CC BY-NC-ND 4.0 · Appl Clin Inform 2022; 13(05): 991-1001
DOI: 10.1055/s-0042-1757554
AIDH Summit 2022

Evaluating Digital Health Capability at Scale Using the Digital Health Indicator

Leanna Woods
1   Centre for Health Services Research, The University of Queensland, Brisbane, Australia
2   Digital Health Cooperative Research Centre, Sydney, Australia
3   Queensland Digital Health Centre, The University of Queensland, Brisbane, Australia
Rebekah Eden
4   School of Information Systems, Queensland University of Technology, Brisbane, Australia
Andrew Pearce
5   Healthcare Information and Management Systems Society, Singapore, Singapore
Yu Ching Ides Wong
6   Prevention Division, Queensland Health, Brisbane, Australia
Lakshmi Jayan
5   Healthcare Information and Management Systems Society, Singapore, Singapore
Damian Green
7   eHealth Queensland, Queensland Health, Brisbane, Australia
Keith McNeil
6   Prevention Division, Queensland Health, Brisbane, Australia
Clair Sullivan
1   Centre for Health Services Research, The University of Queensland, Brisbane, Australia
3   Queensland Digital Health Centre, The University of Queensland, Brisbane, Australia
8   Digital Metro North, Metro North Hospital and Health Service, Brisbane, Australia
› Author Affiliations


Background Health service providers must understand their digital health capability if they are to drive digital transformation in a strategic and informed manner. Little is known about the assessment and benchmarking of digital maturity or capability at scale across an entire jurisdiction. The public health care system across the state of Queensland, Australia has an ambitious 10-year digital transformation strategy.

Objective The aim of this research was to evaluate the digital health capability in Queensland to inform digital health strategy and investment.

Methods The Healthcare Information and Management Systems Society Digital Health Indicator (DHI) was used via a cross-sectional survey design to assess four core dimensions of digital health transformation: governance and workforce; interoperability; person-enabled health; and predictive analytics across an entire jurisdiction simultaneously. The DHI questionnaire was completed by each health care system (n = 16) within Queensland in February to July 2021. DHI is scored 0 to 400 and dimension score is 0 to 100.

Results The results reveal a variation in DHI scores reflecting the diverse stages of health care digitization across the state. The average DHI score across sites was 143 (range 78–193; SD35.3) which is similar to other systems in the Oceania region and global public systems but below the global private average. Governance and workforce was on average the highest scoring dimension (x̅= 54), followed by interoperability (x̅ = 46), person-enabled health (x̅ = 36), and predictive analytics (x̅ = 30).

Conclusion The findings were incorporated into the new digital health strategy for the jurisdiction. As one of the largest single simultaneous assessments of digital health capability globally, the findings and lessons learnt offer insights for policy makers and organizational managers.

Protection of Human and Animal Subjects

The study was performed in compliance with the Ethical Principles for Medical Research Involving Human Subjects and received multisite ethics approval from the Royal Brisbane and Women's Hospital [ID: HREC/2020/QRBW/66895], and research governance approvals from all sites.

Publication History

Received: 29 April 2022

Accepted: 24 August 2022

Article published online:
19 October 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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Rüdigerstraße 14, 70469 Stuttgart, Germany

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