How Georgia Built Its National Digital Health Strategy With 47 Stakeholders in One Room

Digital health has long promised to reshape how countries deliver care, yet the path from ambition to working policy is littered with strategies that never leave the page. A new implementation case study from Georgia, published in PLOS Digital Health, offers one of the most detailed accounts yet of how an upper-middle-income country in the WHO European Region can co-develop a national digital health strategy with the very people who will have to execute it. Between June and September 2025, researchers and government partners convened a Multistakeholder Convergence Workshop in Tbilisi, bringing together forty-seven participants from the public sector, private industry, academia, and development partners to stress-test and refine the country’s draft National Digital Health Strategy.

The methodology at the heart of the effort was not invented from scratch. The team adapted the Asian Development Bank’s Digital Health Convergence Meeting Toolkit and a four-phase blueprint methodology, tools previously applied mainly in Asian settings. That geographic transfer is itself significant. Published evidence on operational, multi-stakeholder approaches to co-developing digital health strategies has been scarce outside Asia and Africa, and skeptics have questioned whether structured convergence techniques designed for one region can function in a country pursuing alignment with European Union frameworks. The Georgian case suggests they can, provided the process is carefully localized and anchored in national institutions.

Participants were organized into five thematic working groups, each tasked with reviewing sections of the draft strategy and generating concrete recommendations. Rather than allowing discussion to drift into vague aspiration, the organizers required every output to be mapped against the seven WHO-ITU eHealth strategy building blocks, the internationally recognized framework covering governance, legislation, interoperability, workforce, services, infrastructure, and financing. Two independent coders then performed a hybrid deductive-inductive thematic analysis of the workshop outputs, with a third-party arbitrator resolving disagreements between them. This analytical rigor matters because it converts the raw material of a workshop—opinions, objections, and proposals—into a documented evidence base that policymakers can defend.

The resulting revised strategy is strikingly specific. It comprises six strategic goals and thirty-eight priority activities, a level of granularity that many national strategies never achieve. Among the key technical decisions, the working groups recommended adopting a federated data governance model, an architecture in which data remains distributed across institutions under shared rules rather than being centralized in a single repository. They also recommended using Georgia’s existing national identification number as the health identifier instead of creating a separate Health ID, a choice that avoids duplicating infrastructure and simplifies the linkage of patient records across providers.

Interoperability received equally concrete treatment. The revised strategy endorses HL7 FHIR as the standard for health data exchange, LOINC for laboratory data, and the WHO Family of International Classifications, including ICD-11, complemented by SNOMED CT. For readers outside health informatics, these choices amount to a common language for machines: FHIR defines how clinical information travels between systems, LOINC standardizes test names and results, and ICD-11 and SNOMED CT encode diagnoses and clinical concepts in ways that make data comparable across hospitals, regions, and borders. Adopting these standards positions Georgia to participate in cross-border health data flows, including the emerging European Health Data Space, which will require member-aligned countries to handle health data under strict interoperability and governance rules.

Governance recommendations were just as consequential as the technical ones. The workshop participants called for enacting a stand-alone Digital Health Act to give the strategy a firm legal foundation, and for establishing a dedicated Digital Health Unit within the Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs to steward implementation. They further recommended integrating digital health into professional education, ensuring that future clinicians and health managers are trained in the systems they will use, and extending the strategy’s horizon to 2030 with a mid-2026 review checkpoint to allow course correction without waiting for a full strategy cycle to lapse.

Why does a single country’s planning workshop deserve international attention? Because the failure mode of national digital health strategies is well documented: documents drafted by consultants or small technical teams, announced with fanfare, and then quietly shelved because the ministries, hospitals, vendors, and professional bodies expected to implement them were never genuinely consulted. The convergence approach inverts that sequence. By placing forty-seven stakeholders in structured working groups and forcing their recommendations through a transparent synthesis process, the exercise built what the authors describe as reinforced national ownership, a quality that no external technical assistance can substitute for. The output was not merely a better document but a coalition of actors who understood and had shaped its contents.

The case also carries lessons for the wider WHO European Region, where many countries face a common dilemma: they want the benefits of digital health—continuity of care, population health analytics, efficient procurement—but lack a tested playbook for building consensus around hard technical choices. Decisions such as federated versus centralized data governance, or reusing a national identifier versus minting a new one, are politically charged precisely because they touch on privacy, institutional power, and cost. The Georgian experience demonstrates that a structured, time-bounded workshop with independent thematic analysis can surface these tensions early and resolve them into explicit, defensible commitments rather than leaving them to derail implementation years later.

There are, of course, limits to what a case study can prove. The article documents a successful process for validating and refining a draft strategy, not the long-term outcomes of implementation, which will depend on financing, political continuity, and the passage of the recommended Digital Health Act. The mid-2026 review checkpoint built into the strategy acknowledges exactly this uncertainty, creating a formal moment to assess whether the thirty-eight priority activities are progressing. Still, the authors argue that the approach is highly transferable, and the evidence they present—technically specific outputs, broad stakeholder participation, and alignment with European frameworks—makes a credible case that convergence methodology, born in Asia, has found a second home in the European Region.

For health systems everywhere watching the digital transformation wave, Georgia’s workshop offers a deceptively simple takeaway: the hardest problems in digital health are rarely the technology itself. Standards like FHIR and ICD-11 are mature, and architectural patterns like federated governance are well understood. What is scarce is the disciplined, inclusive process by which a country decides which of these tools to adopt, in what sequence, and under whose authority. By treating strategy development as a convergence problem rather than a drafting problem, Georgia has turned a policy document into a shared national project, and in doing so has provided a template that other countries pursuing universal health coverage in the digital age may soon follow.

Subject of Research: Co-development of Georgia's national digital health strategy through a multistakeholder convergence workshop

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

Article References: Gzirishili, N., Grover, M., Sethi, R., Beridze, M., Roubal, T., Sulaberidze, L., Davtyan, K., Domente, S., & Adapa, K. (2026). Co-developing Georgia’s National Digital Health Strategy through a multistakeholder convergence workshop: An implementation case study from the WHO European Region. PLOS Digital Health, 5(10), e0001787. https://doi.org/10.1371/journal.pdig.0001787

Image Credits: AI Generated

DOI: 10.1371/journal.pdig.0001787

Keywords: digital health, Georgia, WHO European Region, health strategy, interoperability, FHIR, data governance, European Health Data Space, multistakeholder workshop, health policy, ICD-11, universal health coverage