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George Crooks, Medical Director for NHS24\nKarima Bourquard, Director of Interoperability at IHE-Europe, France\nMarcello Melgara Responsible for International eHealth Projects, Italy\n\nThe Digital Single Market strategy has raised questions about its impact on U.S.-EU trade and investment, especially with respect to cross-border data flows, data protection, standards development, and competition. These questions arise as both the United States and the EU strive to negotiate the new Transatlantic Trade and Investment Partnership (TTIP). Considering the EU has limited powers regarding the organisation of member states\u2019 health systems and can only recommend actions; what immediate actions should willing states and/or companies take in order to be competitive?