Sustainable value generation from digital health investments: lessons from EU-funded projects preceding the European health data space

Abstract

Purpose: The pursuit of eHealth interoperability across Europe has seen substantial public investment in EU-funds (over €200 million) and in experts' time over the last two decades. In an era of preparation towards the European Health Data Space (EHDS) recovering this knowledge is essential and this article aims to identify such EU-funded projects and assess the long-term accessibility of their outputs. It derives consequences for impact and knowledge transfer and highlights implications for health policy worldwide and the developing EHDS.

Methods: We conducted a narrative review, informed by methodical searching and reported following PRISMA-ScR guidance, of the outputs of 31 EU-funded digital health interoperability projects spanning two decades (2005-2024). Project websites, access to deliverables and peer-reviewed publications were methodically assessed. The findings were critically analysed regarding current EU policy frameworks and discussed considering global relevance.

Findings: Despite the ambitious goals and funding allocated to these projects, a substantial portion of their outputs is no longer accessible, published as academic or even as grey literature, hindering the development of EU interoperable eHealth systems. 8 projects generated no peer-reviewed publications and nearly half lacks functional project websites post-project terminus. Existing EU repository CORDIS appears insufficient or inappropriately used as just half of projects have comprehensive outputs available there. These shortcomings limit cumulative learning, knowledge transfer and the assessment of the sustainability, value and impact of the public funds invested.

Implications: Our findings underscore the importance of strong knowledge governance for publicly funded international digital health initiatives. We recommend funders to implement stronger instruments for mandating open-access publications that are peer-reviewed and the systematic archiving of all project deliverables with citable identifiers. Implementing these measures within publicly funded programmes can limit loss of knowledge and foster sustainable open innovation, promoting more effective and efficient public investment backing digital health systems worldwide.

Keywords: Academic dissemination; Cross-border healthcare; Digital health interoperability; EU-funded projects; Knowledge transfer.