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Digital competences for the health workforce: a systematic review
Bernice Azzopardi Meli1, Corinne Bowman1, Maya Camilleri Sacco1
1Department of Clinical Pharmacology & Therapeutics, University of Malta, Malta.
Background:
The increasing use of digital technologies in healthcare demands a workforce that can use them effectively. A digitally competent workforce is critical, yet the specific competences and capabilities required remain insufficiently defined. This study aims to identify core digital competences and capabilities for the health workforce to inform the development of a digital health competence framework.
Methods:
A systematic review following PRISMA guidance was conducted. Literature published in English between 2014 and 2024 was searched in MEDLINE, PubMed, CINAHL, PsycInfo, Cochrane Library, Scopus, ProQuest, BASE and the first 10 pages of Google and Google Scholar. Two reviewers independently screened all records, resolving discrepancies through discussion within a team of five. The methodological quality of the included studies was assessed using Joanna Briggs Institute tools, while mixed-methods studies were appraised with the Mixed Methods Appraisal Tool. Thematic synthesis following Thomas and Harden was used to code competence statements line by line, develop descriptive themes and generate analytical themes.
Results:
The initial search identified 9414 records, from which 108 peer-reviewed studies and digital health competence frameworks were included. Key findings indicated that competences identified fall within three core domains: (a) leadership, focused on governance and strategic thinking, (b) procedural, addressing digital professional development and quality improvement, and (c) enabling, emphasising patient engagement, and the mindset required for the effective integration of digital tools in patient-centred care.
Conclusion:
Many studies presented fragmented competence lists rather than integrated frameworks linking digital practice, education and workforce development. The review also highlights the need to better understand behavioural elements associated with digital technology use, rather than focusing on professional obligation. Distinguishing competence from capability appears crucial in digital environments. Future research should build upon these findings to construct a unified digital health competence framework and drive international consensus on core workforce competences.
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