Public value and guiding values of national digital health strategy in France

Abstract

Digital health can enhance health outcomes and has become an even more important priority on health agendas. In Europe, more than 4 out of 5 states have a national digital health strategy (NDHS) or policy. Still, challenges persist in their adequate formulation and execution. This research aims to contribute to understanding if and how a NDHS can be enhanced using a “public value” lens. It does so by exploring different stakeholders’ perceptions of guiding values within the French NDHS. The study thematically analysed three focus group discussions involving 19 participants (n=19) from different backgrounds. Findings highlight persisting technical and cultural issues in France and uncover digital health-specific aspects of “public value”. Whilst public clients, health professionals, and private sector align on the necessity of ethics, interoperability, pragmatic considerations, patient-centricity, and coproduction, disparities arise regarding ethics, cultural change, and data. Hence, findings confirm the plurality of perceptions of “public value” among different stakeholders. With this, a framework of public values is developed to guide digital health policymakers, implementers, and developers. The main novel argument developed is the dual interplay of democratic and managerial value classes, in a context where digital health’s successful implementation and adoption are seen as hinging on adequate management and culture and the underlying values. This thesis proposed that the two value classes can respectively foster trust and performance, two complementary and measurable values. Ultimately, the “public value” lens appears well tailored for further research in digital health strategy, and useful to guide adequate digital health implementation and adoption.

Date of Award	1 Feb 2024
Original language	English
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Henrique Martins (Supervisor)