Abstract
Digital maturity assessments can inform strategic decision-making. However, national approaches to assessing the digital maturity of health systems are in their infancy, and there is limited insight into the context and processes associated with such assessments. This viewpoint article describes and compares national approaches to assessing the digital maturity of hospitals. We reviewed 5 national approaches to assessing the digital maturity of hospitals in Queensland (Australia), Germany, the Netherlands, Norway, and Scotland, exploring context, drivers, and approaches to measure digital maturity in each country. We observed a common focus on interoperability, and assessment findings were used to shape national digital health strategies. Indicators were broadly aligned, but 4 of 5 countries developed their own tailored indicator sets. Key topic areas across countries included interoperability, capabilities, leadership, governance, and infrastructure. Analysis of indicators was centralized, but data were shared with participating organizations. Only 1 setting conducted an academic evaluation. Major challenges of digital maturity assessment included the high cost and time required for data collection, questions about measurement accuracy, difficulties in consistent long-term tracking of indicators, and potential biases due to self-reporting. We also observed tensions between the practical feasibility of the process with the depth and breadth required by the complexity of the topic and tensions between national and local data needs. There are several key challenges in assessing digital maturity in hospitals nationally that influence the validity and reliability of output. These need to be explicitly acknowledged when making decisions informed by assessments and monitored over time.