BACKGROUND: The development of effective eHealth strategies is critical to enhancing healthcare systems' efficiency and outcomes. However, there is limited comparative analysis of eHealth strategies across health systems, particularly in terms of their vision, objectives, implementation methods, and follow-up processes. This study compares the eHealth strategies of nine health systems, focusing on three key dimensions: vision and objectives, means to achieve objectives, and structures for follow-up. METHODS: A comparative qualitative analysis was conducted using publicly available eHealth strategy documents from nine health systems: Australia, Denmark, Estonia, Finland, Norway, Sweden, the UK (NHS England), Catalonia (Spain), and the USA (Veterans Affairs). The analysis mapped these systems' visions, objectives, implementation methods, and follow-up structures. RESULTS: Findings show that most systems articulate clear visions and strategic goals. However, there is considerable variability in the level of detail regarding the means of achieving objectives and structures for follow-up. Australia and Estonia present the most comprehensive strategies, with clear tasks, responsibilities, timelines, and follow-up mechanisms. In contrast, countries like Sweden and Catalonia provide less detailed strategic plans, particularly in terms of follow-up processes. CONCLUSIONS: While most studied health systems include clear visions and strategic goals, there is variability in the detail and comprehensiveness of their implementation and evaluation frameworks. Strategies with detailed implementation plans and follow-up processes, such as those from Australia and Estonia, offer valuable models. Further research is recommended to explore the practical impact of these strategies on healthcare delivery, patient outcomes, and system efficiency. Additionally, the role of stakeholder involvement in shaping these strategies warrants further investigation.