Comparative analysis of digital health strategies in Malta and Estonia : lessons and policy implications

Abstract

This dissertation presents a comparative analysis of the digital health strategies adopted by Malta and Estonia, with the aim of identifying key differences, shared challenges, and opportunities for mutual learning. Digital health refers to the application of information and communication technologies (ICT) to enhance healthcare delivery, improve patient outcomes, ensure continuity of care, and support healthcare professionals in their daily work. By focusing on core digital health services such as e-prescriptions, electronic health records, telemedicine, and remote patient monitoring, the study investigates how each country uses these tools to address public health challenges. An exploratory qualitative methodology was employed, comprising document analysis of national digital health policies and semi-structured interviews with Maltese healthcare professionals. The data analysis yielded five overarching themes: Governance and Strategic Decision-Making; Digital Transformation and Health Information Systems; Health Workforce; Service Delivery and Access; and Financing and Sustainability. Findings reveal that while Estonia has achieved a high level of digital health integration supported by strong digital infrastructure and citizen engagement, Malta is still in the process of expanding and consolidating its digital health systems. However, both countries face common healthcare challenges, including workforce shortages, rising chronic diseases, and ageing populations. The analysis highlights valuable lessons each country can learn from the other. Malta could benefit from Estonia’s citizen-centric digital model, while Estonia might draw insights from Malta’s focus on patient safety and regulatory rigour. The study concludes with policy recommendations to encourage cross-country collaboration and strengthen the long-term sustainability of digital health systems.