Driving Sustainable Healthcare: The Role of Artificial Intelligence in Digital Transformation

Abstract

This paper examines the deployment of Artificial Intelligence (AI) within healthcare systems in three Central and Southern European Union member states—Romania, Poland, and Portugal—representing a spectrum from emerging to advanced digital health maturity. It evaluates how AI-driven digital transformation contributes to sustainability, operational efficiency, and improved patient outcomes within distinct national contexts. A mixed-methods approach combining a systematic review of Web of Science-indexed literature (2020–2024), secondary analysis of the EU Digital Economy and Society Index (DESI) 2024, and institutional benchmarking data from the European Commission's Digital Health Accelerator Programme is employed. A Sustainability Efficiency Index (SEI) is applied across five healthcare domains for each country. Significant variation exists across the three countries. Portugal achieves a Year 3 SEI of 0.51, approaching the EU-27 average of 0.43, while Poland records 0.39 and Romania 0.28, reflecting infrastructure and workforce readiness gaps. AI-driven waste reduction ranges from 12–38% by domain and country, with remote monitoring yielding the highest gains in all three contexts. This is among the first comparative analyses to apply a standardized SEI framework to AI healthcare adoption across Central and Southern EU member states, offering differentiated policy recommendations calibrated to national digital maturity levels. Possible practical implications: Policymakers in lower-DESI countries such as Romania should prioritize EU-funded infrastructure modernization and EHR interoperability before large-scale AI deployment, while higher-DESI countries like Portugal can advance toward full Green AI ecosystems aligned with net-zero health targets.