Health equity readiness index for digital health organizations.
7 affiliations
- 1School of Medicine, University of St. Gallen, St. Gallen, Switzerland.
- 2School of Health Sciences, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland.
- 3Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland.
- 4Department of Management, Technology, and Economics, ETH Zürich, Zürich, Switzerland.
- 5School of Medicine, University of St. Gallen, St. Gallen, Switzerland. [email protected].
- 6Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland. [email protected].
- 7Department of Management, Technology, and Economics, ETH Zürich, Zürich, Switzerland. [email protected].
Abstract
Background
As healthcare becomes increasingly digitalized, new challenges and opportunities arise for advancing health equity. In response, a broad range of frameworks and recommendations have emerged to guide equitable innovation. Yet despite this momentum, real world progress remains limited and many digital health organizations (DHOs) struggle to translate health equity principles into concrete, actionable strategies. One promising avenue for closing this implementation gap lies in the use of organizational readiness assessments that not only diagnose current capacity but also help to define a roadmap for improvement. In response, this study introduces the Health Equity Readiness Index and a supporting novel self-assessment tool designed to support DHOs in evaluating and advancing their readiness to act on health equity.Methods
Drawing on established frameworks from health equity, responsible AI, digital innovation, and organizational change, we created a five-dimensional Health Equity Readiness Index, encompassing strategy, governance, culture, data, and community collaboration. Each dimension was operationalized into 15 readiness indicators across four levels. A corresponding digital self-assessment tool was developed and evaluated for usability, acceptability, and perceived utility through user testing and a structured online survey targeting DHOs.Results
The resulting tool provides a structured, low-barrier mechanism for DHOs to assess their current equity capacity and identify priority areas for improvement. Survey results (N = 124) showed broad applicability across diverse organizational contexts, with respondents spanning regions, service types, and roles. Participants rated the tool highly across all constructs (M ≥ 4.39/5). Qualitative feedback highlighted five overarching strengths (clarity, diagnostic value, actionability, usability, awareness) and three areas for future improvement (examples, customization, additional features). Overall, respondents perceived the tool as both relevant and actionable for guiding equity-oriented strategy.Conclusion
This study contributes a novel framework and diagnostic tool for advancing organizational readiness for health equity in digital health, supporting DHOs in moving from intention to implementation. It also offers potential utility for funders, regulators, and health systems seeking to institutionalize equity through incentives or benchmarking.
Related
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BibTeX
@article{wagon2026health,
title = {{Health equity readiness index for digital health organizations.}},
author = {Laura Wagon and Marcia Nißen and Tobias Kowatsch},
journal = {International journal for equity in health},
year = {2026},
month = aug,
doi = {10.1186/s12939-026-02964-2},
url = {https://europepmc.org/article/MED/42972415},
note = {CC BY},
}
RIS
TY - JOUR
TI - Health equity readiness index for digital health organizations.
AU - Laura Wagon
AU - Marcia Nißen
AU - Tobias Kowatsch
PY - 2026
DA - 2026/08/06
JO - International journal for equity in health
DO - 10.1186/s12939-026-02964-2
UR - https://europepmc.org/article/MED/42972415
AB - Background As healthcare becomes increasingly digitalized, new challenges and opportunities arise for advancing health equity. In response, a broad range of frameworks and recommendations have emerged to guide equitable innovation. Yet despite this momentum, real world progress remains limited and many digital health organizations (DHOs) struggle to translate health equity principles into concrete, actionable strategies. One promising avenue for closing this implementation gap lies in the use of organizational readiness assessments that not only diagnose current capacity but also help to define a roadmap for improvement. In response, this study introduces the Health Equity Readiness Index and a supporting novel self-assessment tool designed to support DHOs in evaluating and advancing their readiness to act on health equity.Methods Drawing on established frameworks from health equity, responsible AI, digital innovation, and organizational change, we created a five-dimensional Health Equity Readiness Index, encompassing strategy, governance, culture, data, and community collaboration. Each dimension was operationalized into 15 readiness indicators across four levels. A corresponding digital self-assessment tool was developed and evaluated for usability, acceptability, and perceived utility through user testing and a structured online survey targeting DHOs.Results The resulting tool provides a structured, low-barrier mechanism for DHOs to assess their current equity capacity and identify priority areas for improvement. Survey results (N = 124) showed broad applicability across diverse organizational contexts, with respondents spanning regions, service types, and roles. Participants rated the tool highly across all constructs (M ≥ 4.39/5). Qualitative feedback highlighted five overarching strengths (clarity, diagnostic value, actionability, usability, awareness) and three areas for future improvement (examples, customization, additional features). Overall, respondents perceived the tool as both relevant and actionable for guiding equity-oriented strategy.Conclusion This study contributes a novel framework and diagnostic tool for advancing organizational readiness for health equity in digital health, supporting DHOs in moving from intention to implementation. It also offers potential utility for funders, regulators, and health systems seeking to institutionalize equity through incentives or benchmarking.
SN - 1475-9276
ER -