Which country in Europe provides the best eHealth services? Try Malta

Allowing citizens to easily access eHealth services online is a key objective for most countries in Europe. However, the realization of such large-scale projects remains a distant dream for most nations on the continent. In fact, new data from the European Commission eGovernment Benchmark reveals that while access to most public services online has generally improved, a gaping digital divide between the nations surveyed persists when it comes to the provision of digital health services.

Covering the 27 EU member states, European Free Trade Association countries including Iceland, Norway and Switzerland, and EU candidate countries such as Albania, North Macedonia and Turkey, the report analyzed more than 14,000 government websites for to assess levels of accessibility for citizens across the country. Europe. Perhaps unsurprisingly given their established reputations for digital innovation and strong civil societies, Scandinavian and Central European countries ranked highly in most categories, along with Eastern European tech hubs like Estonia.

One notable participant, however, was Malta. Known more for its booming tourist trade than its startup culture, the Mediterranean nation has yet to establish a strong reputation for innovation in digital government services. However, Benchmark data reveals that at least nine out of ten government services in Malta can be found through a government portal, with users accessing these services without the need to print out application forms or visit a government counter in person services. Indeed, while other European countries struggle to roll out their digital identity systems, more than 90% of government services in Malta can be accessed through the national digital identity system.

The reason for Malta’s success in e-government is largely down to its long-term investment in IT. In 2014, it was launched Digital Malta Strategy, a vision for the islands to prosper as a “digitally enabled nation in all sectors of society”, with a particular focus on using ICT to improve access to health and social services, improve education across demographics and create quality jobs. Building on this momentum three years later, the country launched a €40 million Project CONVERGE to strengthen its nascent e-governance program by developing new systems and platforms for the tourism sector and disaster response, as well as building its national health infrastructure called ‘eHealth’.

The physical size of the islands – which together form an area five times the size of London – is also a key factor in Malta’s success in driving digital government initiatives, explains Prof Ernest Caccia, Dean of the University of Malta’s Faculty of ICT. “It has the full range of government services, but on a smaller scale, so we can return results faster,” says Cachia. “There are advantages to being small.”

The eGovernment benchmark data also shows that two other relatively small countries, Estonia and Luxembourg, rank behind Malta as the highest scoring countries for digital government services. Technical monitor previously reported on how countries such as Estonia pioneered e-government services such as digital identity systems, often through innovative projects such as country-wide hackathons where developers from around the world were invited to participate.

While size may not be the primary determinant of a country’s success in providing digital government services, it can play an important role in enabling countries to respond quickly and efficiently to emerging trends. Research of nesta on how innovation happens in five countries with populations under ten million reached a similar conclusion. “Lacking large domestic markets or the scale to lead research in any field, they made the most of their existing strengths 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 the eGovernment benchmark data, while citizens’ access to online public services is facilitated in 77% of European countries, key eHealth services are still in their infancy. Only three countries – again Malta, Luxembourg and Estonia – have eHealth maturity scores above 90%, meaning that citizens in these three countries are well supported by digital health services.

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Benchmark’s analysis of the data also shows that at least eight countries have an eHealth maturity score below 50%, which in turn means that people in those countries must resort to non-digital methods to access certain health services. In Albania, for example, citizens will not be able to obtain a European Health Insurance Card online or apply for electronic health records. Similarly, teleconsultations with doctors are not available in Austria and citizens do not have access to digital means of registering and rescheduling hospital appointments. Meanwhile, in France and Germany, efforts to set up online services to obtain an “e-prescription” from a hospital doctor are currently lagging behind those in Spain and Italy.

Inequitable access to these key health services is even more pronounced when it comes to migrants. Benchmark research data shows that foreign nationals can only access three in ten services (34%) online, with the lack of English information on hospital websites the biggest barrier. While the maturity of digital government services has advanced since the pandemic, there is still room for improvement, explains Mark Reinhardt, head of public sector and healthcare at IT consultancy Capgemini.

“We saw that good digital capabilities in the health space allowed countries to better deal with the pandemic by helping to organize vaccination campaigns and decentralizing treatments during lockdowns,” says Reinhardt. However, “this year’s eGovernment Benchmark Report identifies eHealth as a clear area for improvement in terms of user accessibility and experience across the board.”

Bridging the divide when it comes to providing eHealth services will be a key challenge for EU countries over the next few years, 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 agenda for digital transformation across the region, aimed at helping countries achieve the transformation goals set out in the 2030 Digital Compass – a set of policies covering skills and digital infrastructure. But an analysis of the targets set by the EU to improve the bloc’s digital infrastructure across the board shows that member states have a long way to go.

Although improving digital literacy is not too far from the targets set for 2030, other aspects of the EU’s plans, such as improving access to 5G, for example, remain in the distance. Countries such as 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 such as Romania and Bulgaria continue to lag behind. It remains to be seen whether EU member states that have demonstrated success in introducing digital governance initiatives can deploy resources and expertise across the region.