Accepted for/Published in: JMIR Research Protocols
Date Submitted: Jul 8, 2025
Date Accepted: Oct 31, 2025
International Case Studies to Identify Success Factors and Contextual Conditions in the Digital Transformation of Healthcare Systems and Derive Lessons for Germany: A Study Protocol for a Mixed-Methods Study
ABSTRACT
Background:
Germany’s healthcare system continues to face significant challenges in its digital transformation due to outdated structures, interoperability issues, strict data protection regulations, and low user acceptance, despite numerous legislative initiatives and substantial financial resources. In contrast, several international healthcare systems have successfully advanced their digital transformation, offering valuable insights and potential lessons for Germany.
Objective:
This study, as part of the 'NADI' research project, analyzes international healthcare systems to identify key success factors and formulate pragmatic recommendations for German policymakers to enhance the country’s digital health implementation.
Methods:
This study uses a mixed-methods triangulation approach combining case study selection, qualitative expert interviews and a quantitative online survey to develop practical policy recommendations for the digital transformation of healthcare in Germany. The study applies the concept of tipping points and success factor research to identify critical moments and success factors in the digital transformation of the healthcare system, where certain actions or conditions fundamentally influence adoption and success.
Results:
From November 2024 to July 2025, interviews with international healthcare experts will be conducted. A quantitative survey is planned for September 2025. Initial results are expected to be published by the end of 2025.
Conclusions:
The utilization of a case study methodology has been demonstrated to facilitate the acquisition of invaluable insights into international best practices, whilst concurrently offering the opportunity to identify specific success and failure factors. The employment of qualitative expert interviews serves to contextualize the international results on tipping points and success factors in the implementation and use of digital health tools. The transfer of the international results to Germany represents a central core of the research project, the objective of which is to investigate practical implementation. The combination of these approaches forms a comprehensive basis for deriving specific recommendations for action for the German healthcare system.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.