Australia and Estonia are ahead of the competition for comprehensive and well-structured frameworks for digital health implementation.
Australia’s eHealth strategy has been ranked as a world leader alongside Estonia for its comprehensiveness and organisation, making it a useful blueprint for other countries looking to develop or enhance their own eHealth strategies, new research has shown.
Researchers from Sweden’s Uppsala University conducted a comparative qualitative analysis of nine countries’ eHealth frameworks, including Australia, Denmark, Estonia, Finland, Norway, Sweden, the UK (NHS England), Catalonia and the US (Department of Veteran Affairs), focusing on the clarity and rigour of the strategies’ visions, objectives, methods of implementation and follow-up protocol.
The findings, published in BMC Health Research, revealed significant variation in the level of detail provided and areas of focus targeted by each strategy, with only five countries outlining an explicit eHealth vision (Australia, Estonia, Finland, Norway and Sweden) and only three offering specifics about the actors and steps involved in the implementation process (Australia, Estonia and NHS England).
While most strategies were structured around six to seven strategic goals, with the exception of Sweden with only four goals, the areas of focus addressed by these goals also varied considerably across the nine countries, including patient involvement, preventive healthcare, telemedicine, information management, standards and consistent terminology use and data analysis.
According to researchers, Australia’s eHealth strategy “stood out” for its comparatively detailed description of its development process, stakeholder engagement, approach to governance and articulation of a pre-constructed follow-up and evaluation protocol.
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Other notable features of Australia’s eHealth strategy, similar to other frontrunner Estonia, included its comprehensive metrics for assessing performance aligned with a “strong commitment to both innovation and evidence-based practice” and a more thorough integration with other national health and digital inclusion strategies.
Recognised limitations to the comparative analysis included the exclusion of non-OECD countries and systems not funded using a single-payer, tax-funded model with universal coverage, in addition to researchers’ dependence on publicly sourced documents and a lack of exploration of the real-world effectiveness of the eHealth strategies.
“Strategies like Australia’s, Estonia’s and Norway’s exemplify more detailed and cohesive approaches, emphasizing stakeholder involvement and alignment with other governing strategies, but also the importance of a pre-defned follow up and evaluation,” researchers wrote.
“However, many systems lack clarity in describing implementation plans or explicit measures for follow-up, leaving room for improvement in ensuring strategy execution and accountability.
“Drawing inspiration from Australia and Estonia, decision-makers should prioritise clear vision statements that align with both national and health-specific objectives.
“Additionally, ensuring stakeholder involvement from the outset is crucial. This can increase the chances of successful strategy development and help identify potential barriers early on.”
The full study is available here.