Governance structures impact on eHealth

•Understanding the difficulties of realizing nationwide eHealth is a critical issue, especially in terms of broader political factors issues that affect implementation and adoption.•Structural reforms, policies and the processes driving the rapid dissemination of eHealth have a combined influence on the overall progress of eHealth adoption.•The dynamic relationship between governance and eHealth plays a critical role in terms of implementation success and failures.•Successful eHealth implementation approach requires a synergetic partnership between all parties in the government.

BackgroundNational eHealth implementation efforts need to move beyond the scope of making technology the primary focus and instead consider the broader spectrum of influences that can either hinder or facilitate eHealth adoption such as governance structures and policies. In this study, Denmark serves as an ideal candidate for further examination due to the country׳s rich history of intertwining events that have played an important role in the dynamic relationship between governance and eHealth success and failures.MethodsA case study approach was used to gather a combination of primary and secondary data sources. All data collection was carried out through desk-research. Data collection relied on performing an extensive search of literature for relevant studies using combinations of keywords that reflected eHealth and governance-related topics. Inclusion and exclusion criteria׳s were applied to identify relevant papers.ResultsThis study reveals that despite Denmark׳s high deployment of eHealth technologies, the Danish healthcare system faces significant interoperability challenges which stem from the country׳s decentralized and centralized approach to eHealth implementation.ConclusionStructural reforms, policies and the processes driving the rapid dissemination of eHealth have a combined influence on the overall progress of eHealth adoption. Successful national eHealth implementation requires that countries act sensitive to the dynamics of governance, and specifically strive for the right balance between centralization and decentralization to nurture synergy and transparency between all stakeholders involved in the dissemination of eHealth systems.