Black Book Market Research issues a global operational alert alongside the release of its 2026 "State of Global Healthcare Technology" report, a no-cost, nearly 700-page reference covering 147 countries and 70+ EHR/EMR/EPR, interoperability, cybersecurity, and healthcare IT vendors. The 2026 edition introduces a conflict-recovery supplement and a proposed framework for vendor coordination on continuity-of-care infrastructure.

LONDON, GB / ACCESS Newswire / December 29, 2025 / Black Book Market Research today announced a proposed 2026 framework for a Global Health System Connectivity Compact, calling on the EHR/EMR industry, interoperability and health data exchange providers, cybersecurity firms, and core healthcare infrastructure vendors to align around a shared humanitarian and clinical-safety objective: ensure that patient information can move safely across facilities during conflict and in the first critical months of recovery, without fragmentation, lock-in, or post-crisis commercial exploitation.

"Modern care depends on identity resolution, medication truth, imaging and lab continuity, and transaction-grade clinical handoffs," said Doug Brown, Founder of Black Book Market Research. "In conflict settings, those capabilities fail first. 2026 is a defining opportunity for global vendors to coordinate on a neutral, standards-based continuity layer: resilient patient matching, FHIR-enabled exchange, offline-first workflows, and cyber-hardened deployments, so hospitals can reconnect care safely regardless of platform. This is a humanitarian opportunity to build interoperability as patient safety infrastructure."

WHY A GLOBAL COMPACT IS NEEDED NOW: DIGITAL CONTINUITY IS CRITICAL HEALTH INFRASTRUCTURE

In war and post-war settings, healthcare IT is not primarily a modernization agenda. It is operational safety infrastructure. When clinical data continuity collapses, the consequences are immediate and measurable: misidentification, incomplete medication and allergy history, duplicated imaging, delayed referrals, interrupted follow-up for chronic disease, and avoidable harm during transfers between facilities.

Black Book's alert emphasizes that reconstruction windows can inadvertently create a second disruption if vendors pursue rapid, disconnected deployments that satisfy short-term procurement timelines but leave countries with incompatible systems, stranded data, and expensive bespoke integration. The Compact positions interoperability and cyber resilience as a shared public-good layer so hospitals can exchange essential information even when power is intermittent, connectivity is degraded, workforce capacity is constrained, and cyber threats rise.

"This is not the time for proprietary islands and integration toll roads," Brown added. "It is the time for vendor-to-vendor cooperation on open interfaces, tested exchange patterns, and resilient architectures that survive outages and attacks."

THE NINE CONFLICT-DRIVEN "HOSPITAL IT COLLAPSE ZONES" UNDERLINING THE COMPACT

Black Book's 2026 report identifies nine conflict-affected geographies where (1) there was meaningful pre-conflict health system capability and (2) current conditions have severely impaired hospital operations, staffing, and healthcare IT-limiting or preventing scalable EHR/EMR and interoperability deployment:

• Ukraine

• Occupied Palestinian Territory (especially Gaza and parts of the West Bank)

• Lebanon (conflict-affected border/southern areas)

• Sudan

• Yemen

• Syria

• Somalia and Ethiopia (conflict-affected, fragile regions)

• Myanmar

• Afghanistan

Across these settings, even where clinicians remain and care continues, hospitals frequently lose the digital continuity required for safe coordination and transfer of care.

THE COMMON FAILURE MODE: THE "FOUR-KNOCKOUT" PATTERN THAT TAKES HOSPITAL IT OFFLINE

Black Book observes a recurring four-part operational pattern that collapses hospital IT and prevents enterprise EHR/EMR and interoperability from taking hold:

• Power instability: outages, generator dependence, fuel scarcity, and unstable distribution undermining uptime for networks, imaging, labs, and medication systems.

• Connectivity disruption: intermittent internet, damaged infrastructure, constrained cellular coverage, and elevated cyber threats disrupting safe exchange and remote support.

• Workforce displacement: IT teams, clinical informaticists, trainers, and departmental champions displaced or unavailable-breaking implementation and stabilization cycles.

• Security and governance fragmentation: unsafe facilities, disrupted procurement, unpredictable access, and unclear data stewardship reducing the standardization and trust required for interoperable exchange.

Under these conditions, the immediate objective is not "digital transformation." It is continuity of care: minimum viable patient identity, medication and allergy history, trauma documentation, lab and imaging continuity, and safe data exchange.

THE GLOBAL HEALTH SYSTEM CONNECTIVITY COMPACT: A NEUTRAL, PUBLIC-GOOD CONTINUITY LAYER

A proposed Compact is a voluntary, neutral framework through which EHR/EMR vendors, interoperability platforms, cybersecurity firms, cloud and infrastructure providers, and implementation partners commit to shared technical and operational practices that enable safe continuity of care across facilities and across vendors during recovery.

The Compact is designed so competitors can still differentiate on workflow excellence, specialty capability, performance, and services while cooperating on the shared foundations that keep patient care coherent: identity, exchange, resilience, and security.

TEN FOUNDATIONAL COMMITMENTS FOR 2026 (TECHNICAL + OPERATIONAL)

1. Standards-first exchange by default
   Open, documented interfaces and practical exchange roadmaps for essential clinical summaries, referrals, and event notifications.

2. API-first interoperability infrastructure
   FHIR-based APIs, API management, and proven reference implementations that reduce bespoke integration.

3. Portable identity and minimum continuity datasets
   Patient matching plus a minimum dataset that can follow displaced populations across facilities and regions.

4. Offline-first and low-bandwidth operation
   Store-and-forward, local caching, sync-on-connect, and downtime-to-uptime reconciliation patterns.

5. Cyber-hardened deployment baselines
   Segmentation, privileged access controls, immutable backups, and routine restore testing embedded in every rollout.

6. Secure governance primitives
   Auditability, consent models where feasible, and clear data stewardship aligned to ministries and humanitarian coordination.

7. Humanitarian licensing and rapid provisioning
   Crisis-ready licensing models and rapid provisioning for verified facilities, ministries, and humanitarian partners.

8. Predictable interoperability pricing during recovery
   No surprise integration tolls that penalize hospitals for exchanging essential care data.

9. Shared enablement at scale
   Joint multilingual training libraries, super-user programs, and remote support to rebuild local capability.

10. Vendor-to-vendor integration exercises
    Routine connectathons and interoperability drills to validate real exchange under constrained conditions.

"2026 can be the year the industry treats interoperability as patient safety infrastructure, where the default is 'connect first' and the competitive edge is earned on usability, clinical performance, and services-not on trapping data," Brown said. "If global vendors align on a public-good continuity layer, they can materially reduce suffering, accelerate recovery, and help rebuild institutional trust, one safe clinical handoff at a time."

UKRAINE 2026: A NEAR-TERM OPPORTUNITY TO PROVE A NEW GLOBAL STANDARD

Black Book notes that Ukraine, because of its pre-war clinical depth and hospital infrastructure base, may become the most immediate large-scale test of whether the global healthcare IT industry can support rapid recovery responsibly and in coordination if conditions stabilize.

If stable access corridors and infrastructure restoration allow rebuilding at speed, Black Book is calling for a neutral Ukraine Health IT Restoration Compact aligned to the Global Connectivity Compact, prioritizing:

• continuity of care over platform competition

• interoperability over fragmentation

• resilience and cyber safety over speed-to-contract

• local capacity-building over long-term dependency

A PRACTICAL, PEOPLE-FIRST RESTORATION PLAYBOOK (WHEN CONDITIONS ALLOW)

Phase 1 - Stabilize (first 0-90 days of stable access)

• Readiness assessments: power, connectivity, cyber posture, device inventory, staffing

• Continuity Kits: resilient networking, endpoint security, downtime workflows, offline-first documentation, rapid-recovery backup patterns

• Data salvage support: patient indexes, medication catalogs, lab and imaging indexes

Phase 2 - Re-open digital operations (3-9 months)

• Restore core workflows: ED/trauma documentation, medication administration, labs, imaging access, discharge summaries

• Implement interoperability-first architecture: patient identity services, terminology, event notifications, secure referral and care summary exchange

Phase 3 - Scale and unify (9-18 months)

• Expand cross-facility referrals and specialty coordination

• Support longitudinal care (rehabilitation, behavioral health, chronic disease)

• Institutionalize cyber resilience: incident response runbooks, segmentation, immutable backups, restore testing

HOW US HOSPITAL BOARDS, EU HEALTH SYSTEMS, AND GLOBAL PHILANTHROPISTS CAN SUPPORT DIGITAL RECOVERY

Black Book urges hospital leaders, boards, foundations, and donors-especially in North America and Europe-to complement emergency aid with reconstruction-grade support that keeps hospitals functional now and prepares them for rapid digital restart when conditions allow.

High-impact support categories:

• Resilient power for care delivery and IT (generators, UPS, microgrid components, fuel logistics support)

• Connectivity and secure networking (routers, switching, secure Wi-Fi, backup connectivity, hardened network design)

• Cyber resilience (endpoint protection, identity and access support, backup/restore modernization, incident response assistance)

• Clinical continuity tooling (downtime workflows, offline registries, scan-to-structured abstraction, secure patient summary exchange)

• Workforce investment (clinical informatics training, nursing super-user programs, biomedical/IT technician rebuilding)

• Interoperability enablers (patient identity services, terminology services, API infrastructure, integration engineering capacity)

ABOUT BLACK BOOK MARKET RESEARCH

Black Book Market Research is an independent healthcare technology research and benchmarking organization. Its annual State of Global Healthcare Technology resource provides actionable insight into healthcare IT, EHR/EMR adoption, interoperability readiness, and vendor performance across 147 countries and 70+ suppliers. Industry stakeholders can register to download a complimentary preview edition at https://blackbookmarketresearch.com/2026-black-book-state-of-global-healthcare-technology

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Phone: 1-800-863-7590
Email: research@blackbookmarketresearch.com

SOURCE: Black Book Research