Dr Peeter Ross, MD, PhD, is a professor of digital health and the head of the research unit eMedLab of Tallinn University of Technology (TalTech), Estonia. Peeter also holds the positions of radiologist at East Tallinn Central Hospital. He is the founder and board member of SMIS International OÜ, a digital health and radiology consulting company, and SafeToAct OÜ, which develops and manufactures simulation phantoms for interventional radiology training. He is also a short-term consultant to the World Bank, the Asian Development Bank, and the German Development Bank KfW. Dr Ross has previously been a member of the Supervisory Board of the Estonian E-Health Foundation and the Estonian Health Insurance Fund.

Peeter has actively participated in the design and implementation of the Estonian nationwide Digital Health Platform. He has advised on the design and implementation of large-scale digital health projects in more than 20 countries worldwide and has been involved in several EU-funded healthcare innovation projects. As a professor of digital health at TalTech, Prof. Ross is responsible for research and education in healthcare innovation and change management through digital applications.

Healthcare and social care are one of the largest service economy sectors in society. Like other service sectors, healthcare is also going through a phase of digitalization. In Estonia, the past 20 years have shown how valuable a nationwide digital health platform can be. Now we aim to people‑centred healthcare system, where new digital services support longer, healthier lives.

The evolution of digital health could be conceptualized across three levels and linked to system layers, key challenges, and future development directions. Digital Health 1.0 focuses on the digitization and initial storage of health data, including the implementation of electronic health records and information systems, supported by standardized terminologies, classifications, and data security frameworks. Digital Health 2.0 advances toward digitalization and integration, encompassing data exchange standards, access governance, and interoperability between diverse health information systems. Digital Health 3.0 emphasizes personalized, value-added services, including artificial intelligence-based decision support, digital therapeutics, and personalized health records.

Despite technological progress, several critical challenges persist. These include the lack of a unified data model, insufficiently standardized terminology, fragmented and largely manual data entry processes, and limited interoperability across systems. Additional barriers involve constraints in data reuse, issues related to data privacy and anonymization, and the slow integration and scalability of new applications.

Key areas to cope with these challenges include improved data entry and coding solutions, the development of semantic interoperability, enhanced integration of information systems and databases, and patient-centered decision support tools. Furthermore, it should be emphasized that next level digital health platforms should utilize patient-generated health data, advance the development of data architectures and governance models, and assess the value of digital health services. Overall, the digital health could be framed as a holistic ecosystem in which technological, organizational, and scientific components must be aligned to enable next-generation healthcare services.