Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Monday, March 11, 2019 at 4:00 PM to 4:30 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?


Currently submitted to: Journal of Medical Internet Research

Date Submitted: Jun 6, 2019
Open Peer Review Period: Jun 11, 2019 - Aug 6, 2019
(currently open for review)

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 facilitation 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. 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, Grenovic 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

JMIR Preprints. 06/06/2019:14956

DOI: 10.2196/preprints.14956


Request queued. Please wait while the file is being generated. It may take some time.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.