The Health Information System (HIS) Stages of Continuous Improvement (SOCI) toolkit was used to assess the maturity of the Serbian HIS across 5 domains using a 5-point Likert scale.

The process of maturity assessment using the HIS SOCI toolkit in Serbia in 2021 served to establish a baseline status, strengthen dialogue among different key stakeholders in the field of digitalization of health care, and identify areas that were not covered by the initially drafted program for digitalization.

Policymakers should consider using available methods and tools for qualitative assessment of the maturity level of HIS before developing an eHealth strategy.

The use of maturity assessment tools brings additional perspectives and considerations that could supplement and fortify the process of strategy development.

Program managers can track the success of HIS development in the future using established and quantified baseline results of HIS maturity assessment.

Since the health information system (HIS) in public health care services in Serbia was introduced in 2009, it has gradually expanded. However, it is unclear how well the HIS components have developed and the whole system’s stage of maturity.

In June–September 2021, a maturity assessment of the Serbian HIS was conducted for the first time using the HIS Stages of Continuous Improvement (SOCI) toolkit. The toolkit measures HIS status across 5 HIS domains: leadership and governance, management and workforce, information and communication technology (ICT), standards and interoperability, and data quality and use. The domains were further divided into 13 components and 39 subcomponents whose maturity stage was assessed on a 5-point Likert scale, indicating the level of development: (1) emerging/ad hoc; (2) repeatable; (3) defined; (4) managed; and (5) optimized. The toolkit was applied in a working group of 32 professionals and experts who were engaged in developing the new national eHealth strategy and action plan.

The overall maturity score of the Serbian HIS was 1.6, which indicates a low level. The highest baseline score (2) was given to the standards and interoperability domain, and the lowest (1.1) was given to ICT infrastructure. The remaining 3 domains (leadership and governance, Management and Workforce, and Data Quality and Use) were similarly rated (1.7, 1.7, and 1.6, respectively).

A baseline assessment of the maturity level of Serbian HIS indicates that the majority of components are between the emerging/ad hoc stage and repeatable, which represent isolated, ad hoc efforts, with some basic processes in place and existing and accessible policies. This exercise provided an opportunity to address identified weaknesses in the upcoming national eHealth strategy.

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