This paper aims at formulating standardization recommendations, both for Romanian specialists developing telehealth software and platforms and for Romania as EU member, which is in a national landscape with a multitude of unconnected medical systems and own architectures that no longer have their place in a common European medical reality. The paper addresses a range of issues such as communication between devices, international recognition of national systems, elimination of proprietary API’s with mandatory open interfaces, choice of a common software development language, the usage of a common European cloud, semantic interoperability, ensuring security and respecting patient privacy. All of these cannot be understood and implemented without the knowledge of the European framework, the European ethics guidelines, the strategy for electronic health records, so that the interactions between healthcare systems can be made totally on all levels (data, services and processes) at national level. This system, in turn, needs to be integrated into the single European digital health system.