Survey of 21,555 verified hospital and health system software users outside the U.S. identifies 2026's highest-velocity markets for EHR/EMR modernization, revenue cycle automation, interoperability tooling, analytics, RIS/LIS, patient engagement, and applied AI

LONDON, UK / ACCESS Newswire / December 30, 2025 / Black Book Market Research today released results from the 2026 Black Book Global Healthcare IT Survey (International), reflecting feedback from 21,555 verified hospital and health system software users across 147 non-U.S. countries. Findings show that the fastest health-IT adoption in 2026 is concentrated in countries where modernization is being accelerated by government mandates, national claims-exchange infrastructure, and interoperability compliance requirements, turning platform upgrades into immediate operational and financial imperatives.

Across the highest-velocity countries, 84% of respondents report that health systems are no longer digitizing one department at a time. Instead, they are standardizing end-to-end platform architectures that combine: EHR/EMR as the clinical system-of-record; API/FHIR integration layers; identity and consent services; analytics; revenue cycle automation (where applicable); RIS/LIS connectivity; omnichannel patient communications; and governed AI deployed directly inside clinical workflows.

"Internationally, 2026 is the breakout year where interoperability and connectivity become procurement gatekeepers," said Doug Brown, Founder of Black Book Market Research. "Where policy and payer rails are mature, adoption accelerates and AI shifts from pilots to production embedded inside real workflows."

Global 2026 Highlights

• EHR/EMR modernization is accelerating: 65% of surveyed hospitals in the fastest-adopting countries report active EHR replacement or expansion in 2026, versus 13% in slower-adopting markets.

• Interoperability is now the "price of entry": 92% say FHIR/API interoperability is a top-three procurement requirement for new platform decisions.

• Clinical AI is moving into production:18% report AI in production in at least one workflow (e.g., imaging triage, documentation support, operational optimization), up from 11% in 2025.

• RIS/LIS and diagnostics are becoming tightly integrated: 69% report RIS/PACS modernization or structured-reporting integration tied directly to EHR workflows.

• Patient engagement is becoming core operational infrastructure: 66% report deployment of omnichannel patient communications integrated into scheduling, intake, reminders, and results notifications.

2026's Fastest-Adopting Countries and Why Adoption Is Accelerating

Southeast Asia: mandate-driven acceleration at national scale

Across Southeast Asia, EHR/EMR modernization and interoperability are shifting from discretionary IT initiatives to participation requirements for how hospitals connect, report, and operate at scale. Respondents describe compressed procurement cycles and a decisive move toward exchange-ready architectures, standardized data capture, interoperable APIs, and shared services that enable cross-organization data movement.

Why Southeast Asia is primed to be among 2026's largest adopters:

• Policy-driven digitization is shortening timelines: compliance deadlines and reporting requirements convert modernization into a "must-execute" program.

• Consolidation among provider groups increases the ROI of enterprise platforms: fewer core systems, more standardization, faster rollout of shared services.

• Mobile-first service expectations amplify demand for integrated patient communications and digitally enabled access, pushing engagement tooling into the core stack.

• Workforce constraints (clinical and administrative) elevate automation value-especially for documentation support, scheduling throughput, and diagnostics workflow optimization.

Indonesia - compliance-led modernization and enterprise consolidation

• EHR/EMR modernization activity: 78%

• Interoperability tooling adoption (API/FHIR, exchange services): 84%

• 2026 accelerators: compliance-driven digitization, compressed procurement cycles, and platform consolidation by large provider networks.

Additional insight: Indonesia's scale rewards vendors and health systems that can deliver repeatable deployment patterns (multi-site rollout playbooks, standardized order sets, national reporting templates) and interoperability-by-default integration layers that reduce dependence on point-to-point interfaces.

Vietnam - structured-data maturity and operationalized reporting

• EHR/EMR modernization activity: 72%

• Population health and analytics expansion: 71%

• 2026 accelerators: structured-data requirements, maturation of registries and standards, and operationalized reporting needs.

Additional insight: Vietnam's adoption profile signals a shift from basic digitization to data utility, analytics-ready documentation, standardized coding, and system-wide reporting. This favors platforms that treat data quality as a product feature (structured templates, terminology alignment, governance workflows), not an afterthought.

GCC: claims exchange modernization plus national transformation programs

Revenue cycle management remains a central priority across the GCC because "state healthcare" does not automatically equate to frictionless reimbursement. Respondents describe an increasingly mixed-payment environment where mandatory insurance and payer contracting drive demand for industrial-grade eligibility, prior authorization, coding, claims, denials, and remittance operations.

In Saudi Arabia, the NPHIES exchange effectively turns reimbursement into a real-time compliance and interoperability workflow - forcing tight integration between clinical documentation, authorization logic, and claims submission to avoid denials and delays. In parallel, utilization controls, auditing requirements, and expanding public-private participation increase contract complexity, making modern RCM platforms foundational to digital health transformation.

Why the GCC is positioned as a major 2026 adopter:

• National payer rails and exchange infrastructure transform "good interoperability" into reimbursement continuity-a direct financial lever.

• High expectations for service speed and experience accelerate patient access, scheduling automation, and digital front-door investments.

• Large-scale transformation programs create the conditions for multi-year platform consolidation replacing fragmented legacy estates with enterprise stacks.

• Operational complexity (multi-payer, utilization management, audit pressure) increases the value of automation, analytics, and coding intelligence.

Saudi Arabia - exchange-driven claims automation and enterprise standardization

• Revenue cycle modernization activity: 39%

• Claims connectivity and exchange-driven automation: 26%

• 2026 accelerators: standardization around coding automation, authorization workflows, denials analytics, and payer connectivity.

Additional insight: Saudi Arabia's trajectory disproportionately benefits solutions that couple clinical-financial integrity (documentation-to-coding alignment, authorization-aware ordering) with transaction reliability (high-availability integration, auditability, and exception handling at scale).

United Arab Emirates - broad-based adoption across data, engagement, and AI

• Analytics and population health platforms: 63%

• AI in production (clinical or operational): 34%

• 2026 accelerators: mature provider competition, modernization mandates, and platform consolidation to support data-driven operations.

Additional insight: Competitive provider landscapes amplify differentiation through throughput, experience, and outcomes visibility. This creates a natural pull for analytics platforms, orchestration layers, and governed AI that is measurable, auditable, and embedded into workflow - not isolated innovation labs.

Europe: interoperability compliance and secondary-use readiness reshaping procurement

Across leading European markets, respondents indicate procurement decisions increasingly hinge on the ability to support cross-organization exchange, auditable consent and identity, and standards-based APIs that sustain both care coordination and regulated data reuse. European buyers are prioritizing exchange-ready architectures: interoperability layers, shared-record enablement, and analytics foundations, because multi-stakeholder data flows (regional networks, national records, and secondary-use frameworks) increasingly define operational viability, vendor eligibility, and long-term platform scalability.

• Interoperability as a top-three procurement driver (Europe subset): 62%

• Consent and identity services adoption or planned deployment: 41%

• 2026 accelerators: cross-organization exchange requirements, consent enforcement, and standardized APIs shaping vendor selection.

Additional insight: Europe's adoption curve is increasingly governed by trust frameworks consent, identity, provenance, and auditability. Vendors that can operationalize governance (not just claim standards compliance) are advantaged, particularly where secondary-use readiness and regulated sharing are converging with clinical interoperability requirements.

Latin America: roadmaps converting into funded implementation cycles

Momentum in Latin America is shifting from strategy to execution as national and regional roadmaps translate into procurement cycles and live rollouts. Respondents report EHR platform decisions increasingly tied to measurable implementation timelines, integration requirements, and operational performance targets. Multi-payer operating realities are also tightening the clinical-financial loop through standardized documentation and coding discipline - strengthening the business case for downstream automation and analytics.

• Budgeted EHR modernization (2026):55%

• Revenue cycle plus clinical-financial integration initiatives:44%

• 2026 accelerators: structured modernization programs and multi-payer pressures increasing demand for coding standardization and claims analytics.

Additional insight: Latin America's fastest adopters are selecting platforms that can scale operationally across heterogeneous networks supporting interoperability, billing complexity, and analytics without requiring large specialized IT teams. Implementation velocity and lifecycle cost predictability are emerging as decisive differentiators alongside feature breadth.

Africa: from donor pilots to national platforms

Acceleration across African markets is being defined by a pivot from donor- and program-specific deployments toward national platform architectures capable of scaling across regions and care settings. Respondents report procurement decisions increasingly shaped by national priorities for governance, interoperability, and standardized reporting. The fastest-moving organizations are aligning to shared identifiers, common data standards, and exchange layers because without these foundations, scaling EMRs, analytics, and cross-facility continuity of care becomes operationally brittle and financially inefficient.

• Interoperability initiatives influencing procurement: 38%

• EHR expansion beyond program silos: 43%

• 2026 accelerators: shared identifiers, standardized reporting, and national exchange layers as prerequisites for scale.

Additional insight: Africa's 2026 adoption momentum is strongest where digital health is being treated as national infrastructure with governance, shared services, and scalable architectures that reduce fragmentation. Platforms that support incremental scale (facility-by-facility expansion without re-implementation), offline-resilient operations where required, and standards-based exchange are positioned to benefit most from this shift.

What Global Providers Are Buying in 2026: The Interoperability-First Platform Stack

Respondents in the fastest-adopting markets are converging on a consistent architecture:

• EHR/EMR modernization (enterprise core; specialty integration)

• Interoperability tooling (API/FHIR integration layer, event notifications, MPI/provider registries, consent/identity)

• Revenue cycle automation (coding, authorizations, denials analytics, payment integrity)

• Analytics and population health (risk stratification, surveillance, quality)

• RIS/LIS modernization (order/results integration, structured reporting, diagnostic workflow optimization)

• Clinical AI enablement (governance, auditability, inference embedded in workflows)

Fast adopters show +18 points higher interoperability-layer penetration and +12 points higher AI production deployment rates than slower-adopting markets.

Survey Confidence and Coverage

Survey scope (international sample): 21,555 verified hospital and health system software users across 147 non-U.S. countries. Ninety-three percent of respondents were from developed and upper-middle-income markets. Results are reported at a 95% confidence level; for overall proportion estimates, this sample size corresponds to an approximate maximum margin of error of ±0.7 percentage points under standard random-sampling assumptions. Precision varies by country, segment sample sizes, and weighting methodology.

Availability

The full 2026 Black Book Global Healthcare IT Survey (International) includes country rankings, module-level adoption indicators (EHR/EMR, revenue cycle, interoperability, analytics, AI, RIS/LIS, patient engagement), and procurement drivers by region.

To request the full release package, charts, and executive commentary:
Black Book Market Research
Email:research@blackbookmarketresearch.com
Gratis Industry Download 2026 Global Resource guide: https://blackbookmarketresearch.com/2026-black-book-state-of-global-healthcare-technology

Media Contact:research@blackbookmarketresearch.com

SOURCE: Black Book Research