OBJECTIVES: Digital solutions represent key opportunity for healthcare systems, while expected to improve efficiency, boost quality and reduce costs of care. The objective of this study was to analyse initiatives related to current and future trends in funding paths for eHealth 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: Depending on countries, moderate to high level of changes in eHealth funding paths are anticipated in the 5 years to come. Most extensive changes are foreseen in the US, France and Italy. Strong eHealth expansion in the US results from legislative initiatives supporting new payment and healthcare delivery models, regulatory changes encouraging development and facilitating eHealth approval, removal of restrictions for current telemedicine services, and increased federal funding. France demonstrates a strong political will to fund eHealth since funding paths for selected eHealth solutions became sustainable in 2018 and current tele-monitoring pilot programs were extended. Testing of new healthcare models may also impact eHealth adoption. In Italy, beside regional initiatives, national actions like inclusion of telemedicine services under “essential level of care” and the National eHealth Pact, are expected to influence eHealth funding. In Canada, provincial organisations specialised in provision of telemedicine services are emerging. In the UK, several institutions supporting development and adoption of eHealth have been founded. In Spain, there is a focus on ensuring inter-regional compatibility of digital solutions. In Germany, improvement of decisional processes related to eHealth is expected.

CONCLUSIONS: Identified initiatives are encouraging for the future of eHealth funding paths. However, the potential organisational impact of eHealth solutions on healthcare systems is highly debated, and countries are still dealing with current existing pathways versus piloting new ones to find optimised funding routes.