Q1-Q2 2026 European provider-user Black Book Research survey finds data valorisation, governed secondary use, cohort discovery, trial feasibility and RWE readiness now defining the next generation of hospital EHR/EPR leadership
COPENHAGEN, DK / ACCESS Newswire / May 21, 2026 / Black Book Research today released new European findings on the accelerating shift from electronic health record adoption to research-ready clinical data environments, identifying a new class of EHR/EPR and clinical data platform vendors enabling hospitals to support clinical trials, real-world evidence, registries, AI-enabled analytics and governed secondary use directly from routine care workflows.
Black Book's Q1-Q2 2026 European Data Valorisation Performance Index evaluated EHR/EPR performance across eight major European markets, based on responses from 662 healthcare IT leaders, clinical users, data leaders, governance executives and EHR/EPR stakeholders. The study found that Europe's leading hospital technology vendors are increasingly being judged not only on documentation, order entry and interoperability, but on whether they can make hospitals inherently ready for faster feasibility, intelligent patient identification, clinical-trial data connectivity and real-world evidence generation without adding avoidable burden to clinicians.
"Europe is moving beyond digital records," said Doug Brown, Black Book Founder. "The next benchmark is whether the clinical environment itself can become research-capable: capturing care once, governing data at source, identifying eligible patients intelligently and generating RWE-grade evidence without forcing clinicians into parallel research workflows."
A new European market reality: clinical research is becoming embedded infrastructure
Black Book's analysis finds that four forces are converging across Europe: the European Health Data Space, the Clinical Trials Regulation and CTIS, the EU AI Act, and the rapid scaling of federated real-world evidence networks. Together, these are forcing hospitals, sponsors, regulators, CROs and technology vendors to rethink the role of the EHR/EPR.
The EHR/EPR is no longer just the hospital system of record. It is becoming a clinical research data substrate: a governed, interoperable, longitudinal and privacy-controlled environment capable of supporting research operations, regulatory-grade evidence and AI-enabled clinical intelligence.
For clinical trial and RWE teams, this shift addresses a persistent European bottleneck: feasibility estimates that depend on manual investigator judgment, recruitment workflows that require chart review, fragmented patient journeys across care settings, inconsistent source-data quality, and slow, bespoke extracts for registries, safety studies and post-authorisation evidence.
Black Book's findings show that European buyers are now prioritising vendors that can deliver controlled openness: the ability to move data through standards, APIs and research workflows while preserving consent, auditability, provenance, privacy, local governance and hospital control.
Little-known Black Book findings from European EHR/EPR users
Black Book's 2026 study found that the strongest European EHR/EPR performers are separating themselves through data valorisation, not basic digitisation.
Key findings include:
Nearly seven hundred European EHR/EPR stakeholders were surveyed across eight major country markets.
Black Book used an 18-KPI, 100-point Data Valorisation Performance Index measuring clinical capture, documentation burden, interoperability, semantic normalisation, data quality, provenance, governance, privacy, analytics, research readiness, AI readiness and implementation accountability.
7 of 8 country-leading vendors scored above Black Book's 80-point "Data-Ready Performer" threshold.
132 respondents, or 19.9% of the survey panel, came from data, analytics, AI and research leadership roles.
Another 102 respondents, or 15.4%, represented privacy, security and governance leadership.
Source-data trustworthiness represented 38 of 100 DVPI points, confirming that clinical research readiness begins with capture quality, documentation usability, semantic consistency, provenance and data integrity.
Research cohort discovery, trial/RWE/registry support and analytics actionability represented 18 of 100 DVPI points, making research enablement a material EHR/EPR performance factor.
Interoperability and API openness represented 14 points, while privacy, consent, governance, de-identification, auditability and access control represented another 14 points.
In related Black Book EHDS readiness research, European leaders identified lack of interoperability, legacy infrastructure and data-quality variation as the largest practical barriers to secondary use at scale.
Black Book concludes that the European EHR/EPR market is now entering a new procurement phase: research-ready hospital infrastructure.
What clinical trial and RWE researchers need from hospitals now
Clinical trial sponsors, CROs, academic investigators, regulators and RWE teams increasingly need hospital systems that can support:
Faster feasibility
Hospitals must be able to query governed clinical data against computable inclusion and exclusion criteria, using structured diagnoses, medications, labs, procedures, observations, encounters, notes and longitudinal patient context.
Intelligent patient identification
Researchers need eligibility detection that works inside clinical operations without forcing clinicians into manual screening. The emerging requirement is consent-aware, explainable, workflow-sensitive patient identification.
RWE-grade source data
Real-world evidence teams require data lineage, provenance, terminology mapping, missingness profiles, timestamp integrity, deduplication, quality scoring and reproducible analytic outputs.
Federated and hospital-controlled secondary use
European hospitals need architectures that support local stewardship, auditable access, pseudonymisation, de-identification, opt-out enforcement and federated research models where analysis can move to the data.
Clinical-trials data connectivity
Trial operations increasingly require EHR/EPR connectivity to cohort discovery, CTMS, eSource, eCRF/EDC, registries, imaging, laboratory systems, safety reporting and common data models.
Burden-neutral workflow design
Clinical research data must be produced as a by-product of high-quality care, not through duplicate research documentation.
"The research community does not need another disconnected extract layer," said Brown. "It needs hospitals that are permanently data-ready, trial-ready and RWE-ready through the systems clinicians already use."
Top European vendors advancing the research-ready hospital model
Black Book's analysis highlights nine European EHR/EPR and clinical data platform vendors shaping this next phase of hospital data valorisation.
Tietoevry Lifecare / Lifecare Data Platform - Finland
Tietoevry led Black Book's European data valorisation results, with Finland emerging as the strongest example of an EHR-plus-data-platform model. Its position reflects the ability to consolidate fragmented clinical information into a governed foundation for operations, analytics, reporting, research and AI-enabled secondary use.
Clinical research value: population-scale data readiness, privacy-controlled analytics, pseudonymised research access, RWE enablement and governed secondary-use infrastructure.
System C CareFlow EPR - United Kingdom
System C led the UK market, with strong user scores for NHS workflow fit, patient flow, discharge coordination, integrated-care visibility and operational analytics. For clinical trial teams, this means research-relevant data can be generated from ordinary NHS workflows rather than separate study processes.
Clinical research value: pragmatic NHS trial readiness, patient-flow intelligence, pathway analytics, integrated-care data and recruitment operations support.
Systematic Columna CIS / Open Columna - Denmark
Systematic led Denmark, reflecting the importance of regional-scale continuity, hospital-municipality interoperability, open standards and cross-sector clinical data flow. This is especially important for RWE because patient journeys increasingly extend beyond acute hospital walls.
Clinical research value: cross-sector longitudinal evidence, registry support, care-pathway analytics and Nordic-scale interoperability.
Nervecentre - United Kingdom
Nervecentre represents the rise of real-time workflow data as a research asset. Its relevance lies in mobile-first clinical workflow, task management, escalation, deterioration visibility, patient flow and discharge coordination.
Clinical research value: workflow telemetry for pragmatic trials, operational RWE, real-time patient identification, deterioration signals and burden-neutral recruitment workflows.
ChipSoft HiX - Netherlands
ChipSoft led the Netherlands, reflecting deep Dutch hospital workflow alignment, EPD/PDMS integration, documentation quality, departmental data capture and cohort-readiness. Its strength is turning local clinical depth into structured and reusable hospital intelligence.
Clinical research value: Dutch hospital data consolidation, PDMS-integrated evidence, registry readiness, specialty data capture and local cohort discovery.
Cambio COSMIC - Sweden
Cambio led Sweden, with strengths in structured regional data, semantic consistency, clinical usability, open interfaces and research data accessibility. In region-led healthcare systems, these capabilities are essential for computable phenotypes, registries and RWE reproducibility.
Clinical research value: structured Nordic regional EHR data, open-interface strategy, governed reuse and scalable research data accessibility.
InterSystems TrakCare / HealthShare - France
InterSystems led France, standing out for interoperability execution, longitudinal data integration, identity management, governance, normalisation, consent-aware workflows, analytics feeds and cohort access.
Clinical research value: governed longitudinal data layers for fragmented environments, multi-system cohort discovery, secondary use, RWE and clinical-trials connectivity.
CompuGroup Medical / CGM - Germany
CGM led Germany, where care fragmentation, outpatient-hospital continuity and privacy-sensitive secondary use remain central challenges. CGM's relevance is strongest where patient journeys must be understood across ambulatory and inpatient settings.
Clinical research value: German longitudinal evidence generation, ambulatory-hospital linkage, registry support, privacy-aligned workflows and local market fit.
CGM SELENE - Spain
CGM SELENE led Spain, with strong performance in Spanish regional hospital workflow, inpatient clinical history, consultations, medication workflows, discharge data, reporting, registry support and cohort-discovery readiness.
Clinical research value: Spanish regional hospital trial readiness, high-volume clinical data capture, registry support, pathway evidence and feasibility acceleration.
Research readiness is now an EHR/EPR procurement category
Black Book concludes that Europe's next clinical research advantage will come from hospitals that are data-valorised by design.
The most advanced EHR/EPR environments will not simply store clinical information. They will make routine care data computable, governed, research-accessible, privacy-controlled and connected to clinical-trial and RWE workflows.
For sponsors, CROs and RWE organisations, Black Book expects site selection to increasingly factor in hospital data valorisation maturity, including interoperability, cohort discovery, consent-aware patient identification, real-world data quality, clinical-trials connectivity and evidence-generation capacity.
About Black Book Research
Black Book Research is an independent healthcare IT market research and public opinion research firm known for provider-user surveys, vendor performance measurement, healthcare technology rankings and data-driven market intelligence across global healthcare sectors. Media Contact: research@blackbookmarketresearch.com 1.800.863.7590 https://www.BlackBookMarketResearch.com
SOURCE: Black Book Research
View the original press release on ACCESS Newswire:
https://www.accessnewswire.com/newsroom/en/healthcare-and-pharmaceutical/european-ehr%2fepr-market-enters-research-ready-era-as-clinical-trials-1168561
