Hospital Online Service Provision Index (HOSPI): A Mirror of Digital Maturity in Healthcare

In the age of digital transformation, hospitals are more than physical spaces; they are digital ecosystems of care. The Hospital Online Service Provision Index (HOSPI), developed by UNU-EGOV, is a tool that reflects how well hospitals adapt to this paradigm. By evaluating the online presence of hospitals since 2019, HOSPI offers an insightful lens into the evolving relationship between healthcare institutions and the communities they serve.

The HOSPI methodology is structured around four criteria: Content, Services, Community Interaction, and Technology Features, each dissected into indicators and sub-indicators. HOSPI is more than an assessment instrument; it is a roadmap toward digital equity in healthcare. The Content criterion evaluates the relevance, clarity, and completeness of institutional information provided online. It includes management transparency, organizational structure, quality metrics, and patient information, all of which are essential for fostering trust and understanding between hospitals and their users. The Services criterion measures the scope and interactivity of digital health services. It examines whether patients can manage appointments, access medical records, and use telemedicine tools, key features for reducing administrative burdens and enhancing care accessibility in a digital-first world. The Community Interaction criterion assesses how hospitals engage patients and society online. It includes feedback tools, communication channels, and transparency mechanisms. A strong score here indicates responsiveness, participatory values, and alignment with public expectations for open, inclusive institutions. The Technology Features criterion focuses on technical functionality, such as navigation, mobile responsiveness, security, and accessibility compliance. It reflects the digital maturity of a hospital’s online infrastructure and its capacity to serve all users effectively, including those with disabilities.

Since its creation, HOSPI has been applied in Portugal, Malaysia, Ecuador, and Greece. These cases demonstrate HOSPI’s flexibility as a global benchmarking tool, adaptable to various healthcare systems and governance contexts. The application of HOSPI across diverse contexts reveals consistent patterns in the development of hospital websites. While most hospitals provide basic technological features such as navigability, accessibility, and general institutional information, they underperform in offering advanced, patient-centred services. Online appointments, telemedicine, administrative interactions, and patient care tools remain largely absent, limiting the potential of hospital websites to act as comprehensive digital health platforms. Content provision is often restricted to essential details, with limited transparency regarding quality metrics, research activity, or detailed medical guidance, undermining trust and informed decision-making. Community interaction features, such as feedback channels, forums, and media engagement, are inconsistently implemented, with many hospitals failing to create meaningful two-way communication. Collectively, these findings underscore a gap between technical adequacy and functional depth, highlighting the need for investment in richer online services, inclusivity, and continuous website maintenance to transform hospital websites into effective instruments of patient empowerment and institutional accountability.

HOSPI not only reveal what is visible on a webpage, but it also exposes the digital pulse of healthcare systems. It uncovers not just which hospitals provide online services, but how they do so, whether these services empower, include, and respond to real user needs. A hospital with a user-friendly website that offers open data on infection rates and welcomes community feedback is not just digitally advanced, it is ethically aligned with transparency and participation.

What HOSPI ultimately offers is a vision. A vision of healthcare institutions where digital front doors are as important as physical ones, where patients are partners, not just users. As governments and health providers confront new waves of expectations and technological possibilities, tools like HOSPI help chart the course, clearly, inclusively, and with purpose. By embracing HOSPI as a continuous evaluative process, hospitals can move from isolated digital initiatives to a coherent, responsive, and sustainable digital health strategy.