Fonda Federico, Galazzi Alessandro, Chiappinotto Stefania, Justi Linda, Frydensberg Morten Sønderskov, Boesen Randi Lehmann, Macur Mirna, Reig Erik Andrés, Espaulella Elisenda Reixach, Palese Alvisa
Department of Medical Science, University of Udine, Viale Ungheria 20, 33100 Udine, Italy.
Health Innovation Centre of Southern Denmark, Forskerparken 10, 5230 Odense, Denmark.
Healthcare (Basel). 2023 Dec 20;12(1):16. doi: 10.3390/healthcare12010016.
Digitization has become involved in every aspect of life, including the healthcare sector with its healthcare professionals (HCPs), citizens (patients and their families), and services. This complex process is supported by policies: however, to date, no policy analysis on healthcare digitalization has been conducted in European countries to identify the main goals of digital transformation and its practical implementation. This research aimed to describe and compare the digital health policies across four European countries; namely, their priorities, their implementation in practice, and the digital competencies expected by HCPs. A multiple-case study was performed. Participants were the members of the Digital EducationaL programme invoLVing hEalth profEssionals (DELIVER), a project funded by the European Union under the Erasmus+ programme, involving three countries (Denmark, Italy, and Slovenia) and one autonomous region (Catalonia-Spain). Data were collected using two approaches: (a) a written interview with open-ended questions involving the members of the DELIVER project as key informants; and (b) a policy-document analysis. Interviews were analysed using the textual narrative synthesis and the word cloud policy analysis was conducted according to the Ready, Extract, Analyse and Distil approach. Results showed that all countries had established recent policies at the national level to address the development of digital health and specific governmental bodies were addressing the implementation of the digital transformation with specific ramifications at the regional and local levels. The words "health" and "care" characterized the policy documents of Denmark and Italy (309 and 56 times, 114 and 24 times, respectively), while "development" and "digital" (497 and 478 times, respectively) were common in the Slovenia document. The most used words in the Catalonia policy document were "data" and "system" (570 and 523 times, respectively). The HCP competencies expected are not clearly delineated among countries, and there is no formal plan for their development at the undergraduate, postgraduate, and continuing educational levels. Mutual understanding and exchange of good practices between countries may facilitate the digitalization processes; moreover, concrete actions in the context of HCP migration across Europe for employment purposes, as well as in the context of citizens' migration for healthcare-seeking purposes are needed to consider the differences emerged across the countries.
数字化已渗透到生活的方方面面，包括医疗保健领域，涉及医疗保健专业人员（HCPs）、公民（患者及其家属）以及医疗服务。这一复杂过程受到政策支持：然而，迄今为止，欧洲国家尚未对医疗保健数字化进行政策分析，以确定数字转型的主要目标及其实际实施情况。本研究旨在描述和比较四个欧洲国家的数字健康政策；即它们的优先事项、在实践中的实施情况以及HCPs所需的数字能力。进行了一项多案例研究。参与者是参与数字教育项目的健康专业人员（DELIVER）的成员，该项目由欧盟在伊拉斯谟+计划下资助，涉及三个国家（丹麦、意大利和斯洛文尼亚）和一个自治区（加泰罗尼亚 - 西班牙）。数据通过两种方法收集：（a）对DELIVER项目成员进行开放式书面访谈，将其作为关键信息提供者；（b）进行政策文件分析。访谈采用文本叙述综合法进行分析，词云政策分析按照准备、提取、分析和提炼方法进行。结果表明，所有国家都在国家层面制定了近期政策以应对数字健康的发展，特定政府机构正在处理数字转型的实施，在地区和地方层面有具体影响。“健康”和“护理”这两个词在丹麦和意大利的政策文件中出现频率较高（分别为309次和56次，114次和24次），而“发展”和“数字”（分别为497次和478次）在斯洛文尼亚的文件中较为常见。加泰罗尼亚政策文件中使用最多的词是“数据”和“系统”（分别为570次和523次）。各国对HCP能力的期望没有明确界定，在本科、研究生和继续教育层面也没有关于其发展的正式计划。国家之间的相互理解和良好实践的交流可能会促进数字化进程；此外，需要采取具体行动，以应对HCPs出于就业目的在欧洲范围内的迁移情况，以及公民出于寻求医疗保健目的的迁移情况，以考虑各国出现的差异。
