Table 2.
Key facilitators, barriers, and success factors for digital health adoption.
| Facilitators | Barriers | Success factors |
| Priority: Digital health is a priority to improve the quality of health services in Switzerland; politicians are educated on the importance and issues related to digitization | Decentralization and lack of interoperability: Switzerland has 26 cantons and different health laws; there is no common interface for electronic patient record interoperability. Furthermore, there are 4 different languages used (French, German, Italian, and Romansh) | Context clarification: There is a need to put national regulation in place for security, privacy, and “hacking” of digital health innovations (medical devices) |
| High-income country: Large investments are being made in innovation; furthermore, most people are educated and have personal technologies such as smartphones | Lack of long-term planning: People can change health insurance every year, which limits long-term investment of insurance companies | Responsibilities clarification: The responsibilities of different stakeholders need to be clarified, for example, who pays which costs |
| Size: Switzerland is a small country where people know each other | Experience: There is relatively limited experience within Switzerland | Import: Switzerland could make better use of the considerable number of expats bringing in their expertise |
| Culture of innovation: Switzerland has a thriving start-up, and health companies’ “valley” and local initiatives are trialed. Many initiatives over the past two decades have taken place, including the establishment of pharma companies | High health care costs: The overuse of health care is insufficiently limited. Patients pay high insurance and in return want high-quality services. There is a lack of willingness to pay for digital health | Value proposition clarification: The benefits and impact on costs for citizens, for example, fees for services, need to be clarified |
| Consensus: Swiss people like to solve problems together with all stakeholders and common agreement. Opportunities to share data are provided | Low agility: There is a general lack of willingness to share personal data. Rigid and slow adoption of innovation, for example, a paper billing system (“System de Tarification”) | Change enablement: Change processes need to be better enabled to achieve an appropriate proportion of people using a digital health innovation |