Structure & Governance


The broad set of changes needed to deliver integrated care at a regional or national level presents a significant challenge. It needs multi-year programmes with excellent change management, funding and communications, and the power to influence and (sometimes) mandate new working practices. This means alignment of purpose across diverse organisations and professions, and the willingness to collaborate and put the interest of the overall care system above individual incentives. It also 3 means managing the introduction of eHealth services to enable integrated care in a way that makes them easy to use, reliable, secure, and acceptable to care professionals and citizens alike.

  • Enabling properly funded programmes, including a strong programme, project management and change management; establishing ICT or eHealth competence centres to support rollout; distributed leadership, to reduce dependency on a single heroic leader; excellent communication of goals, progress and successes.
  • Managing successful eHealth innovation within a properly funded, multi-year transformation programme.
  • Establishing organisations with the mandate to select, develop and deliver eHealth services.

Indicators of maturity:

Evidence of effective planning and management of change, including stakeholder involvement; collective decision-making; benefits realisation; regular communication of progress; establishment or re-orientation of eHealth competence centres, usability labs etc.


  1. No overall attempt to manage the move to integrated care
  2. Change underway, but with fragmented organisations & plans
  3. Formation of task forces, alliances and other informal ways of collaborating
  4. Governance established at a regional or national level
  5. Roadmap for a change programme defined and broadly accepted
  6. Full, integrated programme established, with funding and a clear mandate.
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