PAROMA-MED goes beyond the state of the art by delivering a fully integrated, open-source, cloud–edge federative platform that enables secure, privacy-preserving, and compliant cross-border data sharing and AI-driven analytics in healthcare environments. Unlike existing solutions, the platform combines Data Space concepts, zero-trust identity and access management, continuous attestation, consent-aware data governance, federated learning, and DevSecPrivOps into a single, validated framework, demonstrated through real healthcare use cases. Key results include a functional federation marketplace with automated partner attestation and contract enforcement, advanced consent and identity management aligned with GDPR and FHIR standards, and scalable AI services for distributed learning and inference. The project also generated reusable architectural designs, open-source components, and novel IP, contributing to standardisation and interoperability efforts within emerging European Data Spaces. To ensure further uptake and long-term success, key needs include large-scale pilots with healthcare providers, integration into operational health data infrastructures, continued support for standardisation and regulatory alignment, and access to sustainable funding and market mechanisms. These steps will facilitate replication, exploitation, and potential commercialisation of PAROMA-MED results across healthcare and other data-sensitive sectors.