OBJECTIVES: eHealth solutions emerged as promising innovations enhancing care over patients and enabling efficient delivery of healthcare services. The aim of this study was to assess current country-specific opportunities and challenges for market access of eHealth solutions in France, Germany, Italy, Spain, the United Kingdom, Canada and the United States.

METHODS: A targeted literature review was performed in Medline and Embase, complemented by ad-hoc and primary search with eHealth experts and payers.

RESULTS: Study findings revealed varying level of eHealth implementation across analysed countries, rated in 6-point scale as 2 in Germany, through 2.4 to 2.7 in the US, Canada, UK, Italy, 3 in France, and 3.3 in Spain.

Key barriers for adoption of eHealth solutions are associated with the immaturity of funding paths and scarcity of nation-wide, sustainable funding opportunities. eHealth is usually funded under pilot programs conducted at local and regional levels, and funding paths are not well defined. In Canada, Spain and Italy, system decentralization hampers expansion of solutions across country. In the US and Germany, payers and clinicians may express resistance to eHealth, since many programs failed to show benefits, and it is considered as disrupting current clinical practice.

Adoption of eHealth solutions is mainly driven by governmental initiatives and reforms. Canada and the UK have established numerous organizations supporting digital healthcare transformation and adoption of eHealth. France introduced legislative provisions for telemedicine and developed guidelines facilitating assessment of eHealth solutions. Innovative care and payment models are also drivers for digital technologies, as they emerge in the US and could be explored in France through new regulations and in Spain at local level.

CONCLUSIONS: Despite advances of eHealth solutions, their wide utilization and adoption is impeded, encountering country-specific hurdles. Clear regulatory and funding frameworks, standard interoperability and early cooperation of stakeholders along solution development may positively impact eHealth market access.