Nowadays, eHealth and pHealth solutions have to meet advanced interoperability challenges. Enabling pervasive computing and even autonomic computing, pHealth system architectures cover many domains, scientifically managed by specialized disciplines using their specific ontologies. Therefore, semantic interoperability has to advance from a communication protocol to an ontology coordination challenge including semantic integration, bringing knowledge representation and artificial intelligence on the table. The resulting solutions comprehensively support multi-lingual and multi-jurisdictional environments.