Multidisciplinary measuring of maturity and readiness in national digital public health systems: The digital public health maturity index

The rapid digitalization of health systems has brought unprecedented opportunities and challenges in public health. There is a critical need for tools to comprehensively evaluate the maturity of national digital public health (DiPH) systems for strategic planning, resource allocation, and the sustainable development of robust DiPH infrastructures. This dissertation aims to address this gap by developing the Digital Public Health Maturity Index (DiPHMI), a tool designed to measure the maturity of DiPH systems from interdisciplinary perspectives. All studies contributing to this dissertation emphasized the need for interdisciplinary approaches in DiPH, identifying diverse disciplines contributing to this domain. A scoping review of DiPH tools mapped out the characteristics of 179 DiPH interventions, revealing significant heterogeneity among DiPH tools, with a predominant focus on clinical healthcare. The narrative review identified 286 indicators currently used to measure digital maturity and readiness in public health systems, highlighting gaps in existing assessment instruments. The final study was a Delphi process involving 82 international experts who agreed on 96 indicators to evaluate DiPH system maturity. The findings of these studies were integrated to form the DiPHMI to assess national DiPH systems comprehensively. The findings underscore the necessity of an interdisciplinary approach in evaluating DiPH systems. Existing maturity assessment tools predominantly focus on clinical health settings, neglecting broader non-clinical public health dimensions. The DiPHMI fills this critical gap by incorporating a wide range of indicators capturing the complexity of DiPH systems. This comprehensive approach facilitates a better understanding of the strengths and weaknesses of national DiPH systems, enabling targeted interventions and informed policy-making. As such, the DiPHMI represents a significant advancement in the evaluation of DiPH systems.