Digital Health Gains Still Out of Reach, BMJ Commission Finds
Despite heavy investment, a BMJ Future Health Commission survey finds digital health has yet to ease workloads or cut costs, with EHR usability, interoperability, and training gaps undermining clinician trust.
The BMJ Future Health Commission has published new findings suggesting that Europe’s rapid investment in digital health infrastructure is yet to yield the anticipated productivity benefits. Drawing on survey data from over 300 healthcare professionals (HCPs) and qualitative interviews across diverse care settings, the report documents a striking gap between optimism for digital transformation and its lived impact on clinical workflows.
Fewer than half of respondents reported that digital systems had eased administrative burden (47%), reduced delivery costs (44%), or decreased clinical workload (38%). In contrast, a majority (80%) acknowledged improvements in care delivery, and 76% expressed optimism about healthcare’s digital future.
Usability challenges with EHRs
Electronic health records (EHRs), the most entrenched digital platform in European health systems, emerged as a paradoxical case. HCPs with the highest exposure to EHRs were significantly less likely to perceive efficiency benefits than their peers. This suggests that while EHRs have succeeded in digitising information, shortcomings in design, interoperability, and integration with clinical practice have limited their capacity to reduce workload.
“These findings indicate that poor experiences with EHRs may erode clinician confidence in digital health more broadly, slowing adoption of emerging tools such as predictive analytics, patient-flow optimisation, and remote monitoring systems,” the Commission notes.
Trust as a critical determinant
The report positions trust as the decisive factor in digital health adoption. It distinguishes between:
Foundational trust, established through transparent regulatory standards and certification processes.
Operational trust, earned when frontline clinicians are actively involved in the design, selection, and training for new systems.
Stephen McAdam, Segment Director for Digital Health at DNV, commented: “Trust is the critical currency of digital health. Rigorous standards ensure baseline safety, but confidence is ultimately secured on the ward, where usability and workflow fit determine whether technologies accelerate or obstruct care.”
Five priorities for digital transformation
The Commission sets out five evidence-based recommendations for closing the expectation–reality gap:
Evaluate organisational confidence in EHRs, addressing usability deficits before scaling.
Implement interoperability standards to facilitate secure, seamless data exchange.
Commit to longitudinal training programmes that extend beyond deployment and target both clinical and non-clinical staff.
Institutionalise clinician and patient involvement in procurement and design decisions to align systems with real-world practice.
Strengthen risk management frameworks for data quality, security, and emergent threats.
Implications for research and policy
The findings arrive as European governments, including the UK, advance long-term digital strategies aimed at alleviating workforce shortages and rising demand. Yet, the Commission cautions that investment in infrastructure alone is insufficient.
“Digital health’s promise will only be realised through rigorous implementation science, participatory design, and systematic evaluation of outcomes,” said Dr Helen Surana, Editor in Chief of BMJ Innovations. “Without these, digital transformation risks remaining a policy ambition rather than a clinical reality.”
For researchers and policymakers, the report highlights a pressing need for translational studies that evaluate not only the technical capabilities of digital systems but also their impact on workflow, safety, and sustainability in practice.
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BioFocus Newsroom