An exploratory survey of the digital technologyreadiness of the health care workforce acrossnine EU member states
DOI:
https://doi.org/10.12923/pielxxiw-2025-0037Keywords:
digital health infrastructure, EU health policy, health care workforce, survey, digital readiness, cybersecurityAbstract
Introduction. Recent crises such as COVID-19, cyber-attacks on health care digital infrastructure, mass migration and war, highlight the crucial role of digital technology in service delivery. The establishment of the EU4 Health Programme in 2021, emphasized the need for an EU wide comprehensive enhancement of workforce digital skills with an emphasis on crisis resilience. At present there is almost no comparative EU wide workforce survey research in this area to inform effective policy implementation.
Aim. To explore the use of digital technologies, the expressed training needs, the wellbeing and perception of organisational capacities referenced to digital technology across health care workforce in nine European Union states.
Methods. A 36-item survey was developed focused on digital competencies, digital use, cybersecurity awareness, training needs, sense of wellbeing and perception of organisational readiness to implement digital change, utilising convenience sampling. For purposes of analysis workforce respondents were divided between clinical and non-clinical staff. Data was analysed using SPSS according to a pre-registered analysis plan.
Results. After data cleaning, 2,028 respondents’ answers were analysed. Non-clinical staff demonstrated higher proficiency and usage rates in digital technologies. Significant differences between non-clinical and clinical staff were noted in security awareness, with clinical staff having significantly less knowledge/ awareness. All respondents perceived their organisations as only moderately ready to implement digital health care change.
Conclusions. These exploratory results highlight need for policy development and interventions that enhance digital competencies across the EU health workforce. The results also suggest there is a need to address organisational capacities to support both training of the workforce and effective use of the workforce’s digital skills once these are acquired.
References
1. Euractiv. Digital health data compromise hailed as ‘most important health legislation’ in this mandate. 2024 [cited 2022 May 2]. Available from: https://www. euractiv.com/section/health-consumers/news/digital-health-data-compromise¬hailed-as-most-important-health-legislation-in-this-mandate/
2. World Economic Forum. Global Risks Report 20th Edition Insight Report. 2024. Available from: https://www.weforum.org/publications/global-risks-report-2025/
3. Hore K, Hoi Tan M, Kehoe A, et al. Cybersecurity and critical care staff: A mixed methods study. Int J Med Inform. 2024;185:105412. Available from: https://doi.org/10.1016/j.ijmedinf.2024.105412
4. Wells JSG. Preparing for hybrid warfare and cyberattacks on health services’ digital infrastructure: What nurse managers need to know. J Nurs Manag. 2022;30(6):2000¬20004. Available from: https://doi.org/10.1111/jonm.13633
5. Reuters. UK hospitals face ‚unprecedented’ blood shortage after cyber attack. 2024 [cited 2024 Jul 25]. Available from: https://www.reuters.com/world/uk/uk-hospitals¬face-unprecedented-blood-shortage-after-cyber-attack-2024-07-25/
6. McKeon J. Healthcare Data Breaches Continue to Impact Patients in New Year. 2024 [cited 2024 Jul 2]. Available from: https://healthitsecurity.com/news/healthcare¬data-breaches-continue-to-impact-patients-in-new-year
7. European Union Agency for Cybersecurity. ENISA Threat Landscape: Health Sector. 2023 [cited 2024 Jul 2]. Available from: https://www.enisa.europa.eu/news/checking¬up-on-health-ransomware-accounts-for-54-of-cybersecurity-threats
8. European Parliament and Council of the European Union. Regulation (EU) 2021/522 of the European Parliament and of the Council of 24 March 2021 establishing a Programme for the Union’s action in the field of health (‘EU4Health Programme’) for the period 2021-2027, and repealing Regulation (EU) No 282/2014. 2021 [cited 2023 Feb 2]. Available from: https://eur-lex.europa.eu/legal-content/EN/ TXT/?uri=uriserv:OJ.L_.2021.107.01.0001.01.ENG
9. World Health Organization. Global strategy on digital health 2020–2025. Geneva: WHO; 2021. Licence: CC BY-NC-SA 3.0 IGO.
10. Kaihlanen AM, Gluschkoff K, Laukka E, et al. Information system stress, informatics competence and well-being of newly graduated and experienced nurses: a cross-sectional study. BMC Health Serv Res. 2021;21. Available from: https://doi.org/10.1186/s12913-021-07132-6
11. Anmella G, Fico G, Roca A, et al. Unravelling potential severe psychiatric repercussions on healthcare professionals during the COVID-19 crisis. J Affect Disord. 2020;273. Available from: https://doi.org/10.1016/j.jad.2020.05.061
12. Grandinetti P, Gooney M, Scheibein F, et al. Stress and maladaptive coping of Italian health care professionals during the first wave of the pandemic. Brain Sci. 2021;11:1586. Available from: https://doi.org/10.3390/brainsci11121586
13. Organisation for Economic Co-operation and Development. Empowering the health workforce: Strategies to make the most of the digital revolution. 2021.
14. Committee on Digital Skills for Health Professionals of the European Health Parliament. Digital Skills for Health Professionals. 2016 [cited 2023 May 2]. Available from: https://www.healthparliament.eu/wp-content/uploads/2017/09/Digital¬skills-for-health-professionals.pdf
15. Longhini J, Rossettini G, Palese A. Digital Health Competencies Among Health Care Professionals: Systematic Review. J Med Internet Res. 2022;24(8):e36414. Available from: https://doi.org/10.2196/36414
16. Brørs G, Larsen MH, Hølvold LB, et al. eHealth literacy among hospital health care providers: a systematic review. BMC Health Serv Res. 2023;23:1144. Available from: https://doi.org/10.1186/s12913-023-10103-8
17. Borges do Nascimento IJ, Abdulazeem HM, Vasanthan LT, et al. The global effect of digital health technologies on health workers’ competencies and workplace: an umbrella review. Lancet Digit Health. 2023;5(8):e534-e544. https://doi.org/10.1016/S2589-7500(23)00092-4
18. Schneider M, Krauss T, Craig M, et al. Health workforce demand and supply across the European Union. BASYS; 2022 [cited 2024 Jul 2]. Available from: https://www.basys. de/aktuelles/hwf/pdf/BASYS%202022%20-%20HWF%20Summary%20Report.pdf
19. All Policies for a Healthy Europe. Bridging the gap: Digital skills in health and care. 2023 [cited 2023 Mar 3]. Available from: https://healthyeurope.eu/blog/updates/ policy-paper-bridging-the-gap-digital-skills-in-health-and-care/
20. Fahy N, Williams G. Use of digital health tools in Europe before, during and after COVID-19. Policy Brief 42. Copenhagen: WHO Regional Office for Europe; 2021.
21. European Union Commission. Communication From The Commission To The European Parliament And The Council 2020 Strategic Foresight Report Strategic Foresight – Charting The Course Towards A More Resilient Europe COM/2020/493 final. [cited 2022 May 2]. Available from: https://eur-lex.europa.eu/legal-content/ en/ALL/?uri=CELEX%3A52020DC0493
22. European Union Commission. European Commission’s Blueprint – Digital Transformation of Health and Care for the Ageing Society (WE4AHA Co-ordination and Support Action (CSA) 2017-2020 – 2021). 2021 [cited 2022 May 2]. Available from: https://digital-strategy.ec.europa.eu/en/library/blueprint-digital-transformation¬health-and-care-ageing-society
23. Swedberg R. Exploratory Research. In: Elman C, Gerring J, Mahoney J, editors. The Production of Knowledge: Enhancing Progress in Social Science. Cambridge: Cambridge University Press; 2020. p. 17–41.
24. Vuorikari R, Kluzer S, Punie Y. DigComp 2.2: The Digital Competence Framework for Citizens – With new examples of knowledge, skills and attitudes. Luxembourg: Publications Office of the European Union; 2022. doi:10.2760/490274
25. Shea CM, Jacobs SR, Esserman DA, et al. Organizational readiness for implementing change: a psychometric assessment of a new measure. Implement Sci. 2014;9:7. https://doi.org/10.1186/1748-5908-9-7
26. Topp CW, Østergaard SD, Søndergaard S, et al. The WHO-5 Well-Being Index: a systematic review of the literature. Psychother Psychosom. 2015;84(3):167–76. https://doi.org/10.1159/000376585
27. Department of Health. All-Ireland Digital Capability Framework. 2022 [cited 2022 Dec 2]. Available from: https://www.health-ni.gov.uk/publications/all-ireland¬digital-capability-framework
28. Hughes D. Psychometric validity: Establishing the accuracy and appropriateness of psychometric measures. In: The Wiley Handbook of Psychometric Testing: A Multidisciplinary Approach to Survey, Scale and Test Development. Chichester: John Wiley & Sons Ltd; 2018. https://doi.org/10.1002/9781118489772.ch24
29. European Centre for Disease Prevention and Control. Digital technologies for key public health functions – Results of an ECDC expert consultation. Stockholm: ECDC; 2021.
30. WHO European Region. Health and care workforce in Europe: time to act. 2022 [cited 2024 Jan 23]. Available from: https://www.who.int/europe/publications/i/ item/9789289058339
31. Galazzi A, Fonda F, Chiappinotto S, et al. Recommendations to promote the digital healthcare transformation in clinical practice: findings from an international consensus development method. BMC Health Serv Res. 2025;25(1):929. https://doi.org/10.1186/s12913-025-13079-9
32. The Lancet. Editorial: European health security needs a reboot in 2025. Lancet. 2024;404:2487.
33. European Commission. Olivér Várhelyi COMMISSIONER (2024–2029) Health and Animal Welfare. 2024 [cited 2024 Dec 20]. Available from: https://commission. europa.eu/about/organisation/college-commissioners/oliver-varhelyi_en
34. House of Commons Health and Social Care Committee. Workforce: recruitment, training and retention in health and social care. Third Report of Session 2022–23. London: House of Commons; 2023.
35. Zdunek K, Dobrowolska B, Dziurka M, et al. Challenges and opportunities of micro-credentials as a new form of certification in health science education – a discussion paper. BMC Med Educ. 2024;24:1169. https://doi.org/10.1186/s12909-024-06174-8
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Copyright (c) 2025 John SG Wells, Florian Scheibein, Alvisa Palese , Ivana Barać, Jan Beger, Ieva Bikava, Aelita Bredelytė, Keith Byrne, Frances Cleary (Autor)
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