JMIR Publications

ABSTRACT

Background:

Digital health development is often fragmented, with intervention- and innovation-oriented approaches applied interchangeably despite distinct goals and evaluation criteria. This misalignment can result in limited user engagement, premature scale-up, and implementation failure. Existing frameworks offer guidance, but vary widely in scope, terminology, and purpose.

Objective:

This study aimed to develop a harmonized lifecycle structure that supports alignment across digital health frameworks and stakeholder needs.

Methods:

We conducted a multi-step analysis integrating a rapid review and comparative framework analysis. Relevant influential digital health frameworks were selected based on defined inclusion criteria. We analyzed each framework’s structure, assumptions, and use cases through structured coding informed by implementation science, innovation management, and human-centered design. A grounded, iterative process of constant comparison and thematic abstraction was used to identify shared lifecycle functions and align conceptual elements.

Results:

The study generated four key outcomes: (1) a structured map of conceptually diverse digital health frameworks; (2) a positioning of these frameworks along an intervention–innovation continuum based on their input and output logic; (3) a neutral set of cross-cutting lifecycle functions enabling structured comparison across frameworks; and (4) a practical roadmap that integrates these elements to guide alignment between development efforts and system readiness. The frameworks were grouped into three structural types – development-process models, readiness/maturity models, and macro-level transition models – each addressing different lifecycle functions. Their combined alignment revealed complementary roles in supporting the design, evaluation, scale-up, and systemic adoption of digital health solutions.

Conclusions:

This study offers a transdisciplinary structure that clarifies the contributions of existing digital health frameworks and enables their coordinated use. By introducing neutral lifecycle functions and a practical mapping tool, the work supports researchers, developers, and policymakers in selecting and sequencing frameworks aligned with their goals and contexts. The results promote coherence, evidence-informed decision-making, and more sustainable digital health implementation.