Sustainable health care systems should be focused on outcomes instead of reimbursing for the services provided. Critical levers for accelerating this are patient engagement and a more comprehensive, standardized collection of patient outcomes. Also, more expertise is required on how these data can best be incorporated into the care process. The Innovative Medicines Initiative project, a public-private partnership in the European Union, has launched Health Outcomes Observatory (H2O), a multi-jurisdictional ecosystem to incorporate patient-reported and other health outcomes into health care decision-making across Europe. This initiative will initially focus on diabetes, cancer, and inflammatory bowel disease, evaluating and selecting meaningful outcome standards in a way that ensures broad acceptability among all stakeholders. H2O will provide digital tools for patients and implement a state-of-the-art governance system that gives patients autonomy to control their data flows and allows for ethical data sharing, while enabling value-based care and driving better outcomes for patients.