Tutorial 2 - ICEDEG 2023

Health Sector Online Services, an Assessment Methodology

Tutorial Outline

This half-day tutorial, to be delivered in English, provides practical answers to the questions:

  • Monitoring digital health: how to produce comparable statistical data for assessing the adoption of digital technology in healthcare establishments?
  • What should be assessed in healthcare establishments’ websites? and
  • How should it be assessed?

The tutorial focuses on the concept of health sector online services, the scope of hospitals’ websites, and existing areas of services. In the first part of the tutorial, an analysis of the context and components of hospital websites and what type of services are provided will be presented. It will provide information about the existing practices in hospital websites’ assessment. The status of hospitals’ web presence in Brazil and Ecuador will also be explored. Health Sector Website Assessment Index (HSWAI) methodology (criteria, indicators, weights) will be presented and discussed. Questions addressed in this section include: What is the status of hospital websites today? Which services do they provide? Which methods and tools can be used to assess them? Who should assess them and how? Which are the criteria and indicators that are used to assess hospital websites?


The objective of the second part of the tutorial is to consider the application, the challenges, and the results of the HSWAI methodology application in two European countries, Portugal and Greece. It will provide valuable insights into different ways to approach online services in the health sector, and it will provide the opportunity for an open discussion regarding practices in the Latin America region and identify possible collaboration pathways. Questions addressed in this section include: Do we have any assessment results from hospital websites assessment? Which are the challenges of designing and applying assessment methods? What are the results of HSWAI's initial application?


The primary objective of the tutorial is to introduce the participant to the theory and practice of health sector assessment concepts and methodologies. The tutorial will be anchored in the research conducted by UNU-EGOV Unit in the health sector websites assessment area and the strengths and challenges in HSWAI design, implementation, and application efforts. The secondary objective is to synthesize various international assessment approaches and recommendations in health sector website assessment.


The tutorial uses a combination of theory and practice to achieve these two objectives. Discussions and group work will be based on a guided pedagogical approach to get participants to work with the existing assessment instrument and specific pre-defined questions and apply these to their national and organizational contexts. The cross-country discussion and comparison aim to provide insights into current trends and standards for health sector website assessment and identify any useful trends in assessment principles and requirements. The ability, if any, to minimize assessment effort faced while improving the efficiency and effectiveness of the assessment instrument will be explored. The tutorial is structured as follows:

14:00 – 15:30 Part I

  • Welcome. A short outline of the tutorial program and objective, plus a roundtable of participants.
  • The need for hospital website assessment. Introduction to key concepts, current trends, and dilemmas in health sector online service delivery.
  • Presentations of health sector online presence and assessment initiatives in a national context (Brazil and Ecuador).
  • Alexandre Barbosa - Brazil. Digital Health in Brazil: Monitoring the adoption of digital technologies by healthcare facilities and adoption by healthcare professionals in Brazil. (20 minutes)
  • Patricia Acosta - Ecuador. Presentation of assessment initiatives and the online presence of the health sector in the Ecuadorian context. WAVE tool application to review accessibility in health sector websites. Consideration of Webometrics ranking. (20 minutes)
  • Health Sector Website Assessment Index (HSWAI). Methodology design and features.
  • Professor Manuel Francisco Tupia Anticona, Pontificia Universidad Católica del Perú. Measuring the accessibility of health service portals for people with visual disabilities during the COVID-19 pandemic. 
  • 15:30- 16:00 Coffee break

16:00-17:30 Part II

  • HSWAI application in Greece and Portugal, challenges and results
  • Questionnaire and discussion. Participants discuss HSWAI and their national experiences and provide information through a questionnaire. The core question is to critically review HSWAI based on their national context and identify missing and not-matching elements in their health service delivery ecosystems and governance models.
  • Conclusion. A set of recommendations are outlined based on the tutorial, discussions, and questionnaire results in discussion on how an assessment instrument (HSWAI) can establish an assessment mechanism consisting of a set of criteria, indicators, and sub-indicators plus a process and methodological model to ensure compliance and adaptation to national contexts. Potential collaborations of HSWAI application in national contexts in Latin America will be discussed.

Target audience and prerequisite knowledge

Public and private sector participants will find the tutorial particularly useful. Researchers and academics in e-Health and e-Government area, policymakers and public officials in the health sector, professionals and practitioners in website analysis and design, and health sector personnel (doctors, nurses, information systems development & administration) will also find the tutorial’s combination of theory and practice of interest. No prerequisite knowledge is required. Participants should have a basic knowledge of online government services and health sector service provision.

Importance for the ICEDEG community

Improving health sector electronic services has been on the European Commission Information Society policy agenda for more than fifteen years, from the eEurope initiative to the i2010 Strategy and, most recently, the EU2020 Strategy. The United Nations Economic Commission for Latin America and the Caribbean (ECLAC) has also emphasized that in Latin America and the Caribbean, there are still several obstacles to access to quality and timely health care, generating profound inequalities in the health of the population. This is linked to the structural problems afflicting the health systems of Latin America and the Caribbean and the persistent unequal distribution of the social determinants of health, all of which are crossed by the region's matrix of social inequality.

This demands health sector organizations develop websites enabling patients to receive a high-level health service. Hospitals do not only provide information to their clients, but their websites are increasingly used to facilitate interaction and offer online services to national and international audiences. Their websites have evolved into service channels between health sector organizations, patients, and other stakeholders.

Besides, the Sustainable Development Goals (SDG) urge for new solutions that promote Good health and well-being (SDG3) and Peace, justice, and strong institutions (SDG16). Well-developed health institutions' inclusive websites have good usability, and promote institution transparency, amongst other characteristics, directly contributing to these goals. Furthermore, accessible health-related services and information is fully aligned to leave no one behind and support gender equity and inclusion (SDGs 5 and 10).

The development of websites that better serve patients' needs is thus a key element in the evolution of hospital services provided through the Internet. To deliver the expected level of service, it is important to understand how users perceive and assess health sector web presence.

The topic is directly linked with ICEDEG 2023 track topic ‘Smart Health and ICT.’ It considers, presents, and discusses current research practices in the area of health sector website assessment. It is also relevant to health sector professionals and to government policymakers. The topic opens a discussion relative to an audience worldwide.

History of prior tutorials from the instructor(s)

The tutor will be Dimitris Sarantis. He is a senior academic fellow at the United Nations University Operating Unit on Policy-Driven Electronic Governance in Portugal (https://egov.unu.edu). He currently works on e-Government assessment in various areas (national, local, and health). He collaborates with UNDESA to design and apply the Local Online Service Index methodology in the United Nations e-Government survey. He also participates in the UNU-EGOV team designing and applying HSWAI. Dimitris has co-organized workshops and expert group meetings in the health sector and local government website assessment.

Alexandre Barbosa is the Head of the Center of Studies for Information and Communications Technologies (CETIC.br), a UNESCO Category IICenter for developing an information society based in Sao Paulo, Brazil. Mr. Barbosa is in charge of several nationwide ICT Survey projects in Brazil aimed at producing ICT-related statistics and indicators. Patricia Acosta is an Assistant Professor at Universidad de las Américas, Ecuador. Ph.D. in Computer Science at the University of Alicante, Spain. Research interests include web accessibility, eHealth, telerehabilitation, Human-Computer Interaction, gamification, data science, business intelligence, and innovation. Author of more than 90 scientific publications. Visiting professor-researcher at the Universidad Latina de Costa Rica. UDLA Ambassador (WiDS) in collaboration with Stanford University.


  • Soares D., Sarantis D. and Carvalho J. (2022). Assessment of Portuguese Hospitals' Websites using HSWAI. United Nations University (UNU-EGOV).
  • Soares D., Sarantis D. and Carvalho J. (2021). Assessment of the Portuguese Hospitals Websites using HSWAI. United Nations University (UNU-EGOV).
  • Soares D., Sarantis D. and Carvalho J. (2021). HSWAI: Instrument Design and Validation Process. United Nations University (UNU-EGOV).
  • Soares D., Sarantis D. and Carvalho J. (2019). Health Sector Website Assessment Instrument: notes on the assessment method. United Nations University (UNU-EGOV).
  • Nielsen M. M. (2022). Monitoring and Measurement of Digital Inclusion: A Critical Analysis of Key Global Frameworks. In HICSS (pp. 1-10).
  • Digital Future Society. (2019). Measuring the margins: A global framework for digital inclusion. UNU-EGOV Reports.

Tutorial Instructors

Demetrios Sarantis is Postdoctoral Fellow at UNU-EGOV. Demetrios graduated in Electrical and Computer Engineering by the National Technical University of Athens, holds a MSc in Operational Research and Information Systems from the London School of Economics and Political Science, and a PhD in e-Government from the National Technical University of Athens. He has been employed in software industry and in the Hellenic Telecommunications and Post Commission (EETT), deploying and managing information systems and services and supporting database information infrastructures. He has also worked as researcher in e-Government Unit in Decision Systems Laboratory of School of Electrical and Computer Engineering at the National Technical University of Athens (NTUA), participating in national and international research projects, in the areas of Government Transformation, Interoperability Frameworks, eParticipation, eGovernment, Process Modelling and Re-engineering in Public Sector. He has worked as researcher in Yale University (USA) in the area of Ontology Data Modelling in Biomedicine. His current research interests are Data Modelling-Ontologies, e-Governance. Public Administration, Information Systems Interoperability and Smart Cities.





Alexandre Barbosa is the Head of the Center of Studies for Information and Communications Technologies (CETIC.br), a Unesco Category II Center for developing an information society based in Sao Paulo, Brazil. Mr. Barbosa is in charge of several nationwide ICT Survey projects in Brazil aimed at producing ICT-related statistics and indicators. Mr. Barbosa holds a Ph.D. in Business Administration from the Getulio Vargas Foundation, a Master's Degree in Business Administration from Bradford University, a Master's Degree in Computer Science from the Federal University of Minas Gerais, and a Bachelor of Science Degree in Electrical Engineering from the Catholic University. He has conducted postdoctoral research at HEC Montreal in Canada. 








Patricia Acosta is a committed and strategic technology researcher with extensive experience in software engineering, implementing large-scale projects, and partnering with cross-functional leaders. Passionate about continuous improvement, innovation, and change. With a personal approach to cultivating strong and diverse relationships, facilitating collaborative groups. Certified Researcher by SENESCYT and WiDS (Women in Data Science) ambassador. Reviewer of scientific articles in high-impact journals. Member of the IEEE and the "Intelligent & Interactive Systems Lab" research group of the Universidad las Américas. Facilitator of Research, Advanced Excel, and Electronic Commerce workshops with an academic and business focus.

Blog: http://saccec.com/PatriciaAcosta/




Manuel Francisco Tupia Anticona is a computer Engineer, Master in Systems Engineering with a mention in Software Engineering, Ph.D. in Industrial Engineering. With more than 20 years of professional experience in IT consulting and auditing of technologies, systems, and information security, as well as training in these topics at the enterprise level. Expert in information security, information, and computer security. Extensive knowledge and mastery of national regulations, technical norms, and international auditing standards. He has 28 current international certifications related to security, cybersecurity, auditing, risk, business continuity, governance and management of IT services, anti-corruption, and process management. He has undergraduate and graduate university teaching experience.






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