Successful Member States have a coordinating institution with a clear national mandate.

TH – 05/2019

In the #SmartHealthSystems study, the Bertelsmann Stiftung compared and analysed countries of varying size and differing types of health systems, among these were 14 EU Member States (including Estonia, Denmark and Germany) and three OECD countries (Australia, Canada and Israel). Each of these 17 countries was benchmarked and then evaluated with a new Digital Health Index developed specifically for the study. The index looks at policy activities and strategies, their technical implementation and the actual use of health data by the countries tested.

The Digital Health Index comparison shows that EU Member States and OECD countries are digitalising their health systems at very different speeds. Estonia, Denmark and Canada rank at the top of the index, whereas Germany is one of the countries that is lagging.

However, so far none of the countries surveyed has achieved complete digitalisation, i.e. a perfect state of digitalisation. The study also shows that there is no evidence that the size or infrastructure of a country, the type of healthcare system or the resources available necessarily facilitate digital transformation.

Why are some countries more successful than others?

A look at the successful countries shows that there is no simple recipe for successfully digitalising a healthcare system. However, a clear pattern can be seen: in countries that have found effective digital solutions, the digitalisation of health systems has been given priority by political leaders. There is also broad support from stakeholders involved in decision-making; this is further supported by the exchange of data and good practice.

What can we learn from the study?

The study shows that the progress being made by the European Union’s Member States in the digital transformation of their healthcare systems varies. Countries that are successfully digitalising their health systems owe this to a combination of an effective strategy, strong political leadership and a coordinating institution with a clear national mandate.


The European Commission and Member States should continue to promote the exchange of best practices between health systems and promote common technical specifications and standards for digital health tools and exchange formats.


The study is available here.