State of Digital Health around the world today

The Global Digital Health Monitor (GDHM) is an interactive web-based resource that aims to track, monitor, and assess the enabling environment for digital health throughout the world.

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Indicator Guide
The Global Digital Health Monitor (GDHM) is an interactive digital resource that tracks, monitors, and evaluates the use of digital technology for health across countries. GDHM uses seven key indicator categories to track progress.
Leadership & Governance
Indicator 1 - Digital health prioritized at the national level through dedicated bodies / mechanisms for governance
Does the country have a separate department / agency / national working group for digital health?
1No coordinating body exists and/or nascent governance structure for digital health is constituted on a case-by-case basis.
2Governance structure is formally constituted though not fully-functional or meeting regularly.
3Governance structure and any related working groups have a scope of work (SOW) and conduct regular meetings with stakeholder participation and/or consultation.
4Governance structure is fully-functional, government-led, consults with other ministries, and monitors implementation of digital health and data governance, including artificial intelligence, based on a work plan.
5The digital health and data governance structure is institutionalized, consults with other ministries, and monitors implementation of digital health. It is relatively protected from interference or organizational changes. It is nationally recognized as the lead for digital health. The governance structure and its technical working groups emphasize gender balance in membership.
Indicator 2 - Digital Health prioritized at the national level through planning
Is digital health included and budgeted for in national health or relevant national strategies and/or plan(s)? Note: The focus of this indicator is on the inclusion of digital health or eHealth in the national health strategy.
1Digital health is not included in the national health strategy. It is being implemented in an ad hoc fashion in health programs.
2There is some discussion of inclusion of digital health in national health or other relevant national strategies or plans. Proposed language for inclusion of digital health in national health or relevant national strategies and/or plans has been made and is under review.
3Digital health is included in national health or relevant national strategies and/or plans.
4Digital health is being implemented as part of national health or other relevant national strategies and/or plans.
5Digital health is implemented and periodically evaluated and optimized in national health or other relevant national strategies and/or plans.
Indicator 2a - Health is prioritized in national digital transformation and data governance policies
Do national digital transformation and data governance policies and approaches consider and address potential benefits and risks for public health and individual health?
1National digital transformation and data governance policies do not include potential benefits and risks on public health or individual health outcomes.
2National digital transformation and data governance policies include potential benefits and risks on public health or individual health outcomes on an ad hoc basis.
3National digital transformation and data governance policies systematically includes potential benefits and risks on public health or individual health outcomes but has no strategy(s) for addressing them.
4National digital transformation and data governance policies systematically includes potential benefits and risks on public health or individual health outcomes and has some strategy(s) for addressing them that are not yet implemented.
5All relevant digital transformation and data governance policies fully consider potential benefits and risks for health systems, determinants of health and individual health outcomes (including for children, women and vulnerable groups) and have multisectoral strategies that are fully implemented.
Indicator 3 - Readiness for emerging technologies adoption and governance
Is there a national plan specific to emerging technologies (e.g., AI, Wearables, Blockchain, IoT) to support public health goals?
1There is no emerging technologies (e.g., AI, Wearables, Blockchain, IoT) plan in support of public health goals.
2A plan was developed for at least one emerging technology (e.g., AI, Wearables, Blockchain, IoT) to support public health goals, but it is not being implemented.
3A plan exists for at least one emerging technology (e.g., AI, Wearables, Blockchain, IoT) to support public health goals. Plan(s) identifies governance mechanisms required for emerging technologies.
4A plan for one or more emerging technology (e.g., AI, Wearables, Blockchain, IoT) to support public health is being implemented, is funded, and the results are being monitored. Governance mechanisms required for emerging technologies are in place.
5A plan for one or more emerging technology (e.g., AI, Wearables, Blockchain, IoT) in support of public health is being implemented, is funded, the results are being monitored, and the plan is kept updated. Governance mechanisms are in place and in use.
Indicator 4 - Diversity, Equity, and human rights analysis, planning and monitoring included in national digital health strategies and plans
Has the country assessed/adapted national digital health strategies from an equity and human rights perspective?
1Digital health strategies and programs are developed and implemented without consideration of equity and human rights implications.
2Digital health strategies and programs are developed and implemented with ad hoc consideration of equity and human rights implications.
3Digital health strategies and programs are developed and implemented with formal consideration of equity and human rights implications with no strategy(s) for addressing them.
4Digital health strategies and programs are developed and implemented with formal consideration of equity and human rights implications with ad hoc strategy(s) for addressing them.
5The country is implementing and evaluating the effects of digital health strategies and specific digital health solutions based on equity and human rights impact assessments. Documented strategies are in place to address gaps in access and outcomes for different population groups, including women, children, and marginalized groups.
Indicator 4a - Gender considerations accounted for in digital health strategies and digital health governance
Does the country include gender considerations in the national digital health strategy or its digital health governance?
1Digital health strategies and interventions are developed and implemented without consideration of gender norms, roles, and relations.
2Digital health strategies and interventions are developed and implemented with ad hoc and non-systematic consideration of gender norms, roles, and relations.
3Digital health strategies and programs are developed and implemented with systematic consideration of gender norms, roles, and relations without the policies or structures for accountability (gender-sensitive).
4Digital health strategies and programs are developed and implemented with systematic consideration of gender norms, roles, and relations with specific strategies targeting governance bodies, health workforce, and clients with mechanisms for accountability (gender-specific).
5Digital health strategies, policies, and interventions address gender inequality and foster progressive change in gender dynamics based on routine gender analyses and impact assessments (gender transformative).
Strategy & Investment
Indicator 5 - National eHealth/ Digital Health Strategy or Framework
Does the country have an eHealth or digital health strategy or framework and a costed digital health plan?
1There is no digital health strategy or framework. Draft digital health strategy or framework developed, but not officially reviewed.
2National digital health strategy or framework approved.
3National digital health costed plan developed and approved.
4National digital health strategy and costed plan partially implemented with resources to ensure full implementation.
5National digital health strategy and costed plan fully implemented with planning underway for the next 3-5 year cycle.
Indicator 5a - National digital strategy alignment with Universal Health Coverage (UHC) Core Components
Is the country’s national digital health strategy aligned with universal health coverage and/or UHC core components?
1Digital health strategy does not exist or exists and is not aligned to UHC and does not address any of the core UHC components of coverage, access, uptake, quality, and equity.
2Digital health strategy exists and is partly aligned to UHC, addressing only one core UHC component of coverage, access, uptake, quality, and equity.
3Digital health strategy exists and is partly aligned to UHC, addressing two or more core UHC components of coverage, access, uptake, quality, and equity.
4Digital health strategy exists and is fully aligned to country's UHC goals, but does not include metrics to assess the contribution of digital health towards UHC goals.
5Digital health strategy is fully aligned to the country's UHC goals and includes metrics to assess the contribution of digital health toward UHC targets.
Indicator 6 - Public funding for digital health
Is public funding (including loans) for digital health sufficient for the digital health strategies, priorities (needs), or costed-plan of the country?
1No budget line item for digital health available.
2Non-systematic budget allocated for digital health exists or are projects and/or system-based.
3A structured and systematic budget line item for digital health exists but is significantly insufficient (less than 50% of need) to meet the country's digital health needs.
4A structured and systematic budget line item for digital health exists but is moderately insufficient (above 50% of need) to meet the country's digital health needs.
5Structure and systematic budget line exists for digital health and is completely sufficient to meet the country's digital health needs.
Indicator 6a - Private sector participation and investments in digital health
Given the enabling environment, does the private sector participate and invest in digital health activities?
1The private sector do not visibly participate and invest in country's digital health activities.
2The private sector participation and investment in the country's digital health activities and investment is ad-hoc and limited.
3The private sector participation and investment in the country's digital health activities is systematic but does not meet the needs of the country.
4The private sector participation and investment in the country's digital health activities is systematic and meets the needs of the country.
5The private sector participates and invests in the country's digital health activities in an optimized environment.
Legislation, Policy, & Compliance
Indicator 7 - Legal Framework for Data Protection (Security/ Cybersecurity)
Is there a law on data security (across the full data lifecycle e.g. collection, processing, storage, transmission, use and destruction) that is relevant to digital health?
1There is no law on data security (across the full data lifecycle e.g. collection, processing, storage, transmission, use and destruction) that is relevant to digital health.
2There is a law on data security (across the full data lifecycle e.g. collection, processing, storage, transmission, use and destruction) that is relevant to digital health that has been proposed and is under review.
3There is a law on data security (across the full data lifecycle e.g. collection, processing, storage, transmission, use and destruction) that is relevant to digital health that has been passed, but has not yet been fully implemented.
4There is a law on data security (across the full data lifecycle e.g. collection, processing, storage, transmission, use and destruction), that is relevant to digital health that has been implemented, but not consistently enforced.
5There is a law on data security (across the full data lifecycle e.g. collection, processing, storage, transmission, use and destruction) that is relevant to digital health that has been implemented and enforced consistently.
Indicator 8 - Laws or Regulations for privacy, consent, confidentiality and access to health information (Privacy)
Is there a law to protect individual privacy, governing ownership, consent, access and sharing of individually identifiable digital health data ?
1There is no law to protect individual privacy, governing ownership, consent, access and sharing of individually identifiable digital health data.
2There is a law to protect individual privacy, governing ownership, consent, access and sharing of individually identifiable digital health data that has been proposed and is under review.
3There is a law to protect individual privacy, governing ownership, consent, access and sharing of individually identifiable digital health data that has been passed, but not yet fully implemented.
4There is a law to protect individual privacy, governing ownership, access, consent, and sharing of individually identifiable digital health data that has been implemented, but not consistently enforced.
5There is a law to protect individual privacy, governing ownership, access, consent, and sharing of individually identifiable digital health data that has been implemented and is enforced consistently. Specific laws and protections are in place to protect the privacy of children and other vulnerable groups.
Indicator 9 - Protocol for regulating or certifying devices and/or health services- including provisions for AI and algorithms (at higher stages of maturity)
Are there protocols, policies, frameworks or accepted processes governing the clinical and patient care use of connected medical devices and health services (e.g. telemedicine, applications), particularly in relation to safety, data integrity and quality of care- including provisions for AI and algorithms (at higher stages of maturity)?
1There are no protocols, policies, frameworks or accepted processes governing the clinical and patient care use of connected medical devices and health services (e.g. telemedicine, applications), particularly in relation to safety, data integrity and quality of care.
2Protocols, policies, frameworks or accepted processes governing the clinical and patient care use of connected medical devices and digital health services (e.g. telemedicine, applications), particularly in relation to safety, data integrity and quality of care have been proposed and are under review.
3Protocols, policies, frameworks or accepted processes governing the clinical and patient care use of connected medical devices and digital health services (e.g. telemedicine, applications), particularly in relation to safety, data integrity and quality of care have been passed, but are not fully implemented.
4Protocols, policies, frameworks or accepted processes governing the clinical and patient care use of connected medical devices and health services (e.g. telemedicine, applications), particularly in relation to safety, data integrity and quality of care --including provisions for AI and algorithms- have been implemented, but not consistently enforced.
5Protocols, policies, frameworks or accepted processes governing the clinical and patient care use of connected medical devices and health services (e.g. telemedicine, applications), particularly in relation to safety, data integrity and quality of care - including provisions for AI and algorithms- have been implemented and are enforced consistently.
Indicator 9a - Protocol for regulating and certifying AI within health services
Are there protocols, policies, frameworks or accepted processes governing the use of AI within health systems, services and applications, particularly in relation to ethics, equity, safety, data integrity and quality of care?
1There are no protocols, policies, frameworks, or accepted processes governing AI use in health services.
2Protocols, policies, frameworks, or accepted processes governing AI use in health service have been proposed and under review
3Protocols, policies, frameworks, or accepted processes governing AI use in health service have been passed but are not fully implemented.
4Protocols, policies, frameworks or accepted processes governing AI use in health service have been implemented but are not consistently enforced.
5Protocols, policies, frameworks, or accepted processes governing AI use in health service have been implemented and are enforced consistently.
Indicator 10 - Cross-border data security and sharing
Are there protocols, policies, frameworks or accepted processes in place to support secure cross-border data exchange and storage in support of public health goals while protecting individual privacy? Note: This includes health-related data coming into a country, going out of a country, and/or being used in a country related to an individual from another country.
1There are no protocols, policies, frameworks or accepted processes in place to support secure cross-border data exchange and storage in support of public health goals while protecting individual privacy.
2Protocols, policies, frameworks or accepted processes for cross border data exchange and storage in support of public health goals while protecting individual privacy have been proposed and are under review.
3Protocols, policies, frameworks or accepted processes for cross border data exchange and storage in support of public health goals while protecting individual privacy have been passed, but are not fully implemented.
4Protocols, policies, frameworks or accepted processes for cross border data exchange and storage in support of public health goals while protecting individual privacy have been implemented, but not consistently enforced.
5Protocols, policies, frameworks or accepted processes for cross border data exchange and storage in support of public health goals while protecting individual privacy have been implemented and enforced consistently.
Workforce
Indicator 11 - Digital health integrated in health and related professional pre-service training (prior to deployment)
Is digital health part of curriculum for health and health-related support professionals in training, in general?
1There is no digital health curriculum for health professionals as part of pre-service training requirements.
2Digital health curriculum proposed and under review as part of pre-service training requirements.
3Digital health curriculum implementation underway covering an estimated <50% of health professionals in pre-service training.
4Digital health taught in relevant institutions with an estimated 50-75% health professionals receiving pre-service training.
5Digital health taught in relevant institutions with >75% of health professionals receiving pre-service training.
Indicator 12 - Digital health integrated in health and related professional in-service training (after to deployment)
Specifically, is digital health part of curriculum for health and health-related support professionals in the workforce in general? [Defined as community health workers, nurses, doctors, allied health, health managers/administrators, and technologists]
1There is no digital health curriculum as part of in-service (continuing education) training for health professionals in the workforce.
2Digital health curriculum proposed and under review as part of in-service (continuing education) training for health professionals in the workforce.
3Digital health curriculum is implemented as part of in-service (continuing education) training for <50% health professionals in the workforce.
4Digital health curriculum is implemented as part of in-service (continuing education) training for 50-75% health professionals in the workforce.
5Digital health curriculum is implemented as part of in-service (continuing education) training for >75% health professionals in the workforce.
Indicator 13 - Training of digital health workforce
In general, is training in digital health / health informatics / health information systems / biomedical informatics degree programs (in either public or private institutions) producing trained digital health workers?
1There is no training available for digital health workforce in the country.
2Digital health workforce needs assessed, gaps identified and training options under development.
3Professional training is available, but graduates are not yet deployed.
4Trained digital health professionals available and deployed, but essential personnel gaps remain.
5Sufficient numbers of trained digital health professionals available to support national digital health needs.
Indicator 14 - Maturity of public sector digital health professional careers
Are there public sector professional titles and career paths in digital health?
1No workforce strategy, policy, or guide that recognizes digital health is in place. Distribution of digital health workforce is ad hoc.
2A national needs assessment shows the number and types of skills needed to support digital health with an explicit focus on training cadres of female health workers.
3Digital health staff roles and responsibilities are mapped to the government's workforce and career schemes and 25-50% of needed public sector digital health workforce in place.
4An HR policy and strategic plan exists that identifies skills and functions needed to support digital health with an explicit focus on training cadres of female health workers and an estimated 50-75% of public sector digital health workforce in place.
5A long-term plan is in place to grow and sustain staff with the skills needed to sustain digital health at national and subnational levels with an explicit focus on training cadres of female health workers with an estimated >75% of positions needed filled. Performance management systems are in place to ensure growth and sustainability of the digital health workforce with sufficient supply to meet digital health needs and little staff turnover.
Standards & Interoperability
Indicator 15 - National digital health architecture and/or health information exchange
Is there a national digital health (eHealth) architectural framework and/or health information exchange (HIE) established?
1There is no national digital health (eHealth) architectural framework and/or health information exchange (HIE) established.
2A national digital health architecture and/or health information exchange (HIE) has been proposed, but not approved including semantic, syntactic, and organizational layers.
3The national digital health architecture and/or health information exchange (HIE) is operable and provides core functions, such as authentication, translation, storage and warehousing function, guide to what data is available and how to access it, and data interpretation.
4The government leads, manages, and enforces implementation of the national digital health architecture and/or the health information exchange (HIE), which are fully implemented following industry standards.
5The national digital health architecture and/or health information exchange (HIE) provides core data exchange functions and is periodically reviewed and updated to meet the needs of the changing digital health architecture. There is continuous learning, innovation, and quality control. Data is actively used for national health strategic planning and budgeting.
Indicator 16 - Health information standards
Are there digital health / health information standards for data exchange, transmission, messaging, security, privacy, and hardware?
1There are no digital health / health information standards for data exchange, transmission, messaging, security, privacy, and hardware.
2There are some digital health / health information standards for data exchange, transmission, messaging, security, privacy, and hardware that have been adopted and/or are used.
3Digital health / health information standards for data exchange, transmission, messaging, security, privacy, and hardware have been published and disseminated in the country under the government’s leadership.
4Digital health / health information industry-based technical standards for data exchange, transmission, messaging, security, privacy, and hardware are in use in the majority of applications and systems to ensure the availability (and use) of high-quality data. Conformance testing is routinely carried out to certify implementers.
5Data standards are routinely updated and data is actively used for monitoring and evaluating the health system and for national health strategic planning and budgeting.
Infrastructure
Indicator 17 - Network readiness
Extract the Portuland institute technology pillar of network network readiness index score (https://networkreadinessindex.org )
10
2< 25
326 - 50
451 - 75
5> 75
Indicator 18 - Planning and support for ongoing digital health infrastructure maintenance
Is there an articulated plan for supporting the expansion of digital health infrastructure (including equipment- computers/ tablets/ phones, supplies, software, devices, etc.) provision and maintenance to all public healthcare facilities?
1There is no articulated plan for supporting digital health infrastructure (including equipment- computers/ tablets/ phones, supplies, software, devices, etc.) provision and maintenance.
2A plan for supporting digital health infrastructure (including equipment- computers/ tablets/ phones, supplies, software, devices, etc.) provision and maintenance has been developed, but not implemented.
3A plan for supporting digital health infrastructure (including equipment- computers/ tablets/ phones, supplies, software, devices, etc.) provision and maintenance has been implemented partially, but not consistently with estimated 0-25% of necessary digital health infrastructure needed in public healthcare service sector available and in use.
4A plan for supporting digital health infrastructure (including equipment- computers/ tablets/ phones, supplies, software, devices, etc.) provision and maintenance has been implemented partially and consistently with estimated 25-50% of necessary digital health infrastructure needed in public healthcare service sector available and in use.
5Digital health infrastructure (including equipment- computers/ tablets/ phones, supplies, software, devices, etc.) is available, in use, and regularly maintained and upgraded in >75% of public healthcare service sector. Strategies are being implemented to close outstanding gaps in access/coverage and reach the whole population.
Services & Applications
Indicator 19 - Nationally scaled digital health systems
Public sector priorities are supported by nationally-scaled digital health systems
1National priority areas are not supported by digital health at any scale.
2Few national priority areas are supported by digital health, and implementation initiated (< 25% priority areas).
3Some national priority areas supported by scaled digital health systems (25-50% of priority areas).
4The majority, but not all national priority areas (50-75% of priority areas) supported by scaled digital health systems.
5All nationally prioritized areas supported by national-scale digital health systems (>75%) with monitoring and evaluation systems and results.
Indicator 20 - Digital identity management of service providers, administrators, and facilities for digital health, including location data for GIS mapping
Are health system registries of uniquely identifiable providers, administrators, and public facilities (and private if applicable) available, accessible and current? Is the data geotagged to enable GIS mapping with protocols in place to protect sensitive datasets?
1Health system registries of uniquely identifiable providers, administrators, and public facilities (and private if applicable) are not available, accessible and current.
2Health system registries of uniquely identifiable providers, administrators, and public facilities (and private if applicable) are being developed but are not available for use.
3Health system registries of uniquely identifiable providers, administrators, and public facilities (and private if applicable) are available for use, but incomplete, partially available, used sporadically, and irregularly maintained.
4Health system registries of uniquely identifiable providers, administrators, and public facilities (and private if applicable) are available, used, and regularly updated and maintained. The data is geo-tagged to enable GIS mapping.
5Geotagged Health system registries of uniquely identifiable providers, administrators, and public facilities (and private if applicable) are available for all transactions, systematically used, and regularly updated, maintained, monitored, and evaluated.
Indicator 21 - Digital identity management of individuals for health
Are secure registries or a master patient index of uniquely identifiable individuals available, fully representative of the population, accessible and current for use for health-related purposes?
1No secure registry or master patient index exists.
2A secure registry exists, but is incomplete / partially available, used, and irregularly maintained.
3A secure registry exists, is available and in active use and includes <25% of the relevant population.
4A secure registry exists, is available and in active use and includes 25-50% of the relevant population.
5A secure registry exists, is available and in active use and includes >75% of the relevant population. The data is available, used, and curated. Strategies are being implemented to include missing data and ensure fully representative datasets are available.
Indicator 21a - Digital identity management of individuals for health
Specifically, is there a secure master patient index of uniquely identifiable individuals available, accessible and current for use for health-related purposes?
1No secure master patient index exists.
2A master patient index exists, but is incomplete / partially available, used, and irregularly maintained.
3A master patient index exists, is available and in active use and includes <25% of the relevant population.
4A master patient index exists, is available and in active use and includes 25-50% of the relevant population.
5A master patient index exists, is available and in active use and includes >75% of the relevant population. The data is available, used, and curated. Strategies are being implemented to include 100% of the population.
Indicator 21b - Digital identity management of individuals for health
Specifically, is there a secure birth registry of uniquely identifiable individuals available, accessible and current for use for health-related purposes?
1No secure birth registry exists.
2A secure birth registry exists, but is incomplete / partially available, used, and irregularly maintained.
3A secure birth registry exists, is available and in active use and includes <25% of the relevant population.
4A secure birth registry exists, is available and in active use and includes 25-50% of the relevant population.
5A secure birth registry exists, is available and in active use and includes >75% of the relevant population. The data is available, used, and curated. Strategies are being implemented to include 100% of the population.
Indicator 21c - Digital identity management of individuals for health
Specifically, is there a secure death registry of uniquely identifiable individuals available, accessible and current for use for health-related purposes?
1No secure death registry exists.
2A secure death registry exists, but is incomplete / partially available, used, and irregularly maintained.
3A secure death registry exists, is available and in active use and includes <25% of the relevant population.
4A secure death registry exists, is available and in active use and includes 25-50% of the relevant population.
5A secure death registry exists, is available and in active use and includes >75% of the relevant population. The data is available, used, and curated. Strategies are being implemented to include 100% of the population.
Indicator 22 - Secure Patient Feedback Systems
Specifically, is there a secure Patient feedback system, available, accessible?
1No secure patient feedback system exists.
2A secure patient feedback system exists for some health services, but is incomplete/ partially available, used, and irregularly maintained.
3A secure feedback system exists, is available and in active use and includes data from <25% of the relevant health services and/or geographic location. It is available to some of the population.
4A secure feedback system exists, is available and in active use and includes data from 25-75% of the relevant health services and/or geographic location. It is available to most of the population.
5A secure feedback system exists, is available in accessible formats and in active use and includes data from >75% of the relevant health services and/or geographic location. It is available to 100% of the population.
Indicator 23 - Population health management contribution of digital health
Are current country digital health initiatives contributing to public health reporting and decision making?
1No contribution from any digital health initiative to routine reporting or for data-based decision making for population health management.
2Digital systems used at district/state levels only contribute to country public health reporting and decision making for population health management.
3Digital systems are used at facility or community levels and contribute to the country's public health reporting and decision-making for population health management.
4Digital systems are used at facilities or communities and by individuals and contribute to the country's public health reporting and decision-making for population health management.
5Digital systems used at all levels, including by individuals, contribute to timely country public health reporting and decision making for population health management.