Evaluation of the Digital Transformation of Traveler Entry Forms in the Republic of Palau in 2023.

On June 1, 2023, Palau launched the electronic Palau Entry Form for travelers to integrate health surveillance capabilities with standard border control requirements. This study evaluated whether electronic data collection improved data completeness, operational efficiency, and overall system performance and acceptability compared to paper-based data collection. A comparative analysis was used, comparing quantitative data from paper forms from 2018-2019 (n=65 535) and electronic forms from 2024 (n=80 060). Primary data was also collected from a survey administered to Palau entry system management stakeholders (n=23) during July-August 2025. Data completeness improved with electronic forms compared to paper forms: field completion proportions for key tourism-related questions increased, such as purpose of travel (4.4% increase) and accommodation type (10.8% increase), and traveler's health information was newly captured. Most stakeholders agreed that electronic form data was more complete (83%) and data processing times were faster (78%). Most stakeholders also agreed that electronic forms were more cost-effective than paper forms, particularly for printing (78%) and storage (57%) costs. Overall system acceptability was satisfactory, with 83% of stakeholders supportive of continuing with electronic forms and 74% reporting the transition from paper to electronic forms was smooth and that electronic forms made their jobs easier. This study demonstrated that Palau, a small island country, can successfully implement digital transformation in border management and health surveillance systems. Electronic data collection offered clear advantages in data capture capabilities and cross-agency functionality, informing future digital transformation decisions, and contributing to best practices for similar technology transitions in resource-limited settings, such as Palau.