: legislation for a national electronic health record (EHR) is under revision, and the planned E-HR / EPD will be integrated into SwissHDS when implemented. Also, a new national entity, the National Data Coordination Office for Health (NDKS), is planned to act as data broker/trust center for secondary-use data exchange within SwissHDS. This office will handle data linkage, de-identification, and governance for research or other uses beyond direct care.

Relationship with existing Swiss data-infrastructure efforts (SPHN, E-HR/EPD, etc.)

It is worth mentioning that SwissHDS does not start from zero. It builds upon prior initiatives.

The Swiss Personalized Health Network (SPHN), launched in 2017, which has already built a national infrastructure for research-grade health data, developed interoperable standards under FAIR principles (Findable, Accessible, Interoperable, Reusable), and created a secure environment for data sharing and processing (BioMedIT). At end of 2024, the implementation phase was successfully completed; from 2025 to 2028 the SPHN Data Coordination Center (DCC) will continue as national infrastructure, supporting coordination of health data, interoperability, secure research, and prepare integration into the larger national data ecosystem.

The national Electronic Patient Record or EPR / E-HR is evolving under revised federal legislation to become more comprehensive and better integrated. The plan is that the future E-HR will rely on HL7 FHIR standards and will integrate with SwissHDS once implemented.

Thus SwissHDS aims to unify and extend data-sharing and data-governance efforts that previously were separate (clinical records, research databases, registries) into a coordinated Swiss-wide ecosystem.

What this means for patients, clinicians, researchers in Switzerland, and why it matters

The benefits of implementing such data infrastructure could be significant. Patients would benefit better continuity of care: regardless of canton or care provider, their health data would be more portable, accessible (subject to consent and access controls), and consistent. Health care providers would see improved interoperability, streamlined processes, better coordinated care, less duplication of tests, and more reliable data exchange, especially important for multi-provider, multi-canton care or referrals. Researchers and public-health authorities would gain access (via governed, secure mechanisms) to larger, more comprehensive, and harmonised datasets. This would support real-world evidence (RWE) studies, population health analyses, pharmacoepidemiology, health-system monitoring and innovation. For regulatory bodies, insurers, and health-system planners, SwissHDS could support better data-driven decision-making, quality monitoring, outcomes assessment, and system efficiency. Moreover, establishing SwissHDS now, at a time when regulatory and technical infrastructure is transforming globally (e.g., the EU’s EHDS), places

Switzerland in a good position to maintain competitiveness in research, innovation, and cross-border collaboration.

Parallelism and possible alignment with EHDS

Given that Switzerland is not in the EU, SwissHDS and the EU’s European Health Data Space (EHDS) are separate initiatives. However, there is a clear conceptual parallel: both aim to enable secure, interoperable health-data exchange for care and for secondary use across a broad data ecosystem, respecting privacy and trust.

By implementing the proposed architecture (e.g., data-mesh, standardised data model, interoperable interfaces, secure base services, governance) the SwissHDS internal structure could mirror key aspects of the EHDS. This legitimate the question whter in the future there will be the possibility that Switzerland could establish technical or legal bridges enabling partial alignment or data exchange with the EHDS ecosystem.

This similarity could ease any future bilateral agreements or interoperability arrangements and for research and RWE generation, once SwissHDS and comparable EU infrastructures will be operative, there could be opportunities for cross-border data collaborations (assuming legal and privacy agreements).

However, some important limitations remain: SwissHDS is built for Switzerland’s national context (cantonal health system, privacy laws, governance structures) and may diverge from EHDS in legal details, consent frameworks, data-protection regimes or national legislation. Thus, full “adherence” by Switzerland to EHDS would require additional agreements or adaptations. Nevertheless, the strategic alignment in architecture and principles suggests that SwissHDS could become in practice a Swiss “version” of the EHDS, possibly facilitating future compatibility or cooperation.

Challenges and open questions

Several challenges continue to shape the development of the SwissHDS. One major difficulty is the need to align a wide range of actors across cantons, hospitals, clinics, insurers, regulators and research institutions, each operating with different legacy systems, incentives and governance structures.

Another challenge concerns the legal and ethical foundations required for data protection, consent, data linkage, data governance and the secondary use of health information. Even when technical solutions are available, social acceptance and public trust remain essential conditions for progress.

There is also a concrete risk of uneven adoption. Some providers may advance quickly while others lag behind, creating new forms of fragmentation. Smaller providers may face particular difficulties if they lack the resources or incentives to connect. Added to this is the long implementation timeline: the full roll-out is planned only for 2034, which means that many of the expected benefits may take years to be felt.

Conclusion

The SwissHDS represents Switzerland’s bold attempt to build a national, federated, secure, interoperable health-data infrastructure that serves both patient care and secondary data use. With its formal launch in 2025, a governance structure, architecture vision, and first technical building blocks now in place, SwissHDS is transitioning from design to implementation.

Because it is built around international standards (e.g. FHIR), data-mesh architecture, and a comprehensive governance and service model, SwissHDS has the potential to offer functionality comparable to that of the EHDS, within Switzerland. This might enable future cooperation or data-exchange bridges with EU health-data initiatives.

However, realizing this potential will require sustained commitment from public authorities, stakeholders, providers and citizens, over many years. When completed, SwissHDS has the potential to become the backbone of a modern, data-driven Swiss healthcare system with strong research, innovation and patient-centered care.

Timelines and expected milestones

REFERENCES

DigiSanté – Swiss Health Data Space (SwissHDS). Federal Administration. https://www.digisante.admin.ch/de/swiss-health-dataspace-de

DigiSanté – Architecture Vision. https://www.digisante.admin.ch/de/architekturvision

DigiSanté – Launch of development of first base service (terminology server). https://www.digisante.admin.ch/de/start-entwicklung-basisdienstes

SwissHDS Commission – First meeting summary. https://www.digisante.admin.ch/de/kommission-swisshds

E-Health Suisse – Roundtable for primary system vendors. https://www.e-health-suisse.ch/it/novita/spazio-svizzero-dei-dati-sanitari-tavola-rotonda-per-i-produttori-di-sistemi-primari

SPHN Data Coordination Center (DCC). State Secretariat for Education, Research and Innovation (SERI). https://www.sbfi.admin.ch/en/sphn-data-coordination-center

E-Health Suisse – Electronic Patient Record – Current status. https://www.e-health-suisse.ch/it/coordinamento/cartella-informatizzata-del-paziente/situazione-attuale