Short answer: health care in Spain is run by the 17 autonomous communities, each with its own health service and its own electronic health record (Diraya in Andalusia, HC3 in Catalonia, Abucasis in Valencia, Osabide in the Basque Country, and so on). The Historia Clínica Digital del Sistema Nacional de Salud (HCDSNS) is the national layer that connects them: a node run by the Ministry of Health through which a professional in one region can read a patient's summary report and key documents from another, and a citizen can see which regions hold data about them. The interoperable electronic prescription (receta electrónica interoperable) lets a prescription issued in one region be dispensed in any pharmacy in Spain. Standards are CDA-based documents over the national node; identity is the national health card number linked to the Código de Identificación Personal and the Cl@ve digital identity for citizens.
The regional records
Spain's health records are regional: each of the 17 autonomous communities runs its own primary care and hospital records, patient portal and app, such as La Meva Salut in Catalonia or ClicSalud+ in Andalusia, with its own structure, vendor and coding. The regional record is the complete one for a resident; the national HCDSNS layer serves patients treated elsewhere.
Each regional service runs primary care and hospital records, patient portals and apps (La Meva Salut in Catalonia, ClicSalud+ in Andalusia, Carpeta de Salud in the Basque Country, Mi Carpeta de Salud in Madrid), e-prescription and appointment systems. Coverage within a region is high; the records differ in structure, vendor and coding. A professional's normal view is the regional record; the national layer is consulted when the patient comes from elsewhere.
What the HCDSNS exchanges
Spain's HCDSNS exchanges a defined set of reports between regions: the Historia Clínica Resumida patient summary, discharge, emergency, outpatient, primary care, nursing, laboratory and imaging reports, and e-prescription dispensing data. Regions publish them to the Ministry's national node as CDA documents; the data stays in the region, the node indexes and relays, and every access is logged for the citizen.
The national node supports a defined set of report types: the Historia Clínica Resumida (patient summary with problems, medications, allergies, vaccines), discharge reports, emergency reports, outpatient consultation reports, primary care reports, nursing reports, laboratory and imaging reports, and the dispensing data from e-prescription. Regions publish these reports to the node as CDA documents with national metadata; a professional with a care relationship retrieves them through the regional system, and every access is logged and visible to the citizen. Data stays in the region; the node indexes and relays.
Interoperable e-prescription
Spain's interoperable electronic prescription, completed nationwide in 2021, lets a pharmacy in any region dispense a prescription issued in another by reading the patient's health card and querying the issuing region through the HCDSNS national node. Spain also exchanges ePrescriptions with other EU countries through MyHealth@EU and is among the most active cross-border participants.
Completed in 2021 for the whole country, the service lets a pharmacy in any region dispense an electronic prescription issued elsewhere, by reading the patient's health card and querying the issuing region through the national node. Spain also exchanges ePrescriptions with other EU countries through MyHealth@EU, and is one of the most active participants in the cross-border patient summary. See ePrescription across EU borders.
Standards and codes
Spain's HCDSNS uses HL7 CDA R2 documents with national templates over an IHE-style national node. Diagnoses and procedures are coded in CIE-10-ES, the Spanish clinical modification of ICD-10, medicines in the national Nomenclátor mapped to ATC, laboratory results in LOINC, with SNOMED CT licensed nationally; regional APIs and the national data space adopt FHIR R4.
- Documents: HL7 CDA R2 with national templates for each report type; the national node uses IHE-style registry and retrieve.
- Diagnoses and procedures: CIE-10-ES, the Spanish clinical modification derived from ICD-10-CM and ICD-10-PCS, maintained by the Ministry, with yearly editions; see ICD-10 variants.
- Medicines: the national medicines nomenclature (Nomenclátor) with national codes, mapped to ATC.
- Laboratory: LOINC in national profiles; SNOMED CT is licensed nationally and used in several regions and in the national summary.
- FHIR: regional APIs and new national projects adopt FHIR R4 with Spanish profiles; the national data space work (below) is FHIR-based.
Citizen access
Citizens in Spain see their health record through their regional portal or app, and through the HCDSNS citizen access on the Ministry of Health's portal, with Cl@ve or an electronic certificate, where they can see which regions hold reports about them, download them, mark reports as restricted and read the access log. There is no single national app.
Citizens see their regional record through the regional portal or app, and the HCDSNS citizen access (through the Ministry's portal with Cl@ve or an electronic certificate) shows which regions hold their reports and lets them download them, mark reports as restricted, and read the access log. There is no single national app for the whole record; the regional apps are the daily tools.
Vendors and the national data space
Software vendors in Spain connect to each regional health service, which runs its own procurement, integration standards and onboarding; the HCDSNS national node is reached only through the region. Alongside, the Espacio Nacional de Datos de Salud is building a national FHIR-based data lake for secondary use and planning, aligned with the European Health Data Space.
Software vendors connect to each regional health service, which runs its own procurement, integration standards and onboarding; the national node is reached through the region. The Espacio Nacional de Datos de Salud, funded by the recovery plan, is building a national FHIR-based data lake for secondary use and planning in line with the EHDS, and the Ministry publishes national interoperability specifications for it. Spain's EHDS implementation will bring the priority categories into the European format through the existing national contact point.
For a person with Spanish records
A person with Spanish health records can download reports from their regional portal or from the HCDSNS citizen access and keep them together in a record they control. A personal record such as Anpheros Daily stores those documents and maps the coded content to FHIR so a clinician in another region or country can read them.
Download reports from your regional portal or the national access, and keep them together in a record you control; a record such as Anpheros Daily stores the documents and maps the coded content to FHIR, so a clinician in another region or country can read it. See Health records online.
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
- ePrescription across EU borders
- ICD-10 vs ICD-10-CM vs ICD-10-GM
Sources
- Ministerio de Sanidad: Salud Digital (HCDSNS, receta electrónica, espacio de datos)
- Ministerio de Sanidad: Receta electrónica interoperable
Frequently asked questions
Is there one Spanish health record?
No. There are 17 regional records; the HCDSNS connects them for a defined set of reports and for e-prescription. The regional record is the complete one for a resident.
Can a doctor in Madrid see my Andalusian records?
The reports published to the national node (summary, discharge, emergency, lab, imaging and others), yes, through the regional system with a care relationship; every access is logged and visible to you. Full regional detail stays in the region.
Which codes does Spain use for diagnoses?
CIE-10-ES, the Spanish clinical modification derived from the US ICD-10-CM and ICD-10-PCS, with yearly national editions. Primary care often uses CIAP-2 (ICPC-2) as well.
Can a non-Spanish app connect?
Not to the national node, which serves health services. Citizens can download reports from their regional portal or the national access and bring them to any app; MyHealth@EU carries the summary and prescriptions across borders.
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