Health Review | January – April 2024

DIGITAL TRANSFORMATION (DT) IN HEALTHCARE The following are presented, by the global community, as the main fields of Digital Transformation (DT) in Healthcare: Telemedicine Telemedicine is the remote delivery of healthcare services through Information and Communication Technologies (ICTs). It could be particularly beneficial in a range of services such as medical consultation, diagnosis remote monitoring of patients’ status and educational purposes. Patients could connect with healthcare providers at a distance using video calls, messaging platforms, or other communication tools.

In modern times, technology is the driving force behind all human activity. The Internet is an integral part of people's lives and the majority of daily activities are carried out through it. The health sector is no exception as new concepts such as e-health, mobile health etc. have been introduced. Patients and potential users of health services use the websites of healthcare institutions to find and access information about their health problems in health services. The present research carried out as part of a diploma thesis for the Information and Communication Systems Engineering Department of the "Electronic Governance" Master's Program of the Aegean University, attempts to investigate the quality and completeness of the websites of Greek nursing institutions. The object of the research is the evaluation of hospital websites using the HSWAI evaluation tool. It is an excel file containing four(4) criteria with sixteen(16) indicators and one hundred sixty-eight(168) sub-indicators. Each sub-indicator includes a presumption that is examined to see if it is met by the nursing website under investigation. In the end a score is produced that identifies the hospital website according to the iHSWAI index global ranking. This fact helps the users and potential customers of health services to compare and choose the provider that satisfies them while at the same time it helps the administrations of the institutions to improve and enrich their hospital websites. The research sample consists of public and private nursing institutions operating in the Greek territory. One hundred and twenty-three(123) public hospitals and one hundred and twenty-two(122) private hospitals were evaluated, while sixty-four(64) institutions were not evaluated due to a lack of a website or technical difficulties. The results of the survey revealed that public hospitals have more complete websites as they performed better in the HSWAI score than the prifinvate ones. Also, the comparisons made in the context of the research results showed that the more beds a hospital manages, the better quality and more complete website it has. Also, the quality of hospital websites depends on the geographic area where the hospitals are located and the Health District they belong to.

Every country should aim to strengthen the efficiency, accessibility and quality of its health system. To achieve this goal, the digital transformation of hospitals, which are the main pillars of any health system, is necessary. Patients and potential users of health services use the websites of healthcare institutions to find and access information about their health problems in health services. Greece has two hundred and forty-five(245) public and private hospitals. Using the HSWAI tool of the United Nations University in Portugal – Operating Unit on Policy Driven Electronic Governance, the websites of the aforementioned hospitals were evaluated. The results of the evaluation were used to compare with the corresponding results in a survey conducted in Portugal with the same tool. The current paper deals with the comparison of the overall values according to HSWAI between the hospitals of Greece and Portugal as countries with a European character and both with a similar profile (population, economy, health spending etc). Specifically, comparison was made of overall HSWAI values of Greek and Portuguese hospitals. Also, a comparison was carried out of HSWAI values of Greek and Portuguese hospitals in the four Criterions of the tool such as “Content”, «Services», «Community Interaction» and «Technology Features». From the comparison came up that in three criteria Portuguese hospitals have better performance and Greek hospitals are ahead only in Criterion «Technology Features». In conclusion, Portuguese hospitals have more complete, better quality and more interactive websites than Greek ones.

Globally, the tremendous growth of Information and Communication Technology (ICT) has led to a great expansion of the information produced, emerging new terms such as E-government (EG), Digital Governance (DG), and Digital Transformation (DT) that brought revolutionary changes in public administration and other sectors such as telecommunication, industry, and energy but not enough in public healthcare area. This study set out to explore the level of development of DT of Greek Public Healthcare (GPH) since 2000, focusing on the e-Health and Digital Health (DH) applications and services, and highlighting its accelerated development due to COVID-19 pandemic and its main problems in its application. A review of comparative studies published from 2000 to date was conducted. Search was demonstrated on Organisation for Economic Co-operation and Development (OECD), European Commission and Open Data Institute (ODI) databases, and Greek Legislation Framework. Keywords we used: «Digital Transformation», “Digital Governance”, “e-Health”, “Digital Health”, “Electronic Health Record”, “e-prescription”, “Health Information Systems”, “Health Atlas”, “m- Health/Mobile Health”, “Telemedicine”, “Telehealth”, “ICT Action Plan”. During the first decade, there were many advances in DG and DT, like the Integrated Health Information Systems (IHIS), which in the majority of their implementation have not adequately fulfilled their role remaining as isolated HIS. The second decade, marked by the memorandum and the economic crisis, brought many significant changes in the context of the organization and rational administration of the GPH, especially in the field of DT, DG, and e-Health such as e-prescription, ESY.net, e-inventories, e- warehouses, e- invoicing of hospital charges, electronic Statements of Detailed Health Documents (eDAPY), the United4Health project, the National Telemedicine Network and the partially developed Individual Electronic Health Record (IEHR). Taken together, these results suggest that, Greece still lags in the field of e- Health and significant steps are needed to make GPH cost-effective, accessible, and inclusive, such as among others the integration of IEHR and the import of Laboratory Information System (LIS) and Picture Archiving and Communication System (PACs) data into the IEHR.