Mapping digital health initiatives and technological requirements: A proposal from Sao Paulo State for digital...

Digital transformation in health is driven by Information and Communication Technologies integration and guided by institutional guidelines. Despite multiple models, no consensus exists on assessing facility-level digital health maturity, including organizational capacity and workflows.

To present the preliminary results of Mapping Digital Health (DH) initiatives and Technological Requirements (TR) conducted in public healthcare facilities in São Paulo State.

This descriptive observational study was conducted from March to August 2025 in public healthcare facilities (n = 6,319) across 17 Regional Health Departments in Sao Paulo State. A general sample target of 3,719 facilities was calculated, with specific targets by type: primary healthcare units (n = 2,570), specialty outpatient clinics (AME) (n = 62), hospitals (n = 529), emergency care units (n = 381), and prison units (n = 177). Two questionnaires (26 and 28 items across six and seven domains, respectively) were structured based on key technical and policy reference documents and covered essential domains for assessing DH maturity and TR. Responses on a five-point Likert scale were used to calculate maturity indices classified as incipient, developing, collaborative, or advanced.

Questionnaires responses included 5,325 for DH and for 5,069 TR questionnaires. Prison units and AME met 100% of their response targets, while PHU, emergency care units, and hospitals achieved around 80%. Overall, Sao Paulo State scored 42.0 for DH and 45.7 for TR, both classified as "developing," considered an intermediate stage and reflects a moderate maturity. Prisons units and AME exhibited the highest scores in DH maturity and TR, respectively.

Sao Paulo State shows an intermediate stage of digital health and technological requirement maturity, despite inequalities across facility typologies. The facility-level maturity index enabled a detailed analysis and may contribute to future public policies, training initiatives, and infrastructure investments.