Issued by Black Book Market Research ahead of this week's release of the 2026 "State of Global Digital Healthcare, IT and EMR" a no-charge, 700-page global resource manual covering 147 countries and 70+ EHR/EMR/EPR vendors, spotlighting nine conflict-affected geographies where hospital operations, staffing, and healthcare IT have been severely impaired despite meaningful pre-conflict clinical capability to build on.

NEW YORK CITY, NY / ACCESS Newswire / December 29, 2025 / Black Book Market Research today issued a global alert ahead of the release of its 2026 annual resource, the State of Global Digital Healthcare, IT and EMR, in part, identifying nine conflict-affected geographies where hospital operations, staffing, and healthcare IT have been severely impaired despite meaningful pre-conflict clinical capability to build on.

The 2026 report features reviews of 147 countries and 70+ local, regional, and international healthcare IT vendors. This edition includes a dedicated supplemental section recognizing where hospitals and health leaders face the most extreme operational barriers to restoring or scaling electronic medical records (EMRs), interoperability, and basic digital continuity of care because of active war or intense conflict.

"Healthcare cannot recover when patient identity, medication histories, imaging access, lab continuity, trauma documentation, and referral records are scattered across paper, destroyed infrastructure, and disconnected islands of care," said Doug Brown, Founder of Black Book Market Research. "In 2026, the global EMR and interoperability industry can convert technical capability into humanitarian stability by enabling continuity of care, trusted data exchange, and operational recovery at scale."

WHY THIS IS A 2026 VENDOR IMPERATIVE-NOT ONLY A HUMANITARIAN ISSUE

Black Book's message to international EMR and interoperability suppliers is direct: secure, standards-based connectivity is more than a product category, it is a stabilizing force for public health, clinical safety, and long-term system resilience.

For global EMR vendors already operating in nearby and adjacent regions particularly across Europe, the Eastern Mediterranean, and the Gulf, conflict recovery will increasingly shape 2026-2030 healthcare investment decisions, procurement priorities, and modernization roadmaps. Vendors that have earmarked growth and revenue targets over the next three to five years will be expected to lead with pragmatic, interoperable, and cyber-resilient capabilities that can function under constrained conditions.

"Health systems, ministries, donors, and multilateral partners will not reward closed ecosystems in rebuild environments," Brown added. "The vendors that win trust and long-term market credibility will be those that can prove rapid deployment, cross-platform interoperability, offline-first continuity, and operational resilience while helping rebuild local capacity."

THE NINE CRISIS AREAS WHERE HOSPITAL OPERATIONS AND HEALTHCARE IT ARE COLLAPSING

Black Book identifies nine conflict-affected geographies where (1) there was at least some pre-existing health system capability and (2) the current environment has severely impaired hospital operations, staffing, and IT, limiting or preventing scalable EMR and interoperability deployment:

1. UKRAINE
   Ukraine had a large pre-war specialist hospital network and a strong clinical workforce. Repeated attacks on health facilities and critical infrastructure, combined with displacement of staff and ongoing security risks, have degraded operations and made enterprise acute-care EMR modernization and interoperability difficult in the near term. However, Ukraine is also the most likely among these geographies to require and be positioned to rapidly absor major healthcare IT restoration and rebuilding in 2026 if conditions stabilize.

2. OCCUPIED PALESTINIAN TERRITORY (ESPECIALLY GAZA AND PARTS OF THE WEST BANK)
   Historically capable territorial hospitals and an emerging digital health and EMR footprint now face near-total disruption in many areas. Extensive destruction, extreme shortages of supplies and fuel, intermittent electricity and connectivity, and persistent insecurity constrain sustained and interoperable IT deployment until security, infrastructure, and operational governance materially improve.

3. LEBANON (CONFLICT-AFFECTED BORDER/SOUTHERN AREAS)
   Lebanon has long had a highly skilled medical workforce and advanced private hospital sector. In conflict-affected regions, particularly in the South, operational capacity is narrowed to basic and trauma-focused services, with unreliable power and supply volatility making advanced healthcare IT programs difficult to justify and sustain.

4. SUDAN
   Sudan's civil war has driven a profound collapse of services. Many health facilities are destroyed or non-functional, and access constraints impede staffing, supply chains, and safe operations. Under these conditions, even foundational health information systems are difficult to keep online consistently; national-scale EMR programs are not currently feasible.

5. YEMEN
   Yemen once had a functioning national health system with health IT capability. Years of war have left roughly 20 million people needing care, with many hospitals destroyed or damaged, chronic shortages of medicines, and severely constrained connectivity-forcing digital health toward low-bandwidth, offline-first stopgaps rather than robust, integrated platforms.

6. SYRIA
   Syria's pre-war middle-income health system included significant specialized capacity. Prolonged conflict and fragmentation have damaged infrastructure, disrupted governance, and severely constrained surveillance and immunization activities. Digital health infrastructure is extremely difficult to sustain, standardize, and secure at scale.

7. SOMALIA AND ETHIOPIA (CONFLICT-AFFECTED, FRAGILE REGIONS)
   These settings reflect fragile baselines with pockets of advanced services. Conflict, outbreaks, displacement, and humanitarian access constraints overwhelm hospital operations and limit scalable EMR or interoperability progress to a small number of carefully supported pilots.

8. MYANMAR
   Prior to renewed conflict, Myanmar had functioning hospitals and early digital health pilots. Current fighting, displacement, compounding disasters, and governance constraints have made many facilities inaccessible or under-resourced, hindering structured IT rollouts, workforce training, and continuity programs.

9. AFGHANISTAN
   Afghanistan's long-term conflict, sanctions, and economic collapse have left many hospitals heavily dependent on humanitarian support. Despite continued clinical programs in some areas, many facilities lack stable funding, power, and connectivity required to sustain modern hospital operations supported by enterprise-grade EMRs and interoperable exchange.

THE COMMON FAILURE MODE: THE "FOUR-KNOCKOUT" PATTERN FOR HOSPITAL IT

Across these nine geographies, Black Book observes a consistent operational pattern that prevents enterprise EMR and interoperability from taking hold:

• Power instability: frequent outages, generator dependence, fuel scarcity, and unstable electrical distribution undermine uptime for servers, networks, imaging, labs, and medication systems.
• Connectivity disruption: intermittent internet, damaged infrastructure, constrained cellular coverage, and heightened cybersecurity threats disrupt safe exchange, remote support, and data continuity.
• Workforce displacement: IT teams, clinical informaticists, super-users, trainers, and departmental champions are displaced, reassigned, or unavailable-breaking implementation and stabilization cycles.
• Security and governance fragmentation: unsafe facilities, disrupted procurement, unpredictable access, and unclear data stewardship limit collaboration, standardization, and trust required for interoperability.

In these conditions, the immediate objective is not "digital transformation." It is continuity of care: minimum viable patient identity, medication and allergy history, trauma documentation, lab and imaging continuity, supply chain visibility, and safe data exchange.

UKRAINE 2026: THE MOST IMMEDIATE POST-CONFLICT OPPORTUNITY TO RESTORE HOSPITAL IT AT SCALE

Black Book emphasizes that Ukraine represents the most time-sensitive restoration opportunity in 2026 because of its pre-war capability, depth of clinical talent, and the likelihood that reconstruction can accelerate quickly if access corridors, security conditions, and infrastructure stabilization allow.

If a ceasefire and durable settlement create stable operating conditions, Black Book is calling on global and U.S. EMR vendors and interoperability suppliers to band together, competitors included, under a neutral Ukraine Health IT Restoration Compact with a shared 2026 objective: Restore safe, interoperable, high-availability digital hospital operations across priority regions without vendor lock-in, without fragmentation, and without forcing hospitals to choose between speed and standards.

A PRACTICAL 2026 RESTORATION PLAYBOOK VENDORS CAN EXECUTE TOGETHER

Phase 1 - Stabilize (First 0-90 Days Post-Ceasefire)
• Rapid facility readiness assessments: power, connectivity, cybersecurity posture, device inventory, and staffing
• Hospital Continuity Kits: resilient networking, endpoint security, downtime workflows, offline-first documentation, and rapid-recovery backup patterns
• Emergency data salvage and reconstruction support: patient indexes, medication catalogs, lab baselines, imaging indexes

Phase 2 - Re-Open Digital Operations (3-9 Months)
• Restore core inpatient workflows: ED/trauma, medication administration, lab results, imaging orders/results, discharge summaries
• Implement interoperability-first architecture enabling exchange across different EMRs:
- Standards-based APIs
- Master patient identity and matching services
- Terminology services
- Event notifications (admissions, discharges, transfers)
- Secure referrals and care summary exchange

Phase 3 - Scale and Unify (9-18 Months)
• Expand cross-facility and cross-region referrals and specialty coordination
• Support longitudinal care for war injuries, rehabilitation, behavioral health, and chronic disease
• Institutionalize cybersecurity resilience: incident response runbooks, identity governance, segmentation, immutable backups, and restore testing

THE BUSINESS-READY CALL TO ACTION: A 2026 HEALTH SYSTEM CONNECTIVITY COMPACT

Black Book calls on international EMR and interoperability vendors-particularly those with existing footprints in Europe and surrounding regions and those targeting outsized growth over the next three to five years-to lead a coordinated 2026 operating posture built on measurable commitments:

1. Standards-first exchange by default (open APIs and credible interoperability roadmaps)

2. Offline-first and low-bandwidth modes (store-and-forward, local caching, sync-on-connect)

3. Humanitarian licensing and rapid provisioning for verified facilities and NGOs

4. Portable identity and a minimum continuity dataset for displaced populations

5. Cyber-resilient deployments (segmentation, immutable backups, restore testing, zero-trust patterns)

6. Predictable interoperability pricing during recovery (no surprise integration tolls)

7. Shared training assets (multilingual e-learning, super-user bootcamps, remote support)

8. Vendor-to-vendor integration exercises (joint connectathons and reference implementations)

9. Local workforce rebuilding (train-the-trainer, scholarships, informatics capacity-building)

10. Neutral governance participation aligned to ministries of health and humanitarian coordination

"Connectivity is not a feature. In fragile recovery, connectivity is patient safety," Brown said. "When EMR competitors interoperate by design, they reduce suffering, speed recovery, and help rebuild the societal trust that supports durable peace."

HOW US HOSPITAL BOARDS, EU HEALTH SYSTEMS, AND GLOBAL PHILANTHROPISTS CAN HELP UKRAINE PREPARE FOR 2026 RECOVERY

Black Book urges hospital leaders, boards, foundations, and donors especially in North America and Europe to complement emergency aid with reconstruction-grade support that keeps hospitals functional now and prepares them for rapid digital restart when conditions allow.

High-impact donation categories for Ukraine's hospital IT and operational restoration:
• Resilient power for care delivery and IT (generators, UPS, microgrid components, fuel logistics support)
• Connectivity and secure networking (routers, switching, secure Wi-Fi, backup connectivity options, hardened network design services)
• Cyber resilience (endpoint protection, identity and access management support, backup/restore modernization, incident response assistance)
• Clinical continuity tooling (downtime workflows, offline registries, scan-to-structured abstraction support, secure patient summary exchange)
• Workforce investment (clinical informatics training, nursing super-user programs, biomedical/IT technician rebuilding)
• Interoperability enablers (patient identity services, terminology services, API infrastructure, integration engineering capacity)

ABOUT BLACK BOOK MARKET RESEARCH
Black Book Market Research is an independent healthcare technology research and benchmarking organization. Its annual 2026 State of Global Digital Healthcare, IT and EMR resource is designed for health system leaders, policymakers, philanthropists, and suppliers seeking actionable insight into the status of healthcare IT, EMR adoption, and interoperability capacity across 147 countries and 70+ vendors. Previews can be downloaded to industry stakeholders at no cost at https://blackbookmarketresearch.com/2026-black-book-state-of-global-healthcare-technology

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SOURCE: Black Book Research