The Digital Health Strategy 2026–2030 is entering its final phase, meaning that for the first time the state and its citizens will receive a fundamental document that will establish the new architecture of the healthcare system: connected, secure, transparent and aligned with European standards. Software, applications and national technical solutions are only one segment that will facilitate the achievement of the strategy’s goals for better healthcare, safer decisions, stronger health institutions and greater trust between the patient, the doctor and the system.
By Azir Aliu
In healthcare, information carries life-saving value because it can mean a faster diagnosis, better therapy, an avoided mistake, a shorter path to a specialist, a lower administrative burden and greater security for the patient. When health data are fragmented and scattered across multiple systems or subsystems, care itself becomes fragmented and diffuse. Or, illustratively speaking, when a doctor sees only part of the medical history, the decision is made on the basis of an incomplete and insufficient picture. That is why digital transformation should be understood as an essential healthcare reform in which decisions are made on the basis of data-driven decision-making, rather than as a secondary technical process.
Our healthcare system has already laid important digital foundations. “Moj Termin,” electronic referrals, electronic prescriptions, telemedicine modules, digital services and the existing information systems demonstrate that the public healthcare system has the capacity to modernize even further and more profoundly. We are moving the system into its next, more mature phase: all these systems to be connected into one functional ecosystem in which the patient moves through the healthcare system as one integrated whole, rather than as someone constantly carrying their own medical documentation from counter to counter, from doctor to doctor, from institution to institution.
One of the key concepts in this strategy is connectivity. In technical language this is called interoperability, but in everyday life it means that the healthcare system will no longer be an isolated island, but part of a connected state infrastructure serving citizens. A laboratory result, a specialist’s report, a discharge letter, therapy, diagnostic imaging and medical history will all become part of one understandable, functional, secure and accessible healthcare whole. The same logic applies to connectivity with other institutions. For example, when a child is born, information from the healthcare institution, in accordance with legal rules and personal data protection standards, will be shared in a timely manner with the relevant civil registry offices so parents can more easily obtain a birth certificate. When death occurs, the system should allow information to reach the relevant institutions so the necessary documentation can be issued without families, in their most difficult moments, being exposed to unnecessary physical administrative procedures. This is the essence of a modern and digitalized system — for data to move securely through institutions so that citizens no longer have to move through administrative corridors.
This is also a matter of trust, because the patient has the right to know what exists in their medical file, who accessed their data, for what purpose and on what legal basis. Health data are an extension of a person’s dignity. They contain illness, fear, therapy, hope, privacy and trust. That is why digitalization processes will evolve through the integration of elements deriving from ethics, protection, transparency and patients’ rights.
Patients’ access to their own health data is one of the most important changes brought by this strategy. It means that citizens will be able to access their own records, follow their medical history, understand the data the system creates about them and participate more actively in their treatment. In chronic diseases, prevention, screening and long-term monitoring, this can make an enormous difference. The informed patient will become a partner in caring for their own health.
Digital healthcare will also help doctors, who need fewer administrative obstacles and more clinically relevant information at the right moment. A well-organized electronic healthcare system will save them time, reduce or completely eliminate the need to repeat diagnostic procedures, while enabling better communication between different levels of healthcare protection and creating stronger support for medical decision-making. Technology has value when it helps doctors become more precise, faster and more secure in their actions.
But the real strength of the strategy lies in the fact that it positions the healthcare system as a system that continuously learns. Healthcare generates an enormous amount of data every day — data related to diseases, risks, therapies, outcomes, regional differences, patient needs and institutional capacities. When these data are properly organized and integrated into one whole, we can realistically expect the state to develop a stronger capacity for planning. Through this new systemic capacity, it will become easier to identify where more prevention is needed, where staff shortages exist, where bottlenecks occur, which screening programs should be strengthened and which groups of citizens require special support.
In this way, digitalization also becomes a systemic tool for fairer healthcare because, in both time and space, it will reduce the distance to services, especially for citizens in rural areas, the elderly, socially vulnerable categories and everyone who has more difficulty accessing specialist care. Telemedicine, digital literacy, accessible services and clear user pathways will form an important part of a broader policy of equal access.
I also want to emphasize the European dimension of the strategy, which is especially important. Alignment with the European Health Data Space will mean that we are building our system on standards that will enable secure data exchange, cross-border care, better research, stronger protection of patients’ rights and more robust institutional accountability. But this dimension also carries even deeper developmental value. The data already generated by the healthcare system, if properly protected, de-identified and used according to strict ethical and legal rules, can become the basis for scientific research, the development of artificial intelligence models and more precise health policies. This opens the possibility that in the future we may achieve better targeted preventive programs, more personalized healthcare packages and a deeper understanding of how certain therapies affect our population, including through analyses that take into account the genetic, clinical and public health characteristics of citizens. European values and standards are therefore not established merely as a goal, but accepted as a methodology for order, quality, scientific progress and long-term sustainability.
By 2030, alongside digitalization, we will also begin the careful, regulated and responsible introduction of artificial intelligence into healthcare, in line with the strict criteria established by the European Union through the AI Act. Our approach is for artificial intelligence to serve as a support tool, not a replacement for the doctor. For example, in the analysis of breast cancer screening, in addition to the professional assessment of two radiologists, an AI tool may in the future also be used as additional support for confirmation, comparison and precision of findings. We believe in the potential of artificial intelligence, but even more in the knowledge, experience and responsibility of doctors. The decision must always remain with the human being — the medical professional who knows the patient, understands the clinical picture and carries the final professional and ethical responsibility. That is why the strategy establishes a precise institutional architecture: digital healthcare and the application of AI will have designated authorities, competencies, rules, standards, budgets, staff, oversight and monitoring mechanisms. Reforms can deliver lasting results only when they are embedded within institutions, not when they depend on the enthusiasm of individuals.
It is particularly important that the strategy treats security as an integral part of patient safety. The protection of health data, access control, records of who used the data, system resilience and continuity plans are all part of the modern healthcare culture this strategy seeks to develop.
By 2030 our goal is to have a connected, secure, transparent and European-aligned digital healthcare system. A system in which the patient has greater control over their own data, doctors have better tools for their work and institutions plan on the basis of evidence.
The healthcare of the future will be healthcare that remembers, connects and learns. But it must also be healthcare that understands technology itself is not a reform — it becomes reform only when filled with trust, ethics, knowledge and institutional responsibility. As Deborah Lupton warns, digital health technologies are not neutral tools, but rather “sociocultural artifacts” — created through human decisions, values and assumptions about the body, health, illness and behavior (Digital Health: Critical and Cross-Disciplinary Perspectives, 2018). That is why our strategy frames digitalization as a public responsibility: data must be protected, patients respected, doctors provided with a complete picture and the system must use technology for greater fairness rather than for new inequalities.
In this sense, we also build upon the understanding of the World Health Organization that digital health is the use of information and communication technologies in support of health and health-related fields. This means that the goal is not for citizens to be left alone in front of a screen, but for digital solutions to make care closer, more precise and more humane. Contemporary scientific literature on digital health emphasizes that real change occurs when the patient becomes an active participant in their own healthcare pathway, when the doctor receives stronger support in professional decision-making and when institutions plan on the basis of knowledge, evidence and real needs. In this way, digital transformation will evolve into a new pact of trust between citizens and public healthcare.
The author is Minister of Health of North Macedonia