Service-oriented interoperability: governance mechanisms for the hospital-administration connection in the era of digitalization

Abstract

The digital transformation of public administration and the healthcare system redefines the way institutions collaborate and share data in order to provide efficient and secure public services. In this context, interoperability becomes a strategic infrastructure of integrated digital governance, enabling inter-institutional coordination based on trust, shared responsibility and transparency. The article proposes a conceptual and methodological framework for understanding the governance mechanisms of interoperability between hospitals and public administration, with the aim of strengthening a service-oriented digital architecture. The study aims to analyze existing models and mechanisms of interoperability governance between public institutions and the health system through national and European case studies, while adapting a conceptual and operational governance framework based on co-governance, shared responsibility, and data ethics to support the implementation of integrated digital governance in the public sector. Methodologically, the research uses a comparative analysis of best practices at the national and European level, including: Romania, through the National Strategy on the Governmental Cloud and the integration of health systems with CNAS, Estonia, through the X-Road model, which ensures the interoperability and governance of digital transactions in health, and the European network MyHealth@EU, as an example of transnational co-governance of medical data exchange. The results highlight that service-oriented interoperability is not just a technological solution, but a process of collaborative governance, which strengthens trust between institutions, optimizes information flows and supports the sustainability of digital governance in public health. The conclusions offer development directions for strengthening the normative, ethical and operational framework of interoperability in the European public administration.