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Background Information for Action! is a Joint Action (JA-InfAct) on Health Information promoted by the EU Member States and funded by the European Commission within the Third EU Health Programme (2014–2020) to create and develop solid sustainable infrastructure on EU health information. The main objective of this the JA-InfAct is to build an EU health information system infrastructure and strengthen its core elements by a) establishing a sustainable research infrastructure to support population health and health system performance assessment, b) enhancing the European health information and knowledge bases, as well as health information research capacities to reduce health information inequalities, and c) supporting health information interoperability and innovative health information tools and data sources. Methods Following a federated analysis approach, JA-InfAct developed an ad hoc federated infrastructure based on distributing a well-defined process-mining analysis methodology to be deployed at each participating partners’ systems to reproduce the analysis and pool the aggregated results from the analyses. To overcome the legal interoperability issues on international data sharing, data linkage and management, partners (EU regions) participating in the case studies worked coordinately to query their real-world healthcare data sources complying with a common data model, executed the process-mining analysis pipeline on their premises, and shared the results enabling international comparison and the identification of best practices on stroke care. Results The ad hoc federated infrastructure was designed and built upon open source technologies, providing partners with the capacity to exploit their data and generate dashboards exploring the stroke care pathways. These dashboards can be shared among the participating partners or to a coordination hub without legal issues, enabling the comparative evaluation of the caregiving activities for acute stroke across regions. Nonetheless, the approach is not free of a number of challenges that have been solved, and new challenges that should be addressed in the eventual case of scaling up. For that eventual case, 12 recommendations considering the different layers of interoperability have been provided. Conclusion The proposed approach, when successfully deployed as a federated analysis infrastructure, such as the one developed within the JA-InfAct, can concisely tackle all levels of the interoperability requirements from organisational to technical interoperability, supported by the close collaboration of the partners participating in the study. Any proposal for extension, should require further thinking on how to deal with new challenges on interoperability.

The article describes the evolution of an innovative legal interoperability laboratory within the National School of Public Administration and Local Government in Athens, Greece. While critically analysing its general scope, objectives and structure, the knowledge management perspective of an interoperable legal informatics solution for handling big open legal data is brought into focus. In the context of the laboratory, the use of Legislation Editing Open Software (LEOS), a legal informatics tool that has been developed as a European Union ISA2 solution, is highlighted. Different aspects of and lessons learned from the training of public administrators are discussed while assessing this operations support system for potential use as a web-based authoring tool by the Hellenic public service. The evaluation of both the laboratory and the tool was conducted based on expert surveys, and possible upgrades are discussed to make the training of public administration more efficient.

This article describes some of the challenges raised by multinational operations for the application of international humanitarian law. Such challenges are the result of different levels of ratification of treaties, divergent interpretations of shared obligations, and the fact that there is no central authority that determines who is a party to an armed conflict. The article discusses methods that have been developed to ensure ‘legal interoperability’. Some of these methods attempt to avoid situations where such interoperability is required. Where this is not possible, a ‘maximalist’ or a ‘minimalist’ approach can be taken, and in practice these are usually combined.

This article briefly overviews some of the current and future challenges to NATO legal interoperability arising from the relationship between international humanitarian law (IHL) and international human rights law generally and between IHL and the European Convention on Human Rights in particular.

This paper discusses three main areas of controversy relating to detention in the context of multinational operations: the relationship between international humanitarian law and human rights law; the principle of legality in the context of relying on United Nations Security Council resolutions as a justification for taking detainees; and the transfer of detainees where there is, for example, a substantial risk of torture or cruel, inhuman or degrading treatment or punishment. The paper then considers how the Copenhagen Principles address these issues.

This article examines the Legal Entity Identifier (LEI) as a cornerstone of contemporary digitalised governance. Originally introduced in response to the 2008 financial crisis to address systemic opacity in financial markets, the LEI has since evolved into a global public-good infrastructure that enables interoperability, transparency, and accountability across jurisdictions and sectors. This study investigates the extent to which the LEI can be effectively implemented in Poland and the European Union, and what legal, institutional, and economic barriers constrain its universal adoption. The research employs a multi-method design, combining doctrinal and comparative analysis with empirical evidence from European supervisory projects (the EIOPA, ESMA, ECB, and EBA) and a Polish case study conducted under an NCN project on tax administration. Findings confirm that the LEI strengthens systemic risk monitoring, audit quality, and SME participation in global trade, but also reveal persistent barriers, including renewal costs, administrative burdens, and fragmented domestic identifiers. The analysis identifies four pillars of reform – universality, interoperability, continuity, and public co-financing – necessary to embed the LEI within governance systems. Comparative lessons from the United States and Japan demonstrate that statutory identifiers can extend beyond finance and support innovation while oversight is maintained. The article concludes that only by recognising the LEI as a structural component of digitalised governance can its transformative potential for transparent, resilient, and inclusive public administration be fully realised.

Psychiatric advance directives (PAD), also known as advance statements or advance choice documents, are legal documents that enable people with mental health conditions to specify their treatment preferences in advance for possible future crises. Subtypes of PADs include crisis cards, joint crisis plans, and self-binding directives (also known as Ulysses contracts). These instruments are intended to improve service user involvement and need orientation in the care of mental crises and to avoid traumatization through unwanted treatment. The existing evidence suggests that people who complete a PAD tend to work more cooperatively with their clinician and experience fewer involuntary hospital admissions. Nevertheless, PADs have not been successfully mainstreamed into care due to multiple barriers to the implementation of PADs, mainly around the completion of PADs and their accessibility and use in crises. The reasons for this include the lack of support in the completion process and acceptance problems, especially on the part of professionals. The research to date primarily recommends support for service users from facilitators, such as peer support workers, and training for all stakeholders. In this article, we argue that while these approaches can help to solve completion and acceptance challenges, they are not sufficient to ensure access to PADs in crises. To ensure accessibility, we propose digital PADs, which offer considerable potential for overcoming these aforementioned barriers. Embedded in national health data infrastructures, PADs could be completed and accessed by service users themselves, possibly with the support of facilitators, and retrieved by any clinic in an emergency. We highlight the strengths and limitations of digital PADs and point out that the proposed solutions must be developed collaboratively and take into account digital inequalities to be effective support for people with serious mental health conditions.

Operational health data interoperability in post-transition health systems requires not only technical standards but also enforceable governance arrangements. Affinity domains, as defined in the IHE XDS (Integrating the Healthcare Enterprise Cross-Enterprise Document Sharing) framework, represent a structured organizational-technical model for cross-enterprise document sharing. However, evidence from Central and Eastern Europe on their governance feasibility and implementation readiness remains limited, particularly in systems characterized by institutional fragmentation and evolving regulatory mandates. This study aimed to examine stakeholder perceptions of the prerequisites, risks, benefits, and governance conditions for implementing affinity domains in the Czech health care system. The study further sought to identify system-level readiness factors relevant to national interoperability initiatives in the context of the European Health Data Space regulation. We conducted 18 semistructured interviews between January 2025 and April 2025 with policymakers, regional health authorities, health care providers, health insurance funds, health IT vendors, and independent experts. Participants were selected using purposive and snowball sampling to ensure institutional diversity. Interviews explored governance roles, legal accountability for shared data, enforcement of standards, financing models, and technical readiness. Data were analyzed inductively using thematic analysis in MAXQDA 24 (VERBI Software GmbH), supported by dual coding, consensus discussions, and reflexive memoing. Inductively derived themes were subsequently interpreted against core governance dimensions of affinity domains (rule-making authority, membership and participation, accountability, enforcement, and trust). Five major thematic categories emerged: (1) ambiguous roles and responsibilities marked by fragmented mandates and vendor influence; (2) perceived risks, including institutional distrust, legal uncertainty regarding liability, technical fragmentation, and vendor lock-in; (3) system-level prerequisites such as the need for an empowered coordinating authority, binding interoperability standards (IHE XDS and HL7 FHIR [Health Level 7 Fast Healthcare Interoperability Resources]), sustainable financing, and human resource capacity; (4) perceived benefits, including improved continuity of care, reduced duplication, and enhanced transparency; and (5) structural implementation barriers including political discontinuity, weak enforcement mechanisms, and limited stakeholder engagement. Across stakeholder groups, feasibility was consistently linked to 3 actionable readiness conditions: clearly assigned responsibility and liability for shared data, enforceable technical requirements supported by certification or audit mechanisms rather than voluntary compliance, and financing models addressing both IT infrastructure and organizational change. Affinity domains are recognized as a viable interoperability model in the Czech Republic, but their implementation is constrained primarily by governance deficits rather than technical immaturity. Establishing an empowered coordinating authority, piloting enforceable domain structures, and aligning national governance with European Health Data Space requirements represent necessary steps toward operational interoperability. These findings provide empirically grounded insights into the governance conditions required for scalable health information exchange in post-transition health systems.

Overcoming legal and policy obstacles Ambitious international data-sharing initiatives have existed for years in fields such as genomics, earth science, and astronomy. But to realize the promise of widespread sharing of scientific data, intellectual property, data privacy, national security, and other legal and policy obstacles must be overcome ( 1 ). Although these issues have attracted much attention in some circles, they have often taken a back seat to addressing technical challenges. Yet failure to account for legal and policy issues at the outset of a large transborder data-sharing project can lead to undue resource expenditures and data-sharing structures that may offer fewer benefits than hoped. Drawing on our experience with the Belmont Forum, a multinational earth change–research program, we propose a framework to help plan data-sharing arrangements with a focus on early-stage decisions including options for legal interoperability.

This paper examines the legal framework and technical readiness for the deployment of autonomous train operation in the Slovak Republic. While the European Union has established a harmonised system of interoperability and safety supported by Technical Specifications for Interoperability (TSI), the Fourth Railway Package and the ATO over ETCS concept, national legislation in Slovakia remains largely oriented toward a traditional model of train operation with a dominant human role. The study identifies the key legal gaps that must be addressed, including the redefinition of responsibilities between drivers and automated systems, the adaptation of safety assessment procedures, and the introduction of cybersecurity requirements. The paper also analyses the current state of railway infrastructure in Slovakia, highlighting significant disparities between modernised core corridors and technologically outdated regional lines. The findings show that the successful introduction of autonomous trains will require comprehensive infrastructure upgrades, including full implementation of ETCS Level 2 or higher, the transition from GSM-R to FRMCS, and the modernisation of signalling and communication systems. The study concludes that autonomous train operation in Slovakia is feasible, but its implementation depends on coordinated legislative, technical and organisational development aligned with European standards.