Short answer: the Netherlands deliberately has no central electronic health record. Two national arrangements do the work instead. The Landelijk Schakelpunt (LSP), run by VZVZ, is a national switch: with the patient's explicit opt-in, a GP's summary and a pharmacy's medication record are made retrievable, and an authorised provider elsewhere (an emergency department, a pharmacy on duty) queries the LSP to find and fetch them. MedMij is a trust framework and set of information standards under which certified personal health environments (PGOs, apps chosen by the citizen) retrieve the citizen's data from every connected provider over FHIR and let the citizen collect, read and share it. Behind both stand Nictiz, the national standards institute, and the Wegiz law (2023), which makes electronic exchange mandatory for designated data flows.
The LSP
The Landelijk Schakelpunt (LSP) is the Netherlands' national exchange point, run by VZVZ. It holds no clinical data, only a reference index of which GP or pharmacy has a professional summary or medication data about a citizen who has opted in; an authorised provider with a UZI certificate queries the LSP, which relays the retrieval and logs it.
The LSP holds no clinical data; it holds a reference index: which provider has data about which citizen, for the data types in the scheme. A GP registers a patient's professional summary and a pharmacy its medication data only after the patient has given opt-in consent; a querying provider with a treatment relationship, authenticated with the UZI professional certificate, asks the LSP, which returns the pointers and relays the retrieval. Messages are HL7 v3 (the Dutch AORTA infrastructure), with FHIR-based services being added. Every retrieval is logged and the citizen can see the log at volgjezorg.nl and set their consent per provider. Coverage is high for medication data (most pharmacies) and GP summaries (most practices); other data types are being added by the national programme for exchange in acute care.
MedMij and the PGO
MedMij is the Dutch framework of agreements, label and information standards under which certified personal health environments (PGOs) retrieve a citizen's data from connected providers. A citizen chooses a PGO, logs in with DigiD, and the PGO fetches GP, medication, lab and other data over MedMij FHIR APIs with OAuth 2.0 authorisation the citizen grants.
MedMij is not a system; it is a framework of agreements (afsprakenstelsel) with technical, legal and security rules, a label for compliant parties, and a set of information standards written by Nictiz. Two kinds of parties are certified: DVPs (service providers for persons, the PGO apps) and DVZAs (service providers for care providers, the gateways in front of hospitals, GP systems and labs). A citizen chooses a PGO, logs in with DigiD, and the PGO retrieves data from each provider's DVZA through MedMij-specified FHIR APIs with OAuth 2.0 authorisation granted by the citizen. Data types covered include the GP record, medication, lab results, allergies, vitals, documents, vaccinations, appointments and self-measurements, each as a MedMij information standard with its own FHIR profiles. The citizen may also send data (self-measurements, questionnaires) back to a provider.
Several PGOs exist, some free to citizens (funded through a national scheme in the early years), some tied to insurers or hospitals; the citizen may switch and keeps the data.
Standards
Dutch health data exchange uses Nictiz information standards per use case, the nl-core FHIR profiles built on the zibs (health and care information building blocks), HL7 v3 for older LSP flows and FHIR R4 for MedMij, with SNOMED CT, LOINC, the G-Standaard for medicines and ICD-10 as terminologies, and DigiD and UZI for identity.
- Nictiz information standards: functional and technical descriptions per use case (medication process, GP data, lab, BgZ, the basic care data set), with HL7 v3 CDA/messages for older flows and FHIR R4 for MedMij and new exchanges.
- nl-core: the Dutch FHIR profiles built on the zibs (zorginformatiebouwstenen, health and care information models), the national building blocks for clinical concepts shared across all standards.
- Terminologies: SNOMED CT (the Netherlands is a member and uses it widely), LOINC, the G-Standaard for medicines (mapped to ATC), ICD-10 for registration; the national terminology server distributes them.
- Identity: DigiD for citizens, UZI for professionals, with the eIDAS wallet coming.
Wegiz
Wegiz, the Dutch Wet elektronische gegevensuitwisseling in de zorg of 2023, obliges care providers in the Netherlands to exchange designated health data electronically in designated standards, introduced flow by flow through implementing decrees, starting with digital prescription sending and the basic care data set between hospitals. It also sets a path for certifying the IT systems used.
The Wet elektronische gegevensuitwisseling in de zorg (2023) obliges providers to exchange designated data electronically and in the designated standards, through implementing decrees per data flow (the first: digital prescription sending and the basic care data set between hospitals). It also sets the path for certification of the IT systems used. Together with the EHDS, it is turning what was a voluntary ecosystem into a required one.
For vendors
A vendor connects to the Dutch health data ecosystem through MedMij certification as a DVP for a personal health environment or as a DVZA on the provider side, covering legal agreements, a security assessment, conformance tests and a yearly audit, while hospital and GP systems implement Nictiz standards and join the LSP through VZVZ. Foreign vendors follow the same route.
A PGO vendor goes through MedMij certification as a DVP: legal agreements, security assessment (including a penetration test), conformance tests against the MedMij standards, and a yearly audit. A provider-side vendor becomes a DVZA or uses one. Hospital and GP systems implement the Nictiz standards and connect to the LSP through VZVZ's onboarding. Non-Dutch apps face the same route; there is no shortcut, but the result is a nationwide FHIR interface with citizen-granted access, unusual in Europe.
For a person in the Netherlands
A person in the Netherlands collects their own health record by choosing a MedMij-certified PGO, logging in with DigiD and retrieving data from their GP, pharmacy, hospital and laboratory, then sharing it as they wish. Data exported from a PGO can be kept in a record such as Anpheros Daily, in FHIR with provenance, for use abroad.
Choose a PGO, retrieve your data from your GP, pharmacy, hospital and lab, and share it as you wish. A record such as Anpheros Daily can hold what you export from a PGO, in FHIR with provenance, for use abroad; see Health data portability.
National systems change often. This page describes the situation as published by the operators linked under Sources, last reviewed in October 2026; the operator's documentation is the authority for connection requirements.
Related pages
- National electronic health records in Europe and the US
- MyHealth@EU and the cross-border patient summary
- Your medical data in the EU: GDPR, EHDS and your rights
- Health records online: how to access yours in the EU, UK and US
- FHIR implementation guides explained
- Patient consent platform
Sources
- MedMij
- MedMij: afsprakenstelsel (framework of agreements)
- Nictiz: information standards
- Nictiz: nl-core and zibs
- VZVZ: Landelijk Schakelpunt
- Volgjezorg (citizen consent and access log for the LSP)
- Wegiz: law text (wetten.overheid.nl)
- Rijksoverheid: Gegevensuitwisseling in de zorg programme
Frequently asked questions
Why does the Netherlands have no national record?
A national EPD law was rejected by the Senate in 2011 on privacy grounds. The sector continued with the LSP as a private, opt-in exchange and later built MedMij so citizens could assemble their own record.
What is a PGO?
A persoonlijke gezondheidsomgeving: an app or website, chosen by the citizen, certified under MedMij, that retrieves the citizen's data from connected providers and lets them manage and share it.
Is the LSP opt-in or opt-out?
Opt-in. A GP or pharmacy may only make data retrievable after the patient has given explicit consent, which the patient can manage and revoke.
Can a foreign developer get a MedMij label?
Yes, by meeting the same requirements as Dutch parties: legal agreements, security assessment, conformance to the MedMij standards and audits. The data flows are FHIR with OAuth 2.0, which international teams know.
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