Table 2.

Included papers, considerations, and emerging governance trends.

Reference	Country	Experience and performance (descriptive)	Considerations and suggested improvements (descriptive)	Trends and emerging governance models
Atalag K, 2013 [14]	New Zealand	Suggesting a “middle out” approach; a single top-down approach does not produce the expected outcome; success relies on a relationship based on trust between the authorities and the medical society	The national Single Content Model is flexible and “enables smooth transition to a comprehensive solution through gradual replacement over time”	The openEHR trend and Archetypes; governance based upon a top-down strategy for interoperability
Park YT, 2015 [15]	New Zealand	Strong top-down governance strategy and organizational structures and rules has been the most important factors for successful eHealth governance	Next steps will be to analyze how the eHealth structure influence health outcomes and minimize errors	Strong belief in strong government involvement leads to successful goal attainment in eHealth
De Riel E, 2018 [17]	Haiti	A key learning is leadership engagement to create an understanding of how the system works	Haiti’s health care service is dependent on national and third-party funding; realizing a sustainable information and technology communications infrastructure is a muddle-through process	System migration to the OpenMRS platform to take advantage of a global community and ensure sustainability
Kierkegaard P, 2015 [16]	Denmark	Setting national goals and adapting the middle-out approach as part of a national strategy is the best way to realize full-scale implementation of electronic health records, an approach based on cross-regional coordination	A collective phase-out of all systems may be costly, but it may be the only way to create a common national platform of high interoperability; risk of regions working with one vendor, which creates regional dependency on an actor with market monopoly	The Danish framework is flexible and in line with the European Union eHealth Interoperability framework
Wade VA, 2012 [18]	Australia	This study indicates that telehealth can be a tool to realize medical quality of care governed bottom-up and in line with evidence-based medicine	The medico-legal aspects did not seem to be as difficult as anticipated; national reimbursement schemes may increase substantial system benefits	N/Aa
Crocker M, 2010 [19]	United Kingdom	Image transfer is delayed by an immature technology infrastructure	Bottom-up recommendations from the teleradiology society in United Kingdom has been ignored by the top-down process	N/A
Sutton LN, 2011 [20]	United Kingdom	Creation of a UK reporting “Grid” with remaining organizational and governance challenges	Telehealth challenges around “team organisation” when the reporter and doctor are in separate organizations at a distance	Creation of a medical governance model in radiology across the United Kingdom which harmonize with the national top-down strategy of National Health Services
Bagot KL, 2017 [21]	Australia and United Kingdom	UK model: telemedicine integrated in the specialist work plan; Australia telemedicine was ad hoc	Both networks see telemedicine as part of future organization; can reduce workload by a “follow-the-sun model”	N/A
Mackey TK, 2014: (A call for a mora-torium) [22]	Global	The governance of health-related internet domains should be run by international organizations and not by a for-profit company like Internet Corporation for Assigned Names and Numbers, which does not respond to actors who want this policy change	The international society should stop the Internet Corporation for Assigned Names and Numbers governance model	Is it feasible to realize a global internet governance model based on international interstate cooperation?
Mackey TK, 2014 [23]	Global	The governance model of dot-health and other internet health domains is not run by the World Health Organization or another international health organization, which may represent a global threat to public health: access to evidence-based medicine and quality assured health information	The main challenge is to realize a shift from a privately-run model to an international model governed by legitimate international public health actors	The combination of internet and global markets challenges political and medical governance
Williams, SJ, 2015 [24]	Global	Health apps are a growing trend that realizes “the quantified self”: blurring the lines between health care and wellness through data sharing	N/A	“Quantified-self” apps contribute to a growth of health and wellness data; a “global health and wellness data governance model”?

^aN/A: not applicable.