Integrated personal health and care services deployment: experiences in eight European countries.

Objectives: The deployment and adoption of Integrated Personal Health and Care Services in Europe has been slow and fragmented. There have been many initiatives and projects of this kind in different European regions, many of which have not gone beyond the pilot stage. We investigated the necessary conditions for mainstreaming these services into care provision.

Methods: We conducted a qualitative analysis of 27 Telehealth, Telecare and Integrated Personal Health System projects, implemented across 20 regions in eight European countries. The analysis was based on Suter's ten key principles for successful health systems integration.

Results: Out of the 27 cases, we focussed on 11 which continued beyond the pilot stage. The key facilitators that are necessary for successful deployment and adoption in the European regions of our study are reorganisation of services, patient focus, governance mechanisms, interoperable information systems, policy commitment, engaged professionals, national investments and funding programmes, and incentives and financing.

Conclusion: In those cases which provided evidence of success beyond the pilot stage, we observed a promising trend: awareness and introduction of Integrated Personal Health and Care Services in European regions has increased. Further research will reveal the weight of each facilitator and which combinations of facilitators lead to rapid adoption.