How advanced is your digital public health system? A qualitative analysis of suitable indicators

Abstract Background Revealing the full potential of digital public health (DiPH) systems necessitates a wide-ranging tool to assess their maturity. Essential domains that need to be considered include the literacy and interest in DiPH tool application by society and the workforce and the legal and ICT maturity of DiPH systems. No review has investigated indicators on these national DiPH system maturity (DiPHSM) domains yet. Our narrative review and qualitative analysis aimed to map the landscape of indicators related to DiPHSM measurement and rank them based on their importance for such assessments. Methods As original indicators were not published in scientific databases but as grey literature, we used DuckDuckGo to apply a pre-defined search strategy for 11 countries from all continents classified as having reached level 4 of 5 in the Global Digital Health Monitor. Of the 1484 identified references, 137 were included which named 15806 indicators. Consensus on importance was defined as at least 3 or 4 authors rating an indicator as important. Results We recognized 180 indicators on different constructs with importance for DiPHSM analysis, including the availability and use of Smartphones, computers, the Internet or the DiPH intervention, the existence of skilled workforce, infrastructure (investment), and interoperability between interventions, the secondary use of health data, a DiPH strategy and controlling agency, or the application of big data and artificial intelligence for health data collection, analysis, and sharing. Conclusions Our study holds the potential to develop more comprehensive tools for DiPHSM assessments. Further examination is required to analyze the suitability and applicability of all identified indicators for diverse healthcare settings. By working towards a uniform evaluation of DiPHSM, we foster informed decision-making among healthcare planners and practitioners, improve resource distribution, and continue to drive innovation in healthcare delivery. Key messages • Maturity assessment tools need to consider the complexity of DiPH systems. Thereby, DiPH system evaluations need to be accompanied by analyses of the legal, ICT, and literacy perspective maturities. • New methods are needed to systematically assess and use multidisciplinary grey literature for research.