As the deployment of electronic health record (EHR) systems in the European Union accelerates, awareness increases for the problem of interoperability. Indeed, to fully realise the potential of EHR systems a timely and secure access to such systems to all those that are entitled to use them needs to be ensured. Moreover, the information contained in an EHR should be up-to-date, accurate and correctly understood in it’s communication to other locations, systems or languages. This is called interoperability. Interoperable EHR systems are the most important enabling tools on the road to patient centred care, a lifeline for continuity of care and support to mobility of patients. The European Commission has funded the SemanticHealth project led by empirica Communication and Technology Research to lay down a research and deployment roadmap to facilitate a more “consistent representation of clinical meaning across European and global health systems”. The recommendations developed in the project are grouped around four thematic areas: Electronic health records, ontologies and terminologies, public health, and finally socio-economic issues. The project’s final report, which presents the recommendations and timelines developed in the course of the project, has now been published and is available online. The report clearly shows that interoperability is not just a technical and standardisation challenge. It involves as well leadership, decisions about and investment in political, institutional, organisational, legal and market issues. The main recommendations to policy-makers, industry, healthcare professionals and other stakeholders on the journey towards semantic interoperability” include: o a policy of incremental steps and a focused, modest approach to terminology development, o a coordinated effort to effectively engage with all relevant stakeholders, o the establishment of sustainable national bodies for the adaptation of international classifiations and terminologies, linked in respective European networks, o documentation of the clinical, financial and operational improvements due to the usage of terminologies, ontologies and electronic health records, o and the creation of semantically sound and focused subsets of software like SNOMED CT and ICD 10.