Digitalising health systems relies on the availability of high-quality, interoperable data to deliver efficient, resilient, and equitable healthcare. Digital technologies such as telemedicine, electronic health records (EHRs), digital therapeutics and artificial intelligence (AI) are becoming widely used, enhancing continuity of care and accelerating the timeliness of delivery. Recognising their potential to reduce healthcare disparities, countries are continuing to expand health information infrastructure, and are making health data readily accessible to strengthen system resilience, improve performance, and facilitate cross-border co‑operation (OECD, 2022[1]).
OECD countries have made progress in expanding access to EHRs. In 2024, the average availability of online digital health services reached 82%, an increase from 79% in 2023 among countries with comparable data. Only Belgium and Estonia currently provide full access to EHRs functions. Availability remains low in Ireland, where citizens have access to fewer than 30% of EHR core functionalities (Figure 9.13). Nevertheless, all countries improved EHR accessibility since 2022, with the highest increases in Czechia, France, Ireland, Portugal and the Slovak Republic. This progress reflects growing investment in data accessibility but ensuring interoperability across hospitals, general practices and other healthcare facilities remains challenging. Ensuring interoperability is not only a technical hurdle but also an organisational and governance challenge, as fragmented data systems reduce efficiency, hinder continuity of care, and limit the potential of advanced analytics and AI.
Building trust is essential to encourage the active use of digital health technologies. The 2024 Patient‑Reported Indicator Surveys (PaRIS) survey highlights that older and less educated individuals are less confident in using digital tools to manage their health and report more difficulty understanding health information than younger and more‑educated individuals. Across the surveyed OECD countries, the gap in digital health literacy between education levels exceeds 15 percentage in France, Iceland, Australia, the United States and Wales (United Kingdom), with those having lower education reporting significantly less confidence. By contrast, in Saudi Arabia and Slovenia, individuals with less education report higher confidence, and in Romania, Portugal and Belgium, the gap between groups is comparatively small (Figure 9.14).
During the COVID‑19 pandemic, telemedicine was essential for delivering care. In 2019, remote consultations via phone or video averaged 0.5 per patient per year across OECD countries. By 2021, this more than doubled to 1.3 teleconsultations, with significant increases in Australia, Lithuania, Spain and Slovenia. However, by 2023, the rate of teleconsultations had stabilised to 1.0 per patient per year, reflecting a partial retreat from pandemic peaks while maintaining levels well above pre‑pandemic baselines. Israel had the highest use in 2023 (2.8 teleconsultations per patient per year), while the largest post-pandemic drops occurred in Poland, Lithuania and Spain (Figure 9.15). After realising the benefits through the pandemic, health systems have expanded use of remote consultations, although financial, legal and operational barriers still exist (Keelara, Sutherland and Almyranti, 2025[2]). Sustaining telemedicine use will require not only addressing legal and financial barriers, but also adapting payment systems, strengthening broadband infrastructure, and embedding teleconsultations into mainstream care pathways.
