Black Book's 2026 international survey of 210 health executives highlights a regional push to replace legacy interoperability engines with open, future-proof data architectures.

BARCELONA, ES / ACCESS Newswire / October 14, 2025 / Black Book Research today released new findings from a 2026 Middle East and Africa Interoperability Options Survey, revealing that healthcare leaders in 18 countries are actively piloting or discussing openEHR architectures as sustainable alternatives to legacy middleware, interface engines, and proprietary interoperability tools.

The independent survey conducted in Q3 gathered insights from 210 health system, hospital, ministry, and agency executives responsible for digital transformation, national health data exchange, and population-health initiatives.

Interoperability at an Inflection Point

Across both regions, 72% of respondents strongly agree that described existing middleware and custom interface stacks as "structural barriers" to achieving longitudinal, AI-ready clinical data exchange.

By contrast, 30% reported that their organizations are actively studying or participating in openEHR-oriented initiatives, marking a decisive shift toward data-centric, vendor-neutral interoperability frameworks.

"Healthcare leaders in the Middle East and Africa are signaling readiness to move beyond patchwork integration and toward true semantic interoperability," said Doug Brown, President of Black Book Research. "Our survey findings show growing recognition that openEHR's model-driven architecture can help these regions leapfrog the limitations of legacy middleware."

Key Findings

openEHR Conversations Accelerating: Early pilots and feasibility reviews were reported as underway in Saudi Arabia, the UAE, Oman, and Jordan, while South Africa, Kenya, Nigeria, and Rwanda report exploratory projects embedded within national digital-health modernization agendas.

Vendor Neutrality Rising as a Strategic Priority: 68% of executives cited vendor lock-in as the main deterrent to expanding their current interoperability tools. openEHR's separation of data models from application code is viewed as a foundation for sustainable digital ecosystems.

AI and Data Reuse Demands: 79% of respondents identified the need for AI-ready longitudinal data as a top motivator to shift from rigid HL7/FHIR middleware layers toward semantically consistent, persistent openEHR repositories.

Data Sovereignty and Governance Alignment: 83% of African leaders cited data sovereignty and national control as primary factors driving their evaluation of openEHR architectures.

Incremental Modernization Appeal: openEHR's capacity to coexist with existing systems and interfaces enables a phased migration path, avoiding the high cost and disruption of full-system replacement.

Regional Dynamics

Middle East: Health authorities in the GCC, Jordan, and Egypt are evolving from interface-heavy exchange models toward open, archetype-based data layers that ensure semantic consistency and local language adaptability. National HIE and population health programs increasingly view openEHR as a neutral foundation beneath proprietary EHR platforms.

Africa" Sub-Saharan nations including Kenya, South Africa, Ghana, and Nigeria are evaluating openEHR as a clinical data backbone integrated with established public health and open-source platforms such as DHIS2 and OpenMRS. Respondents emphasized openEHR's value in building federated, longitudinal records capable of supporting analytics, chronic disease management, and universal health coverage initiatives.

Respondents identified several constraints: Limited expertise in archetype modeling and data governance; Procurement structures favoring turnkey vendor solutions' and Variable funding models for scaling pilots to production. However, many national informatics programs are now collaborating with the openEHR community to build regional capacity and knowledge-sharing networks in 2026-2027.

About Black Book Research

Black Book Research is the healthcare industry's most recognized source of impartial, crowdsourced insight on healthcare technology, services, and consulting performance worldwide. Since expanding its global health IT initiatives in 2021, Black Book has conducted research in over 110 countries, gathering verified responses from more than 200,000 healthcare executives, clinicians, and technology leaders each year. Black Book's proprietary survey methodology measures specific key performance indicators (KPIs) tailored to each vendor category, product segment, service line, and regional market to deliver the highest quality, statistically validated results in global healthcare IT benchmarking.

To maintain complete independence and credibility, Black Book charges no vendor participation or review fees, accepts no client-funded influence or sponsorships, and operates with no vendor advisory boards, associations, or vendor-endorsed reference client lists. Every respondent is independently verified, and full transparency is maintained across all survey instruments and published findings. This unwavering commitment to neutrality, rigor, and data integrity has established Black Book as the industry's trusted standard for global health IT satisfaction, adoption, and innovation metrics.

For more information or to access the Global openEHR Growth Opportunities series, visit www.blackbookmarketresearch.com

SOURCE: Black Book Research