"Simplification, decentralization, proximity" - A critical analysis of the digital health framework in Portugal through expert interviews.

Abstract

The implementation of digital health tools and services encounters policy and governance challenges tied to a complex web of stakeholders and influencing factors. This study seeks analyse the digital health framework in Portugal, focusing on digital health policies and interventions. Through a multifaceted approach, this study included the conduction of expert interviews, and an extensive assessment of publicly available official documents, thus allowing a thorough analysis of the national digital health framework. To consolidate all the information gathered, a SWOT analysis was subsequently performed. Eight experts involved with digital health in Portugal were interviewed. Seven key themes were identified and discussed alongside the data extracted from document analysis: 1) the digital health context in Portugal; 2) digital health services, tools, and infrastructure in Portugal: strengths and limitations; 3) budget and resources allocation towards digital health in Portugal; 4) digital health development in Portugal: current status and necessary steps; 5) Digital health accessibility and digital health literacy in Portugal; 6) COVID-19 pandemic and its impact on digital [health] tools usage; and 7) comparison of the digital health framework with other countries: lessons to learn. As digital health has gained momentum in Portugal over the years, it is crucial to enhance governance and transparency, connect digital infrastructures, and promote data availability. These measures, along with a well-defined strategic vision, are essential for cultivating a robust digital health ecosystem.