Providing citizens with easy online access to eHealth services is a key objective of most countries in Europe. Nevertheless, the implementation of such large-scale projects remains a distant dream for most of the continent’s nations. Indeed, new data from the European Commission’s eGovernment Benchmark shows that while access to most online public services has generally improved, there is a yawning digital divide between the nations surveyed when it comes to the delivery of digital health services.
Covering the EU27 member states, the European Free Trade Association countries including Iceland, Norway and Switzerland, as well as EU candidate countries such as Albania, North Macedonia and Turkey, the report analyzed more than 14,000 government websites to measure the level of accessibility for citizens in Europe . Perhaps unsurprisingly, given their well-established reputation for digital innovation and strong civil societies, countries in Scandinavia and Central Europe ranked high in most categories, alongside Eastern European tech hubs such as Estonia.
One notable participant, however, was Malta. Known more for its thriving tourism than its start-up culture, the Mediterranean nation has yet to develop a reputation for innovation in digital government services. However, data from the Benchmark shows that at least nine out of ten government services in Malta can be found through a government portal, allowing users to access these services without having to print out application forms or visit a government service desk in person. While other European countries are struggling to get their digital identity systems off the ground, more than 90% of government services in Malta can be accessed through the national digital identity system.
Much of the reason for Malta’s success in e-government is its long-term investment in IT. Back in 2014 it launched the Digital Malta Strategy, a vision for the islands to thrive as a ‘digitalised nation across all sectors of society’, with a particular focus on the use of ICT to improve access to health and social services and improve people’s lives Education in all areas demographic development and the creation of quality jobs. Building on this momentum, the country launched the €40 million CONvErGE project three years later to complement its nascent e-government program by developing new systems and platforms for the tourism sector and disaster relief, and building its national health infrastructure with the to strengthen the name “eHealth”.
The physical size of the islands – which together form an area five times smaller than London – has also been a key factor in Malta’s success in boosting digital government initiatives, explains Prof Ernest Cachia, Dean of the ICT Faculty at the University of Malta. “The full range of government services is there, but on a smaller scale so we can get results back faster,” says Cachia. “There are advantages to being small.”
Data from the eGovernment Benchmark also shows that two other relatively small countries, Estonia and Luxembourg, are the highest-scoring countries for digital government services after Malta. tech monitor has previously reported on how countries like Estonia have pioneered eGovernment services like digital identity systems, often through innovative projects like the nationwide hackathon, which invited developers from all over the world to participate.
While size may not be the single most important factor in a country’s success in delivering digital government services, it can play an important role in enabling states to respond quickly and efficiently to emerging trends. A Nesta study of how innovation happens in five countries with fewer than 10 million inhabitants came to a similar conclusion. “Because they lack large domestic markets or the scale to be at the forefront of research in all areas, they have made the most of their existing advantages and developed others,” the report’s authors wrote.
The success of these countries is of course not shared equally across the European bloc. According to data from the eGovernment Benchmark, while citizens’ access to online public services has been facilitated in 77% of European countries, key e-health services are still in their infancy. Only three countries – again Malta, Luxembourg and Estonia – have eHealth maturity scores above 90%, which means that citizens in these three countries are well supported by digital health services.
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An analysis of the benchmark data also shows that at least eight countries have an eHealth maturity level below 50%, which in turn means that people in these countries have to resort to non-digital methods to access certain health services. In Albania, for example, citizens could not obtain a European Health Insurance Card online or apply for electronic health records. Also in Austria, teleconsultation with doctors is not available and citizens do not have access to digital means to register and reschedule hospital appointments. In France and Germany, on the other hand, efforts to set up online services to obtain an ‘e-prescription’ from a hospital doctor are currently lagging behind those in Spain and Italy.
The unequal access to these essential health services is even more pronounced when it comes to migrants. Benchmark survey data shows that only three in ten services (34%) can be accessed online by foreign citizens, with the lack of English information on hospital websites being the biggest obstacle. Although the maturity of digital government services has advanced since the pandemic, there is still room for improvement, explains Marc Reinhardt, Head of Public Sector and Health at the IT consultancy Capgemini.
“We have seen that good digital health capabilities have enabled countries to better manage the pandemic by helping to organize vaccination campaigns and decentralize treatments during lockdown,” says Reinhardt. Despite this, “this year’s eGovernment Benchmark report identifies eHealth as a clear area for improvement in terms of user accessibility and experience across the board”.
Closing the gap in eHealth service delivery will be a key challenge for EU countries in the years to come, and there are clear signs that the regional bloc is taking the development of eGovernment services seriously. In July, EU member states agreed on a landmark policy program to implement digital transformation across the region, aiming to help countries meet the transformation goals set out in the Digital Compass 2030 – a set of guidelines that define competencies and cover digital infrastructure. However, an analysis of the targets set by the EU to improve the bloc’s digital infrastructure across the board shows that member states still have a long way to go.
While improving digital literacy is not too far off the 2030 targets, other aspects of the EU plans such as improving access to 5G remain a long way off. Countries like Denmark and Finland are already close to meeting their targets for the share of SMEs with a “baseline level of digital intensity”, but other countries like Romania and Bulgaria are still lagging behind. It remains to be seen whether EU Member States, which have shown success in rolling out digital government initiatives, will be able to spread the resources and expertise across the region.