Co-developing Georgia's National Digital Health Strategy through a multistakeholder convergence workshop: An implementation case study from the WHO European Region.

Abstract

National digital health strategies (DHS) are widely recognized as essential for advancing universal health coverage. However, published evidence on operational, multi-stakeholder approaches to co-development-particularly beyond the Asian and African settings where convergence methodology has previously been applied-remains limited. This study details the application of a convergence-based methodology to validate and refine the draft National DHS of Georgia, an upper-middle-income country, aligning it with European Union frameworks. An implementation case study was conducted in Georgia from June to September 2025. Central to this was the Multistakeholder Convergence Workshop, adapted from the Asian Development Bank Digital Health Convergence Meeting Toolkit and a four-phase blueprint methodology. Forty-seven participants from diverse sectors (public, private, academia, and development partners) collaborated in five thematic working groups. They reviewed the draft DHS, generating recommendations that were synthesized against the seven WHO-ITU eHealth strategy building blocks using hybrid deductive-inductive thematic analysis by two independent coders with third-party arbitration. The revised strategy comprises six strategic goals and 38 priority activities. Key technical recommendations included adopting a federated data governance model, utilizing the existing national identification number instead of a separate Health ID, and establishing a national Health Information Exchange. The strategy endorses FHIR for data exchange, LOINC for laboratory data, and the WHO-FIC (including ICD-11) complemented by SNOMED CT. Governance recommendations emphasized enacting a stand-alone Digital Health Act, forming a dedicated Digital Health Unit within the MoIDPLHSA, integrating digital health into professional education, and extending the strategy horizon to 2030 with a mid-2026 review checkpoint. Structured convergence methodologies, initially developed for Asian settings, can be effectively adapted for upper-middle-income WHO European Region countries pursuing European Health Data Space alignment. This approach produced technically specific outputs, reinforced national ownership, and supported Georgia's transition toward implementation, offering a highly transferable framework for similar contexts.