The Digital Health Competencies in Medical Education Framework: An International Consensus Statement Based on a Delphi Study

Josip Car^{1

2}, Qi Chwen Ong^{3

4}, Tatiana Erlikh Fox^{3

5}, Daniel Leightley¹, Sandra J Kemp⁶, Igor Švab⁷, Kelvin K F Tsoi⁸, Amir H Sam⁹, Fiona M Kent¹⁰, Attila J Hertelendy^{11

12}, Christopher A Longhurst¹³, John Powell¹⁴, Hossam Hamdy¹⁵, Huy V Q Nguyen¹⁶, Sola Aoun Bahous¹⁷, Mai Wang¹⁸, Martin Baumgartner¹⁹, Yodi Mahendradhata²⁰, Natasa Popovic²¹, Andy W H Khong^{3

22}, Charles G Prober²³, Rifat Atun^{24

25}; Digital Health Systems Collaborative; Abebe Bekele Zerihun²⁶, Akira-Sebastian Poncette^{27

28}, Al Joseph R Molina^{29

30}, Albano V L Ferreira³¹, Almir Fajkic³², Amit Kaushal³³, Andrew J Farmer¹⁴, Andrew S Lane³⁴, Andrzej A Kononowicz³⁵, Aparna V Bhongir³⁶, Barnabas T Alayande³⁷, Benard Ayaka Bene², Christian J Dameff³⁸, Cynthia Hallensleben³⁹, David A Back⁴⁰, Dawan J Hawezy⁴¹, Dieudonné Steve M Tulantched⁴², Ekaterina Kldiashvili⁴³, Emmanuel K Achampong⁴⁴, Ganesh Ramachandran⁴⁵, Goran Hauser⁴⁶, Jakob Grove⁴⁷, Jason P Y Cheung⁴⁸, John O Imaralu⁴⁹, John O Sotunsa⁵⁰, Juan P Bulnes Vides⁵¹, Katharine S Lawrence⁵², Louis Agha-Mir-Salim²⁷, Luca Saba⁵³, Luxia Zhang¹⁸, Mahmoud M A Elfiky⁵⁴, Markus W Hesseling⁵⁵, Michelle P Guppy⁵⁶, Mrunal S Phatak⁵⁷, Muna A A Al Saadoon⁵⁸, Nai Ming Lai⁴⁵, Niels H Chavannes³⁹, Oliver Kimberger^{59

60}, Pedro Povoa⁶¹, Poh-Sun Goh⁶², Rebecca Grainger⁶³, Rishi S Nannan Panday⁶⁴, Rowena Forsyth⁶⁵, Sandro Vento⁶⁶, Sang Yeoup Lee^{67

68}, Sanjay Kumar Yadav⁶⁹, Shabbir Syed-Abdul^{70

71}, Simone Appenzeller⁷², Spiros Denaxas⁷³, Stephen Ekundayo Garba⁷⁴, Tabea Flügge⁷⁵, Tomislav Bokun⁷⁶, Vajira H W Dissanayake⁷⁷, Vincent Ho⁷⁸, Yasser A Obadiel⁷⁹

Affiliations

¹ School of Life Course and Population Sciences, King's College London, London, United Kingdom.
² Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom.
³ Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
⁴ School of Public Health, Imperial College London, London, United Kingdom.
⁵ Onze Lieve Vrouwen Gasthuis, Amsterdam, the Netherlands.
⁶ Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.
⁷ Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
⁸ JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China.
⁹ Imperial College School of Medicine, Imperial College London, London, United Kingdom.
¹⁰ Education Portfolio, Faculty Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.
¹¹ Department of Information Systems and Business Analytics, College of Business and The Herbert Wetheim College of Medicine, Florida International University, Miami.
¹² Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
¹³ Department of Biomedical Informatics, University of California San Diego Health, La Jolla.
¹⁴ Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
¹⁵ Gulf Medical University, Ajman, United Arab Emirates.
¹⁶ Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
¹⁷ Lebanese American University School of Medicine, Byblos, Lebanon.
¹⁸ National Institute of Health Data Science, Peking University, Beijing, China.
¹⁹ Center for Medical Data Science, Institute of Artificial Intelligence, Medical University of Vienna, Vienna, Austria.
²⁰ Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
²¹ Faculty of Medicine, University of Montenegro, Podgorica, Montenegro.
²² School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, Singapore.
²³ Stanford Health Center for Education, Stanford University, Stanford, California.
²⁴ Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts.
²⁵ Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, Massachusetts.
²⁶ University of Global Health Equity, Kigali, Rwanda.
²⁷ Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
²⁸ Department of Anesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
²⁹ University of the Philippines, Manila-Philippine General Hospital, Manila, The Philippines.
³⁰ Dr Jose Fabella Memorial Hospital, Manila, The Philippines.
³¹ Faculdade de Medicina, Universidade Katyavala Bwila, Benguela, Angola.
³² Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
³³ Department of Medicine and Department of Bioengineering, Stanford University, Stanford, California.
³⁴ Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
³⁵ Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Kraków, Poland.
³⁶ All India Institute of Medical Sciences, Bibinagar, Telangana, India.
³⁷ Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.
³⁸ Department of Emergency Medicine, University of California, San Diego.
³⁹ National eHealth Living Lab, Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
⁴⁰ Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.
⁴¹ Faculty of General Medicine, Koya University, Kurdistan, Iraq.
⁴² Department of Family Medicine, Université Protestante au Congo, Kinshasa, Democratic Republic of the Congo.
⁴³ Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia.
⁴⁴ Department of Medical Education and IT, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
⁴⁵ School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia.
⁴⁶ Faculty of Medicine, University of Rijeka, Clinical Hospital Centre Rijeka, Rijeka, Croatia.
⁴⁷ Department of Biomedicine, Aarhus University, Aarhus, Denmark.
⁴⁸ Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, SAR, China.
⁴⁹ Department of Obstetrics and Gynaecology, Babcock University, Ilisan-Remo, Nigeria.
⁵⁰ Babcock University, Lagos, Nigeria.
⁵¹ Central American Technological University, Tegucigalpa, Honduras.
⁵² Grossman School of Medicine, New York University, New York City.
⁵³ Department of Radiology, University of Cagliari, Cagliari, Italy.
⁵⁴ Cairo University, Giza, Egypt.
⁵⁵ Department of Digital Health, Children's Health Ireland, Dublin, Ireland.
⁵⁶ School of Rural Medicine, University of New England, Armidale, New South Wales, Australia.
⁵⁷ All India Institute of Medical Sciences, Nagpur, Maharashtra, India.
⁵⁸ Department of Child Health, College of Medicine and Health Sciences, Sultan Qaboos University, Seeb, Oman.
⁵⁹ Department of General Anesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria.
⁶⁰ Ludwig Boltzmann Institute for Digital Health and Patient Safety, Vienna, Austria.
⁶¹ Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.
⁶² Department of Diagnostic Radiology, National University of Singapore, National University Hospital, Singapore, Singapore.
⁶³ University of Otago Wellington, Wellington, New Zealand.
⁶⁴ Amsterdam University Medical Center, Amsterdam, the Netherlands.
⁶⁵ Cyberpsychology Research Group, Biomedical Informatics and Digital Health Theme, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁶⁶ Faculty of Medicine, University of Puthisastra, Phnom Penh, Cambodia.
⁶⁷ Department of Medical Education, Pusan National University School of Medicine, Yangsan, South Korea.
⁶⁸ Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
⁶⁹ Netaji Subhash Chandra Bose Medical College, Madhya Pradesh, India.
⁷⁰ Graduate Institute of Biomedical Informatics, Taipei Medical University, New Taipei City, Taiwan.
⁷¹ School of Gerontology and Long-Term Care, Taipei Medical University, New Taipei City, Taiwan.
⁷² School of Medical Science, The State University of Campinas, Campinas, Brazil.
⁷³ Institute of Health Informatics, University College London, London, United Kingdom.
⁷⁴ Department of Surgery, Faculty of Clinical Science, College of Health Sciences, University of Abuja, Abuja, Nigeria.
⁷⁵ Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.
⁷⁶ University Hospital Dubrava, Zagreb, Croatia.
⁷⁷ Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
⁷⁸ School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.
⁷⁹ Faculty of Medicine, Sana'a University, Sana'a, Yemen.

PMID: 39888625
DOI: 10.1001/jamanetworkopen.2024.53131

Free article

The Digital Health Competencies in Medical Education Framework: An International Consensus Statement Based on a Delphi Study

Josip Car et al. JAMA Netw Open. 2025.

Free article

. 2025 Jan 2;8(1):e2453131.

doi: 10.1001/jamanetworkopen.2024.53131.

Authors

Affiliations

¹ School of Life Course and Population Sciences, King's College London, London, United Kingdom.
² Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom.
³ Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
⁴ School of Public Health, Imperial College London, London, United Kingdom.
⁵ Onze Lieve Vrouwen Gasthuis, Amsterdam, the Netherlands.
⁶ Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.
⁷ Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
⁸ JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China.
⁹ Imperial College School of Medicine, Imperial College London, London, United Kingdom.
¹⁰ Education Portfolio, Faculty Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.
¹¹ Department of Information Systems and Business Analytics, College of Business and The Herbert Wetheim College of Medicine, Florida International University, Miami.
¹² Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
¹³ Department of Biomedical Informatics, University of California San Diego Health, La Jolla.
¹⁴ Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
¹⁵ Gulf Medical University, Ajman, United Arab Emirates.
¹⁶ Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
¹⁷ Lebanese American University School of Medicine, Byblos, Lebanon.
¹⁸ National Institute of Health Data Science, Peking University, Beijing, China.
¹⁹ Center for Medical Data Science, Institute of Artificial Intelligence, Medical University of Vienna, Vienna, Austria.
²⁰ Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
²¹ Faculty of Medicine, University of Montenegro, Podgorica, Montenegro.
²² School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, Singapore.
²³ Stanford Health Center for Education, Stanford University, Stanford, California.
²⁴ Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts.
²⁵ Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, Massachusetts.
²⁶ University of Global Health Equity, Kigali, Rwanda.
²⁷ Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
²⁸ Department of Anesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
²⁹ University of the Philippines, Manila-Philippine General Hospital, Manila, The Philippines.
³⁰ Dr Jose Fabella Memorial Hospital, Manila, The Philippines.
³¹ Faculdade de Medicina, Universidade Katyavala Bwila, Benguela, Angola.
³² Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
³³ Department of Medicine and Department of Bioengineering, Stanford University, Stanford, California.
³⁴ Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
³⁵ Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Kraków, Poland.
³⁶ All India Institute of Medical Sciences, Bibinagar, Telangana, India.
³⁷ Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.
³⁸ Department of Emergency Medicine, University of California, San Diego.
³⁹ National eHealth Living Lab, Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
⁴⁰ Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.
⁴¹ Faculty of General Medicine, Koya University, Kurdistan, Iraq.
⁴² Department of Family Medicine, Université Protestante au Congo, Kinshasa, Democratic Republic of the Congo.
⁴³ Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia.
⁴⁴ Department of Medical Education and IT, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
⁴⁵ School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia.
⁴⁶ Faculty of Medicine, University of Rijeka, Clinical Hospital Centre Rijeka, Rijeka, Croatia.
⁴⁷ Department of Biomedicine, Aarhus University, Aarhus, Denmark.
⁴⁸ Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, SAR, China.
⁴⁹ Department of Obstetrics and Gynaecology, Babcock University, Ilisan-Remo, Nigeria.
⁵⁰ Babcock University, Lagos, Nigeria.
⁵¹ Central American Technological University, Tegucigalpa, Honduras.
⁵² Grossman School of Medicine, New York University, New York City.
⁵³ Department of Radiology, University of Cagliari, Cagliari, Italy.
⁵⁴ Cairo University, Giza, Egypt.
⁵⁵ Department of Digital Health, Children's Health Ireland, Dublin, Ireland.
⁵⁶ School of Rural Medicine, University of New England, Armidale, New South Wales, Australia.
⁵⁷ All India Institute of Medical Sciences, Nagpur, Maharashtra, India.
⁵⁸ Department of Child Health, College of Medicine and Health Sciences, Sultan Qaboos University, Seeb, Oman.
⁵⁹ Department of General Anesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria.
⁶⁰ Ludwig Boltzmann Institute for Digital Health and Patient Safety, Vienna, Austria.
⁶¹ Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.
⁶² Department of Diagnostic Radiology, National University of Singapore, National University Hospital, Singapore, Singapore.
⁶³ University of Otago Wellington, Wellington, New Zealand.
⁶⁴ Amsterdam University Medical Center, Amsterdam, the Netherlands.
⁶⁵ Cyberpsychology Research Group, Biomedical Informatics and Digital Health Theme, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁶⁶ Faculty of Medicine, University of Puthisastra, Phnom Penh, Cambodia.
⁶⁷ Department of Medical Education, Pusan National University School of Medicine, Yangsan, South Korea.
⁶⁸ Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
⁶⁹ Netaji Subhash Chandra Bose Medical College, Madhya Pradesh, India.
⁷⁰ Graduate Institute of Biomedical Informatics, Taipei Medical University, New Taipei City, Taiwan.
⁷¹ School of Gerontology and Long-Term Care, Taipei Medical University, New Taipei City, Taiwan.
⁷² School of Medical Science, The State University of Campinas, Campinas, Brazil.
⁷³ Institute of Health Informatics, University College London, London, United Kingdom.
⁷⁴ Department of Surgery, Faculty of Clinical Science, College of Health Sciences, University of Abuja, Abuja, Nigeria.
⁷⁵ Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.
⁷⁶ University Hospital Dubrava, Zagreb, Croatia.
⁷⁷ Department of Anatomy, Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
⁷⁸ School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.
⁷⁹ Faculty of Medicine, Sana'a University, Sana'a, Yemen.

PMID: 39888625
DOI: 10.1001/jamanetworkopen.2024.53131

Abstract

Importance: Rapid digitalization of health care and a dearth of digital health education for medical students and junior physicians worldwide means there is an imperative for more training in this dynamic and evolving field.

Objective: To develop an evidence-informed, consensus-guided, adaptable digital health competencies framework for the design and development of digital health curricula in medical institutions globally.

Evidence review: A core group was assembled to oversee the development of the Digital Health Competencies in Medical Education (DECODE) framework. First, an initial list was created based on findings from a scoping review and expert consultations. A multidisciplinary and geographically diverse panel of 211 experts from 79 countries and territories was convened for a 2-round, modified Delphi survey conducted between December 2022 and July 2023, with an a priori consensus level of 70%. The framework structure, wordings, and learning outcomes with marginal percentage of agreement were discussed and determined in a consensus meeting organized on September 8, 2023, and subsequent postmeeting qualitative feedback. In total, 211 experts participated in round 1, 149 participated in round 2, 12 participated in the consensus meeting, and 58 participated in postmeeting feedback.

Findings: The DECODE framework uses 3 main terminologies: domain, competency, and learning outcome. Competencies were grouped into 4 domains: professionalism in digital health, patient and population digital health, health information systems, and health data science. Each competency is accompanied by a set of learning outcomes that are either mandatory or discretionary. The final framework comprises 4 domains, 19 competencies, and 33 mandatory and 145 discretionary learning outcomes, with descriptions for each domain and competency. Six highlighted areas of considerations for medical educators are the variations in nomenclature, the distinctiveness of digital health, the concept of digital health literacy, curriculum space and implementation, the inclusion of discretionary learning outcomes, and socioeconomic inequities in digital health education.

Conclusions and relevance: This evidence-informed and consensus-guided framework will play an important role in enabling medical institutions to better prepare future physicians for the ongoing digital transformation in health care. Medical schools are encouraged to adopt and adapt this framework to align with their needs, resources, and circumstances.

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The Digital Health Competencies in Medical Education Framework: An International Consensus Statement Based on a Delphi Study

Affiliations

The Digital Health Competencies in Medical Education Framework: An International Consensus Statement Based on a Delphi Study

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources