Digital healthcare is expanding, but readiness remains uneven. The 2024 Global Digital Health Monitor survey found that most participating countries were in the middle maturity phases, while workforce preparation, data exchange, artificial intelligence governance, and infrastructure planning remained important gaps. In the United States, Medicare telehealth use was lower in 2023 than in 2020, even as physician telemedicine use rose sharply between 2019 and 2021.
Table of contents
- Global digital health maturity
- Governance, strategy, and equity
- Workforce and infrastructure readiness
- Digital services and health information systems
- Medicare telehealth trends
- Physician telemedicine use
Global digital health maturity
The State of Digital Health 2024 Brief reports that 47 countries from all World Health Organization regions completed the 2024 Global Digital Health Monitor survey analysis set. The monitor tracks 23 standard indicators across seven WHO/ITU eHealth Strategy domains, making its maturity phases a broad country-level view rather than a measure of individual patient use.
The largest share of participating countries was in Phase 3. Specifically, 46% were at Phase 3, 25% were at Phase 2, 23% were at Phase 4, and 4% were at Phase 5. The country counts reported for these phases were 12 countries in Phase 2, 22 in Phase 3, 11 in Phase 4, and 2 in Phase 5. Portugal and the Kingdom of Saudi Arabia were the only two Phase 5 countries in 2024. State of Digital Health 2024 Brief
| 2024 maturity phase | Share of participating countries | Number of countries |
|---|---|---|
| Phase 2 | 25% | 12 |
| Phase 3 | 46% | 22 |
| Phase 4 | 23% | 11 |
| Phase 5 | 4% | 2 |
The distribution shows that advanced maturity was not yet typical in the 2024 survey. The brief reported that 63% of countries reached Phase 3 or 4 in the strategy and investment domain, while 72% reached Phase 3 or higher in legislation, policy, and compliance. These domain results describe progress in specific capabilities and should not be read as a single national score.
Several countries changed phase over time. Chad, Jamaica, Kenya, Nigeria, and Sierra Leone each improved by one or more maturity phases in 2024. Benin was in Phase 3 in 2024, 2023, and 2018; Liberia and Madagascar were in Phase 3 in both 2024 and 2023; and Malawi and Tanzania were in Phase 4 in both 2024 and 2023. Nigeria was in Phase 3 in 2024, compared with Phase 2 in 2023 and Phase 3 in 2018. Sierra Leone was in Phase 3 in 2024, compared with Phase 2 in both 2023 and 2018. Uganda was in Phase 3 in 2024 and 2023 and Phase 2 in 2018. Brazil and Canada were each in Phase 4 in 2024. State of Digital Health 2024 Brief
Governance, strategy, and equity
Leadership and governance results were stronger in some areas than in others. The State of Digital Health 2024 Brief found that 55% of countries attained Phase 4 or 5 in the leadership and governance domain, and 56% reached Phase 4 or 5 for digital health governance structures. At the same time, 45% were unprepared for artificial intelligence and emerging technology adoption and governance.
Legal and data-sharing arrangements also varied. Seventy-two percent of countries reached Phase 3 or higher in legislation, policy, and compliance, but 13% reported having no data protection legislation. Nearly half lacked protocols for cross-border health data exchange. About two-thirds had not formalized artificial intelligence governance for healthcare services. These figures indicate that a country can have broader digital health policies while still lacking specific safeguards for data movement and emerging technologies. State of Digital Health 2024 Brief
Equity was present but incompletely institutionalized. About half of reporting countries formally integrated equity considerations into digital health strategies. Only 15% were implementing gender-specific measures at Phase 4, while 10% were implementing policies, interventions, and analyses addressing gender inequality at Phase 5. The maturity distinctions matter: a country may recognize equity in strategy without yet reaching the higher implementation phases described in the brief.
Funding was another limiting factor. Just 17% of countries had structured funding models for digital health, and 17% reported systematic private-sector investment. For healthcare organizations and clinicians, these results suggest that the availability of a digital tool does not necessarily mean that financing, accountability, or long-term governance is established around it.
Workforce and infrastructure readiness
Workforce development was among the clearest areas of unfinished work. The State of Digital Health 2024 Brief reported that 64% of countries were in Phase 1 or 2 in the workforce domain, while 65% were still in Phases 1 and 2 for workforce development. Nearly 52% lacked digital health degree programs, and only 13% reported fully established pre-service and in-service digital health training curricula.
Infrastructure readiness was mixed. Fifty-three percent of countries reached Phase 3 or 4 in infrastructure readiness, but 17% remained in Phase 1. Nearly half still lacked a clear plan to support digital health infrastructure. Only 15% had a plan to maintain digital health infrastructure in 75% of public healthcare services.
Network readiness was comparatively stronger: 86% of countries were in Phase 3 or 4 for network readiness. However, network capability alone does not establish a complete digital healthcare environment. Workforce training, maintenance plans, governance, and interoperable information systems remain separate requirements measured in the brief’s other domains. State of Digital Health 2024 Brief
Digital services and health information systems
The services and applications domain showed broad activity. Seventy-three percent of countries reached Phase 3 or higher, and 95% reported using digital health systems to monitor population health at various phases. National scale was less common: only 9% provided nationally scaled digital health interventions for all health priority areas.
Foundational identity and registration systems were also incomplete. Thirty-four percent of countries lacked unique patient identification systems, and 46% lacked a master patient index. In addition, 27% lacked birth registries and 35% lacked secure death registries. These measures relate to national information infrastructure and do not indicate that every facility or patient lacks a local record.
The State of Digital Health 2024 Brief also found that 58% of countries did not have a fully established national health information exchange system. This helps explain why the presence of digital services should not automatically be interpreted as seamless information continuity. A country may use digital systems to monitor population health while still having limited exchange between organizations or incomplete identity infrastructure. State of Digital Health 2024 Brief
Medicare telehealth trends
CMS Medicare Telehealth Trends Report data show a marked decline in Medicare telehealth use after the early pandemic period. Medicare telehealth users fell from 14,826,919 in 2020 to 6,884,205 in 2023, while the share of Medicare users with a telehealth service fell from 48% to 25%. The report also lists 30,946,785 Medicare Fee-for-Service telehealth eligible users in 2020 and 27,749,896 in 2023. Eligible users are not the same measure as users who received a telehealth service.
Quarterly figures show how use changed within that period. In 2020 Q1, Medicare telehealth users numbered 1,665,085, representing 7% of Medicare users. In 2020 Q2, the figure rose to 10,262,248 and 47%. Later reported quarters were lower: 4,222,546 users and 19% in 2022 Q1; 3,374,471 and 15% in 2022 Q4; 3,243,434 and 15% in 2023 Q1; and 2,783,159 and 13% in 2023 Q4. CMS Medicare Telehealth Trends Report
| Medicare period | Telehealth users | Share of Medicare users |
|---|---|---|
| 2020 Q1 | 1,665,085 | 7% |
| 2020 Q2 | 10,262,248 | 47% |
| 2021 Q4 | 3,716,289 | 16% |
| 2022 Q1 | 4,222,546 | 19% |
| 2022 Q4 | 3,374,471 | 15% |
| 2023 Q1 | 3,243,434 | 15% |
| 2023 Q4 | 2,783,159 | 13% |
The CMS figures describe Medicare users and Medicare periods, not all US patients or all forms of virtual care. They therefore provide a specific view of telehealth use within the Medicare population.
Physician telemedicine use
CDC National Center for Health Statistics Data Brief No. 493 reported that telemedicine use among physicians was 15.4% in 2019 and 86.5% in 2021. Those two measurements describe physician use in different years and show a substantial change during the period covered by the brief.
The 2021 data also differed by specialty and visit share. Among primary care physicians, 53.9% used telemedicine for less than 25% of visits, 27.9% used it for 25% to 49% of visits, and 14.7% used it for 50% of visits or more. Among surgical specialists, 63.3% used telemedicine for less than 25% of visits, while 5.5% used it for 50% of visits or more. Among medical specialists, 27.4% used telemedicine for 50% of patient visits or more. CDC NCHS Data Brief No. 493
Clinicians also reported different views about quality and technology. The share saying telemedicine could provide similar quality of care to some or a great extent was 76.7% among primary care physicians, 73.1% among medical specialists, and 50.6% among surgical specialists. Satisfaction with telemedicine technology for patient visits was 65.5% among primary care physicians, 63.6% among medical specialists, and 49.5% among surgical specialists.
Suitability was not uniform across specialties. In the CDC brief, 49.7% of surgical specialists said telemedicine was not appropriate for their specialty or patients. Together with the lower surgical-specialist shares for high-volume telemedicine use and perceived comparable quality, this finding emphasizes that digital healthcare adoption depends on the clinical context, not only on technical availability. CDC NCHS Data Brief No. 493