Digital technologies as a response to healthcare system crises: agenda-setting of digital health policies in France

Since the COVID-19 crisis, digital health or (‘eHealth’) technologies have been a prominent element of domestic political agendas. However, in France, their emergence on the political agenda had already been linked to another type of crisis: the continuous and enduring crisis concerning the financing of the French healthcare system between 1995 and 2004. The aim of this article is to shed light on the conditions under which digital health technologies may be adopted as ‘solutions’ amidst financial constraint and austerity, based on an in-depth study of the French case. Using the Multiple Streams Framework, combined with a comparative and qualitative methodology, this article explains why digital health technologies were adopted as a central instrument of the 2004 French healthcare reform (the Douste-Blazy reform), but not during the 1995 social welfare reforms (the Juppé plan). It shows that if the perceived political risk associated with a reform increases, political decision-makers are more likely to select economically ambivalent devices, such as the Electronic Health Record (EHR), in order to restore the balance between pursuing policies and retaining votes.