The Digital Health Competencies in Medical Education Framework
Authors: Josip Car, Qi Chwen Ong, Tatiana Erlikh Fox, Daniel Leightley, Sandra J. Kemp, Igor Švab, Kelvin K. F. Tsoi, Amir H. Sam, Fiona M. Kent, Attila J. Hertelendy, Christopher A. Longhurst, John Powell, Hossam Hamdy, Huy V.Q. Nguyen, Sola Aoun Bahous, Mai Wang, Martin Baumgartner, Yodi Mahendradhata, Natasa Popovic, Andy W. H. Khong, Charles G. Prober, Rifat Atun, Abebe Bekele Zerihun, Akira-Sebastian Poncette, Al Joseph R. Molina, Albano V.L. Ferreira, Almir Fajkić, Amit Kaushal, Andrew J. Farmer, Andrew S. Lane, Andrzej A. Kononowicz, Aparna V. Bhongir, Barnabas T. Alayande, Benard Ayaka Bene, Christian J. Dameff, Cynthia Hallensleben, David A. Back, Dawan J. Hawezy, Dieudonné Steve M. Tulantched, Ekaterina Kldiashvili, Emmanuel K. Achampong, Ganesh Ramachandran, Goran Hauser, Jakob Grove, Jason P. Y. Cheung, John O. Imaralu, John O. Sotunsa, Juan P. Bulnes Vides, Katharine S. Lawrence, Louis Agha-Mir-Salim, Luca Saba, Luxia Zhang, Mahmoud M. A. Elfiky, Markus W. Hesseling, Michelle P. Guppy, Mrunal S. Phatak, Muna A. A. Al Saadoon, Nai Ming Lai, Niels H. Chavannes, Oliver Kimberger, Pedro Povoa, Poh-Sun Goh, Rebecca Grainger, Rishi S. Nannan Panday, Rowena Forsyth, Sandro Vento, Sang Yeoup Lee, Sanjay Kumar Yadav, Shabbir Syed-Abdul, Simone Appenzeller, Spiros Denaxas, Stephen Ekundayo Garba, Tabea Flügge, Tomislav Bokun, Vajira H. W. Dissanayake, Vincent Ho, Yasser A. Obadiel
Journal: JAMA Network Open (2025)

Importance Rapid digitalization of health care and a dearth of digital health education for medical students and junior physicians worldwide means there is an imperative for more training in this dynamic and evolving field. Objective To develop an evidence-informed, consensus-guided, adaptable digital health competencies framework for the design and development of digital health curricula in medical institutions globally. Evidence Review A core group was assembled to oversee the development of the Digital Health Competencies in Medical Education (DECODE) framework. First, an initial list was created based on findings from a scoping review and expert consultations. A multidisciplinary and geographically diverse panel of 211 experts from 79 countries and territories was convened for a 2-round, modified Delphi survey conducted between December 2022 and July 2023, with an a priori consensus level of 70%. The framework structure, wordings, and learning outcomes with marginal percentage of agreement were discussed and determined in a consensus meeting organized on September 8, 2023, and subsequent postmeeting qualitative feedback. In total, 211 experts participated in round 1, 149 participated in round 2, 12 participated in the consensus meeting, and 58 participated in postmeeting feedback. Findings The DECODE framework uses 3 main terminologies: domain, competency, and learning outcome. Competencies were grouped into 4 domains: professionalism in digital health, patient and population digital health, health information systems, and health data science. Each competency is accompanied by a set of learning outcomes that are either mandatory or discretionary. The final framework comprises 4 domains, 19 competencies, and 33 mandatory and 145 discretionary learning outcomes, with descriptions for each domain and competency. Six highlighted areas of considerations for medical educators are the variations in nomenclature, the distinctiveness of digital health, the concept of digital health literacy, curriculum space and implementation, the inclusion of discretionary learning outcomes, and socioeconomic inequities in digital health education. Conclusions and Relevance This evidence-informed and consensus-guided framework will play an important role in enabling medical institutions to better prepare future physicians for the ongoing digital transformation in health care. Medical schools are encouraged to adopt and adapt this framework to align with their needs, resources, and circumstances.