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Since the Obama administration declared the development of Electronic Health Records (EHRs) a strategic policy in 2009 and allocated $27 billion to develop such a strategy1, there has been a rapid digital transformation in healthcare systems on a global scale. Some other government bodies, such as the European Union, have also made progress in adopting similar lines of action2.
All these strategies are covered by the 2030 Agenda in its Goal 3 “Good health and well-being” and Goal 9 “Build resilient infrastructure, promote inclusive and sustainable industrialization, and foster innovation.” They also ratified the suitability of the states that have developed public health policies whose strategic lines are based on the digitization of medical information and encouraged other states to follow this path.
Similar suggestions are mentioned in the “Global Strategy on Digital Health 2020-2025” published by The WHO (World Health Organization)3. Such a guide recognizes the existence of a broad consensus around the idea that information technologies will be of the utmost importance to improve the health and well-being of 3 billion people through the interaction of three main actors: private sector, civil society, and technical communities in information and communication technologies. The following are strategic objectives:
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Promoting global collaboration and making progress with the transfer of knowledge on Digital Health.
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Advocating digitally enabled, people-centered health systems.
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Advancing the national implementation of Digital Health Strategies.
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Strengthening governance for digital health at global, national, and regional levels.
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Establishing national interoperable digital health ecosystems, as well as strengthening coordinated collaboration, promoting the use of big data and Artificial Intelligence under appropriate ethical principles and a review of regulations.
Each state has its dynamics and its context. Trying to adapt these general strategic lines to a particular reality can be accomplished thanks to the application of public health policies. It is common for governments to articulate the rules and regulations that satisfy the needs of the states themselves and encourage the development of solutions for third parties, imposing the framework of work that health providers and citizens must follow. This is a very complex process that requires a large amount of economic, administrative, technological, and political effort.
For example, the Spanish and French health systems have very notable differences, while still being neighboring countries and having a similar culture. Spain has a very powerful public network of hospitals and medical centers that is fully paid for with citizens’ taxes, while France has a smaller public network and has co-payment financing between the state, insurers, and patients as a cornerstone (Chevreul et al., 2015), which gives greater freedom to their citizens to choose the practitioner by whom they want to be treated.
The proliferation of digitization and cloud computing made the development of huge state networks that managed the clinical information of citizens possible. Taiwan’s healthcare system can provide a useful frame of reference for possible future developments due to some of its main features. It provides great coverage of patient care ranging from traditional Chinese medicine to odontology, through a cloud information system that allows the integration of medical records used in hospitals and other health care providers. Physicians can access all the information of a patient generated by different institutions, to improve the service provided and avoid duplication in the prescription of medications and performance of treatments (Yeh & Saltman, 2019). For this purpose, a VPN network through which care providers connect their systems with social security information repositories was implemented. Practitioners must use their username and password to access the patient’s medical information. To maintain the privacy of particularly sensitive data, patients have the right to set their passwords to protect access to such information. If a physician wanted to see said information, the patient himself would have to enter his password (Lee et al., 2022).