Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jun 8, 2024
Open Peer Review Period: Jun 10, 2024 - Aug 5, 2024
Date Accepted: Sep 18, 2024
(closed for review but you can still tweet)
How digitally advanced is your public health system? Narrative review of indicators published in grey literature
ABSTRACT
Background:
Revealing the full potential of digital public health (DiPH) systems requires a wide-ranging tool to assess their maturity and readiness for emerging technologies. Although a variety of indices exist to address digital health systems, questions arise regarding the integration of indicators on information-communication-technology maturity and readiness, digital (health) literacy, and interest in DiPH tools by the society and workforce, as well as the legal maturity and readiness of digitalized health systems. Existing tools frequently target one of these domains while overlooking the others. Additionally, no review has been conducted to holistically investigate available national DiPH system maturity and readiness indicators using a multidisciplinary lens.
Objective:
Applying a narrative review, we aimed to map the landscape of DiPH system maturity and readiness indicators published in the grey literature.
Methods:
As original indicators were not published in scientific databases, we applied pre-defined search strings to DuckDuckGo.com and Google.com for 11 countries from all continents classified as having reached level 4 of 5 in the latest Global Digital Health Monitor evaluation. Additionally, 19 international organizations (such as the World Health Organization, World Bank, or International Telecommunication Union) were searched for maturity and readiness indicators concerning DiPH.
Results:
Of the 1484 identified references, 137 were included and named 15806 indicators (2129 after assessment for eligibility and duplication screening). We deemed 286 indicators from 90 references relevant for DiPH system maturity and readiness assessments. Most of these (133) had a legal background, and the fewest (37) were related to social domains. Although most indicators focused on clinical and healthcare-related topics, we identified indicators for various DiPH settings and issues, including data protection, literacy, infrastructure, empowering vulnerable groups, health promotion, public health surveillance, and workforce preparedness.
Conclusions:
Our work is the first to comprehensively analyze the gray literature on maturity and readiness assessments from multidisciplinary perspectives. By this, we contributed towards a more holistic understanding of DiPH and justify why such a perspective is essential when conducting evaluations of digital healthcare systems to effectively leverage digital technologies to optimize public health goals and functions. Although new methods for systematically researching grey literature are needed, our study holds the potential to develop more comprehensive tools for DiPH system maturity and readiness 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 DiPH system maturity and readiness, we foster informed decision-making among healthcare planners and practitioners to improve resource distribution and continue to drive innovation in healthcare delivery.
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Copyright
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