Developing Digital Health Ecosystems for Cost-Effective Public Spending: Challenges and Opportunities in the Republic of Moldova and Eastern Partnership Countries
By: Iulian SECRIERU and Angela SECRIERU
References
- Achuthan, K., Sankaran, S., Roy, S., Raman, R. (2025). Integrating sustainability into cybersecurity: insights from machine learning based topic modeling. Discover Sustainability, 6, 44. https://link.springer.com/article/10.1007/s43621-024-00754-w.
- Chandak, A., Gudapati, J., Kulkarni, P. (2025). The cost-effectiveness and patient satisfaction of telehealth in geriatric care: a systematic review. BMC Geriatr 25, 968. https://doi.org/10.1186/s12877-025-06638-6.
- EU4Digital. (2020). Analysis of the current state of eHealth in the Eastern partner countries. https://eufordigital.eu/wp-content/uploads/2021/02/Analysis-of-the-current-state-ofeHealth-in-the-Eastern-partner-countries.pdf.
- European Court of Auditors. (2024). Digitalisation of healthcare EU support for member states effective overall, but difficulties in using EU funds. Special report. https://www.eca.europa.eu/ECAPublications/SR-2024-25/SR-2024-25_EN.pdf.
- Fan, J., Gao, Y. , Zhao, N., Dai, R., Zhang, H. , Feng, X., Shi, G., Tian, J., Chen, C., Hambly, B. D., Bao, S. (2020). Bibliometric Analysis on COVID-19: A Comparison of Research Between English and Chinese Studies. Frontiers in Public Health, vol. 8. https://www.frontiersin.org/journals/publichealth/articles/10.3389/fpubh.2020.00477/full.
- Galstyan, M. (2022). Contribution of partner countries to EU Youth wiki. Chapter 7: Armenia health and well-being. EU-CE Youth Partnership. https://pjpeu.coe.int/documents/42128013/113172485/Armenia_HW_Ch7_22.pdf/c025f76c-1d1f-e177-69e5--d824c261f5e7
- Gentili, A., Failla, G., Melnyk, A., Puleo, V., Tanna, GLD, Ricciardi, W., Cascini, F. (2022). The cost-effectiveness of digital health interventions: A systematic review of the literature. Frontiers in Public Health. 10:787135. https://pmc.ncbi.nlm.nih.gov/articles/PMC9403754/pdf/fpubh-10-787135.pdf.
- Gotsadze, G., Zoidze, A., Gabunia,T., Chin, B. (2024). Advancing governance for digital transformation in health: insights from Georgia’s experience. BMJ Glob Health. 9:e015589. https://gh.bmj.com/content/bmjgh/9/10/e015589.full.pdf
- Government of the Republic of Moldova. (2023). National Health Strategy “Health 2030” (Government Decision no. 387/2023). State Register of Legal Acts. https://www.legis.md/cautare/getResults?doc_id=138493&lang=ro
- Hu, J., Li, C., Ge, Y., Yang, J., Zhu, S., He, C. (2024). Mapping the Evolution of Digital Health Research: Bibliometric Overview of Research Hotspots, Trends, and Collaboration of Publications in JMIR (1999-2024). Journal of Medical Internet Research, vol. 26. https://www.jmir.org/2024/1/e58987/.
- Hu, C., Liao, X., Fang, Y., Zhu, S., Lan, X., Cheng, G. (2025). Clinical and Cost-Effectiveness of Telehealth-Supported Home Oxygen Therapy on Adherence, Hospital Readmission, and Health-Related Quality of Life in Patients With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Medical Internet Research. vol. 27, e73010. https://www.jmir.org/2025/1/e73010.
- MedTech Europe. (2021). Interoperability standards in Digital Health: A White Paper from the Medical Technology Industry. Brussels. www.medtecheurope.org/wpcontent/ uploads/2021/10/mte_interoperability_digital_health_white-paper_06oct21.pdf
- Mousavi, B.S.F., Mousavi A.S., Kimiafar K., Sarbaz, M. (2022). Evaluating the cost effectiveness of tele-rehabilitation: A systematic review of randomized clinical trials. Frontiers in Health Informatics. 11: 118. https://healthinformaticsjournal.com/downloads/files/368.pdf?utm_source=chatgpt.com.
- Mudge, G. H., Vilenskyi, A., Kumar, U., Kohli, M. (2025). The future of Ukrainian healthcare: the digital opportunity. J Glob Health. vol. 15:03039. https://pmc.ncbi.nlm.nih.gov/articles/PMC12491902/pdf/jogh-15-03039.pdf.
- Okafor, N., M., Rao, A., Thompson, I., Venkat, V., Robinson, C., Kulkarni, S., Frerichs, L., Ndiaye, K., Adenikinju, D., Iloegbu, C., Vieira, J. P. D., Gyamfi, J., Peprah, E. (2025). Evaluating the feasibility, adoption, costeffectivenes, and sustainability of telemedicine interventions in managing COVID-19 within low-and-middle-income countries (LMICs): A systematic review. PLOS Digit Health. 4(4): e0000771. https://pmc.ncbi.nlm.nih.gov/articles/PMC11978082/pdf/pdig.0000771.pdf.
- Regulation (EU) 2025/327 of the European Parliament and of the Council of 11 February 2025 on the European Health Data Space and amending Directive 2011/24/EU and Regulation (EU) 2024/2847. (2025). Official Journal of the European Union, 327. https://eurlex.europa.eu/legal-content/EN/TXT/PDF/?uri=OJ:L_202500327.
- Rezaei, P., Bellini, F., Gorelova, I., D’Ascenzo, F. (2025). The role of AI in accelerating UN efforts to achieve the Sustainable Development Goals. Proceedings of the International Conference on Business Excellence, 19(1). Bucharest University of Economic Studies. https://doi.org/10.2478/picbe-2025-0007.
- Ross, P., Khachatrya, D. (2021). Armenian eHealth Strategy and Action Plan for 2021-2023. Asian Development Bank. https://www.moh.am/uploads/eHealth%20Strategy_ENG.pdf
- Socha-Dietrich, K. (2021). Empowering the health workforce to make the most of the digital revolution. OECD Health Working Papers. Paris. https://www.oecd.org/content/dam/oecd/en/publications/reports/2021/07/empowering-the-health-workforce-to-make-the-most-ofthe-digital-revolution_4a9f0ad5/37ff0eaa-en.pdf.
- Swecare. (2024). Healthcare System in Ukraine: 2024 Report. Stockholm. https://www.swecare.se/media/okhd3tkg/ukrainian-healthcare-system-in-2024-a-comprehensivereport-final-1.pdf.
- van Eck, N.J., Waltman, L. (2010). Software survey: VOSviewer, a computer program for bibliometric mapping. Scientometrics 84, 523-538. https://link.springer.com/article/ 10.1007/s11192-009-0146-3
- WB (World Bank Group). (2021). Digital Health Assessment Toolkit Guide. Version 1.Washington DC. https://documents1.worldbank.org/curated/en/271901636353443086/pdf/Main-Report.pdf.
- WB. (2022). Republic of Moldova. Public Expenditure and Financial Accountability (PEFA) Performance Assessment Report. Washington DC.
- WB. (2023). Digital-in-health: Unlocking the Value for Everyone. Washington DC. https://openknowledge.worldbank.org/handle/10986/40212.
- WB. (2024). Digital Health Blueprint Toolkit: How-to-Guide. Washington DC. https://thedocs.worldbank.org/en/doc/b929829fc3d36bebdf9d93555c64f222-0140022024/related/Digital-Health-Blueprint-Toolkit-How-To-Guide.pdf?utm_source=chatgpt.com
- WHO. (2022a). Health and care workforce in Europe: time to act. https://www.who.int/europe/publications/i/item/9789289058339
- WHO. (2022b). Health Systems in Action: Republic of Moldova. Copenhagen: European Observatory on Health Systems and Policies, WHO Regional Office for Europe. https://iris.who.int/server/api/core/bitstreams/9ec634de-9bf1-4b32-a356-3f7ad9db2c99/content
- WHO. (2022c). Regional strategy for fostering digital health in the Eastern Mediterranean Region (2023–2027). https://applications.emro.who.int/docs/Digital-Health-EMR-2023-2027- eng.pdf.
- WHO. (2024). Health Systems in Action: Georgia. Copenhagen: European Observatory on Health Systems and Policies, WHO Regional Office for Europe. https://www.ecoi.net/en/file/local/2121525/9789289059770-eng.pdf
- WHO (World Health Organization). (2025). Global strategy on digital health 2020-2027. Geneva:World Health Organization. https://iris.who.int/server/api/core/bitstreams/a64d584f-015b-471f-9d86-9ea263cfb516/content.
- Wilkinson, T., Wang, M., Friedman, J., Görgens, M. (2023). A Framework for the Economic Evaluation of Digital Health Interventions. Policy Research Working Paper. World Bank Group. https://openknowledge.worldbank.org/server/api/core/bitstreams/f8d4714e-44f5-43b1-bcc3-798cd0d85c9f/content.
- Yang, K, Hu, Y, Qi, H. (2022). Digital Health Literacy: Bibliometric Analysis. J Med Internet Res. 24(7): e35816. https://pmc.ncbi.nlm.nih.gov/articles/PMC9301558/.
DOI: https://doi.org/10.2478/picbe-2026-0346 | Journal eISSN: 2558-9652
Language: English
Page range: 4716 - 4732
Published on: Jul 23, 2026
Published by: Bucharest University of Economic Studies
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
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© 2026 Iulian SECRIERU, Angela SECRIERU, published by Bucharest University of Economic Studies
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.