Digital transformation is considered an essential and the most appropriate change for addressing the crisis which healthcare organisations and medicine currently face.

According to the World Bank, the Organization for Economic Cooperation and Development and the World Health Organization, the annual wastage involved in the provision of healthcare lacking value amounts to approximately 1.8 billion dollars. Those bodies estimate that there will be a labour shortage of more than 10 million healthcare workers by 2030, mainly in low- and middle-income countries [¹,²]. Meanwhile, the demand for healthcare services from an ageing population with increasing pluripathologies and chronic diseases is growing, thereby creating a clear imbalance between supply and demand. This is in addition to the greater complexity of care, members of the public who expect swift answers and precision in diagnoses and treatments, and a highly technical medicine that is seen as dehumanised. This entire scenario is unfolding within organisational structures that are not accustomed to measuring the results of their work, and in which clinical variability is a constant feature, and with professionals who are dissatisfied with their work.

Today's computational capacity for the analysis, integration and transmission of a wide range of data, together with the applications of artificial intelligence in healthcare, healthcare management, biomedical research and wellness applications, promises to enable a change of direction towards twenty-first century medicine -personalised, precision, predictive, preventive and population-based, as well as patient participatory (6P medicine)-, in which we will eliminate the bureaucratic and repetitive tasks that prevent us from doing what really adds value, and which though it may seem paradoxical, will even create a golden opportunity to enhance the doctor-patient relationship and place it on a more human footing.

This major transformation requires three essential elements: technology, legislative measures that permit innovation and research while ensuring that technologies and data are used safely and ethically, and most importantly, the participation of professionals, and physicians in particular, which is crucial for meeting this new challenge in medicine successfully.

Lack of knowledge and confidence with regard to new technologies is one of the main barriers to their adoption and to successfully implementing change [³], which means that formal and coordinated medical training is required in order to acquire the skills, knowledge and attitudes to use digital technologies effectively.

There is an urgent need for a national plan to enable practising physicians to acquire competencies in three basic areas: first, technical expertise in electronic health information and communication systems, artificial intelligence and data analytics, to enable them to use these tools with confidence and include them in clinical decision-making; second, in digital competencies to improve commu­nication in these new doctor-patient relationship scenarios; and third, training in the ethical and legal aspects inherent in the deployment of the medicine of the future, and on access to, use and governance of healthcare data.

Planning for this digital health training in university medical studies, with a view to educating today's doctors and bridging any gap with the social and working conditions they will encounter when they have to practice, is obviously a key requirement in the strategy for the implementation of digital health. Studies of European medical students' opinions about the lack of medical education in digital health in curricular programmes may perhaps indicate that we are not on the right track, and that a plan of action is required if we are to take full advantage of these generations' innate digital capabilities in order to meet the needs arising from digital health [⁴].

In short, medical education and effective learning in all aspects of digital health must be a priority in digital health strategies, and this is the responsibility of all those involved in continuing medical education and undergraduate and specialised training, as doctors rather than artificial intelligence companies will remain responsible for medicine in the context of digital health. This means that the human-machine interaction in the medical process is only beneficial if we have the knowledge and skills to understand it and modulate it for the benefit of our citizens' health.