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Currently accepted at: Journal of Medical Internet Research

Date Submitted: Jun 6, 2019
Open Peer Review Period: Jun 11, 2019 - Jul 21, 2019
Date Accepted: Jul 30, 2019
(closed for review but you can still tweet)

This paper has been accepted and is currently in production.

It will appear shortly on 10.2196/14956

The final accepted version (not copyedited yet) is in this tab.

Digital health transformation of integrated care in Europe: an overarching content analysis of 17 integrated care programmes

  • Erik Baltaxe; 
  • Thomas Czypionka; 
  • Markus Kraus; 
  • Miriam Reiss; 
  • Jan Erik Askildsen; 
  • Renata Grenković; 
  • Tord Skogedal Lindén; 
  • János György Pitter; 
  • Maureen Rutten-van Molken; 
  • Oscar Solans; 
  • Jonathan Stokes; 
  • Verena Struckmann; 
  • Josep Roca; 
  • Isaac Cano; 



Digital health tools comprise a wide arrange of technologies to support health processes. The potential of these technologies to effectively support healthcare transformation is widely accepted. However, wide scale implantation is uneven among countries/regions. Identification of common factors facilitating and hampering the implementation process may be useful for future policy recommendations.


To analyse the implementation of digital health tools to support healthcare and social care services, as well as to facilitate the longitudinal assessment of the services, in 17 selected integrated chronic care (ICC) programmes from 8 European countries.


A programme analysis based on thick descriptions - including document examinations and semi-structured interviews with relevant stakeholders - of ICC programmes in Austria, Croatia, Germany, Hungary, The Netherlands, Norway, Spain and United Kingdom was performed. A total of 233 stakeholders (i.e. professionals, providers, patients, carers and policymakers) were interviewed from November 2014 to September 2016. The overarching analysis focused on the use of digital health tools and programme assessment strategies.


Supporting digital health tools are implemented in all countries, but different levels of maturity were observed among the programmes. Only few ICC programmes have well-established strategies for a comprehensive longitudinal assessment. There is a strong relationship between maturity of digital health and proper evaluation strategies of integrated care.


Notwithstanding the heterogeneity of the results across countries, most programmes aim to evolve towards a digital transformation of integrated care, including implementation of comprehensive assessment strategies. It is widely accepted that the evolution of digital health tools alongside clear policies towards their adoption will facilitate regional uptake and scale-up of services with embedded digital health tools.


Please cite as:

Baltaxe E, Czypionka T, Kraus M, Reiss M, Askildsen JE, Grenković R, Lindén TS, Pitter JG, Rutten-van Molken M, Solans O, Stokes J, Struckmann V, Roca J, Cano I

Digital health transformation of integrated care in Europe: an overarching content analysis of 17 integrated care programmes

Journal of Medical Internet Research. (forthcoming/in press)

DOI: 10.2196/14956


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