OBJECTIVES: Use of digital health services (DHS) has been rapidly growing in healthcare during and after the COVID-19 pandemic. It is crucial to understand the impact of various DHS on outcomes, costs, and cost-effectiveness. Our aim is to recognize the most potential areas for DHS in healthcare by analyzing the current literature focusing on the outcomes, costs, cost-effectiveness, and outcome mechanisms.

METHODS: The umbrella review is performed using the Centre for Reviews and Dissemination, Cochrane, Ovid Medline, Scopus, and Web of Science in June 2024. The methodological quality of the included reviews and the validity of the research settings has been assessed. The results are categorized by patient group and by type of DHS to get more sharp understanding of the evidence and outcome mechanisms. The impact of digital services on outcomes, cost, and cost-effectiveness will be categorized as no evidence, no dominance, and mixed and positive effect.

RESULTS: Most of the reviews compared the impact of DHS with usual care or non-digital intervention. Synchronous and asynchronous communication were the most used DHS. Preliminary results indicate that overall impact of DHS on outcomes and costs is mixed. The strongest evidence of positive impacts on outcomes has been found among chronic care patients such as cardiological or diabetes patients. The costs were assessed in minority of the reviews, but in most studies, DHS had lower costs compared to the usual care. The quality of the original studies and research settings varied significantly.

CONCLUSIONS: Cost-effectiveness studies of DHS with high-quality setting are scarce. As DHS are believed to be the savior of healthcare as resources diminish and the variety of DHS is growing, it will be important to describe the specific solutions and the outcome mechanisms in more detail to understand the applicability of the results in various contexts.