Europe faces significant demographic challenges, including ageing populations and increasing demand for long-term care services. Digital technologies have the potential to reshape Integrated Long-Term Care (I-LTC) by improving care quality, personalisation, accessibility, and efficiency. However, the successful integration of digital solutions at a systems level requires coordinated strategies, evidence-based policies, and alignment with European values like equity and sustainability.

This webinar explored how digital solutions can support the transformation of European care systems. Given the challenges of providing care to a fast-growing population of older adults, at least four actions are urgently needed:

• An understanding of how digital can help people who need long-term care solutions.
• An appropriate set of policies.
• Evidence-based strategies.
• Actionable policy guidance for decision-makers (e.g., in a range of geographies and over time).

Among messages that emerged strongly in this webinar were:

• The relationship(s) between digital technology and the “human touch”.
• Overall digital training and digital skills needs in the health and care workforce.
• The general needs of informal carers.

Organised by EHTEL, the webinar was supported by the Laurel project, a European Union (EU)-funded project with a focus on future directions in I-LTC. Around sixty (62) people attended including speakers and organisers.

Welcome and background

Marc Lange, General Secretary of EHTEL, and Sara Canella, EHTEL digital facilitator, welcomed the attendees. Marc placed the webinar in its overall context of being one of several 2025 webinars organised by EHTEL in its Imagining 2029 work programme in 2025. Imagining 2029 aims to “put in the spotlight some developments that will come to reality in the next 10, now 5, years.” Several topics are included in this envisioning exercise, such as the transformation of care systems.

Speakers

Sara Canella placed the webinar in the context of the Laurel project. She introduced the three speakers who shared their experiences from three locations and many projects. These included the FRONTIZO (I CARE) in Athens; the European Laurel project; and the DigiCare4CE with its currently running pilots, including one in Treviso, a town in the Veneto region of Italy.

► Theodore Vontetsianos MD, Municipality of Athens Clinic: The innovation of the “FRONTIZO (I CARE)” Programme

Theodore represents the municipality of Athens, Greece. An early technology adopter, Theodore has been involved in digital health in the field of integrated care since 2018-2019, and – as part of that – in the work of the European Innovation Partnership on Active and Healthy Ageing (EIP AHA).  

Theodore drew on input from the FRONTIZO (I CARE), a nationally funded programme supported by the European Social Fund due to run between 2025-2027, and which has benefitted substantially from political support. A kick-off meeting for the initiative was held on 8 April 2025 in Athens City Hall.

About FRONTIZO (I CARE): “It’s a real-life programme" with real patients, personnel, and infrastructure, and a real working, operational, and legal environment. Athens aims at modernising the functioning of municipal clinics, showing the importance of integrated social health care, and providing services that are aligned with each patient’s needs which are often based on a combination of multiple chronic conditions. With this aim in mind, a 72-page application manual has been developed with instructions on how to apply the services being developed. The initiative is reinforced by two advisory boards, one international and another national.

Theodore described Athens experiences with 22 municipal friendship clubs. He drew on the outcomes of a series of past presentations made at these clubs where, “every time I left every club, I felt much happier than when I arrived" at it because of people's desire to participate and volunteer.

Theodore detailed the various phases of in-person person-centred rehabilitation. Examples of the phases included pharmacy services; creation of an electronic health record; goal setting; care plans; education; home-based services; and the assignment of a case manager, and including evaluation. A later phase consists of information and communication technology (ICT)-assisted virtual visits on continued coordinated care, based mainly around the case manager. Theodore was proud to announce: “We have completed the first phase of 140 patients," with a drop-out rate of zero.

The programme has involved the use of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) and is also premised on the concept of value-based health care originally formulated by Michael E. Porter.

Theodore believes that there are many opportunities for future success offered by the initiative. He emphasised: “Our strong weapon, [...] the meaningful tool is the human touch.”

A question posed, after the presentation, related to what makes patients so enthusiastic about the FRONTIZO (I CARE) work.

► Rachelle Kaye, EHTEL and K-Tor Consulting Services: The Laurel Digital Maturity Assessment Tool 

Rachelle described the Laurel project’s background, aims and goals and provided a definition of integrated long-term care (I-LTC). She then focused on the use of digital technology in I-LTC.

Laurel’s aim is to optimise the delivery of I-LTC and, in the project, EHTEL focuses on the use of digital solutions to enable I-LTC services. Rachelle observed that there is “a big gap between what we believe and what we know is right” and the actual changes taking place in integrated care. She expressed the view that: “digital solutions are great, but ultimately it comes down to people.”

Laurel has decided to create a Digital Maturity Assessment Tool to help implementers assessing how far they have come and what still needs to be improved. The tool is aligned in its definition of digital maturity with materials and a framework developed in 2021-2023 by NHS England and other frameworks identified during an in-depth state-of-the-art analysis. The tool is based on a questionnaire.

Laurel focuses on four levels of digital maturity. One tool measures Digital Maturity for Organisations engaged in I-LTC Initiatives. A second relates to Digital Maturity for I-LTC Practices or Initiatives, assessing system readiness, service readiness, technology maturity, business sustainability, and the effectiveness of digital solutions in long-term care services.

Ultimately, Laurel would like to convert this paper-based questionnaire into an online tool, which can be tested, compiled, receive feedback, and revised.

Comments and questions posed, after the presentation, related to the differences between national health services and insurance-based health and care systems; and addressing the assessment of workforce needs.

► Oscar Zanutto, Head of Innovation, ISRAA: Case Study Spotlight - DigiCare4CE

Oscar drew largely on an ongoing Interreg Central Europe project called DigiCare4CE which focuses on the digitalisation of residential care facilities and the provision of digital tools that can simplify tasks. The project runs from 2023-2026. It provides a general model and, ultimately, an online check of digital maturity: this is a six-stage long-term care (LTC) digitalisation tool. The tool shares certain similarities with the Laurel initiative(s).

Oscar listed several pilots embedded in DigiCare4CE on testing digital innovations in Austria, Poland, and Slovakia. Some are related to wound care (where the results can be added directly to the care record); others are on the production and management of reports. Other pilots, connected with environmental, wearable, and Internet of Things (IoT) solutions, are taking place being carried out in Austria, Czechia, Germany, Italy, and Slovakia. The Italian use case undertaken by ISRAA, where Oscar is the head of the innovation and development department, concentrates on artificial intelligence (AI)-driven technology.

“It’s your time”: A poll

Following the three presentations, three quick questions were posed as part of a poll. Of the 17-24 persons who responded to the questions, most people agreed with the statements. The third poll result reflected the greatest range of opinions. The question topics were as follows:

• “Digitally enabled integrated care won’t work unless health, social, and digital policies finally stop operating in silos.”
• “Informal carers are the invisible workforce of I-LTC, and they’re still excluded from policy decisions.”
• “Without making remote care a priority, we’re condemning older adults to institutionalisation over autonomy.”

Panellists and follow-up discussions

EHTEL digital health facilitator, Sara Canella, and EHTEL digital health policy advisor, Sophia Schlette, moderated the conversations with the panellists. Four panellists shared their opinions on how to leverage digital tools for systemic change. They represented four different stakeholder perspectives: technology providers, healthcare organisations, competence centres in the field of care, and the international health-related organisation – the World Health Organization (WHO). Attendees also had the chance to ask questions and share their own views.

Question 1: How can digital technologies help reimagine long-term care in Europe as both sustainable and person-centred for the future?

Tech Provider: Vincent Keunen, CEO & founder of Andaman7, Belgium 

Vincent commented that his company, Andaman7, a Belgian-American eHealth company, has worked on several questionnaires/surveys and scientific studies intended to quantify frailty and influence policymakers. Andaman7 has been part of a movement towards standardising and simplifying questionnaires, making surveys easy to distribute, and quantifying evidence. He sees these activities as helping to guide political/policy choices to enable decision-makers to invest finances where they can be most useful. People must be involved in the co-design of these approaches. He mentioned specific approaches on the part of e.g., EUCROF, ASCOP, and ICOPE.

“We really need these kinds of tools,” commented the moderator. “We need to train people and train the workforce,” added webinar attendee, Laurence Alpay, formerly associate lecturer at the Holland Hoge School. Overall, this is “a good way to move the needle forwards” rather than simply focusing on the need for soft skills, said Vincent.

Healthcare Organisation: Matteo Mauri, Project Manager Coop. La Meridiana, Isidora, Italy

Matteo is involved in a digital television (TV) platform for older adults near the city of Monza, Italy which provides structures largely for day-care centres. In his opinion, the technology is “to amplify the human touch”. Examples of digital technology use include helping people who need care to do what are called mental gymnastics (e.g., through games/exercises) or make video calls. His views outlined the importance of the wider ecosystem e.g., the role of carers and their need for training. It is about “how the people around [the video call module] use the tool to empower the elderly people at home [who need care].” Hence, “We can’t leave patients or carers alone with the technology. We need a trained workforce.”

Question 2: “What stops society from making policies more responsive to the needs of informal carers?”

In her opening remarks to this panel question, Sophia Schlette reminded the audience that informal carers – who are largely family members, friends, and neighbours – provide most long-term care in Europe. The percentage is around 80% of all caregiving time in the EU, according to a Eurocarers estimate. The 76 million mostly female informal caregivers in Europe – about 12.7% of the population – while they are making enormous social and financial contributions to society, are lacking in support, recognition and often, foregoing income.

Informal Carer: Maria Nilsson, Swedish Family Care Competence Centre (Nka), Linnaeus University, Sweden

Maria is a researcher at Linnaeus University who examines how digital technologies support care workers and their clients. She is also a Director of Nka. Her work provides “a bridge between research and practice”. She commented that “informal care is the backbone of the care system”. Informal carers are, however, rarely recognised in terms of e.g., what they need to support their own care or welfare and are not provided with the kinds of tools that enable them to balance the two roles of their own work and other people's care. The September 2022 European Care Strategy presented by the European Commission has, nevertheless, been “a step forward in recent years”. Informal carers, in Maria’s view, need several forms of support: access to information; support for coordination; and support for their own needs (including how to balance work and care responsibilities). Reflecting on the tasks of informal carers, she remarked that “some digital tools might add to the informal carers’ ‘to do’ list” when their “task list is already long.” In future, she felt that time and effort should be dedicated to holding pilot initiatives and involving informal carers in the planning and co-design of initiatives.

An attendee from eHealth Ireland offered information about CAREVW, a virtual ward for patients in Donegal that onboards patients with the needed skills and training.

Question 3: What can health and social care policies do? Can they bring more symbiosis between informal and formal carers?

Policy Expert: Matthias H. Wismar, European Observatory on Health Systems and Policies, WHO

The European Observatory focuses on evidence-informed policymaking. In April 2025, the Observatory published a policy report on digital skills, produced with the support of the BeWell project – an Erasmus+ project working intensively on digital (and green) skills for the health and care workforces. Matthias asserted that in most countries in WHO Europe the workforce is not cyber-mature. The key challenges are to get the skills into the system and infrastructure. Among the skills needed are soft skills. Also needed are: digital team building, digital problem-solving, copyright, safety, and cybersecurity, including very basic skills. In the focus groups on digital skills conducted by BeWell during 2023-2024, attendees emphasised the current health and care workforce crisis and insisted on the urgency of a situation in which: “We don’t have time for more training. It’s all hands on deck!” Matthias therefore proposed that a future webinar/discussion session should be held on agreeing which specific parts of the health and care workforce need what types of skills and on how to get that training "into the system".

Webinar attendees expressed views that digital tools should help care professionals “do more human tasks”; carers, whether formal or informal, need support; and teaching about digital tools might even begin with children at their elementary schools.

Conclusions

EHTEL General Secretary Marc Lange drew the webinar to a close by alerting attendees to a series of four future EHTEL Imagining 2029 webinars which might be of interest to them on topics related to digital technologies and data. EHTEL is pleased to announce several other webinars in the same series which are due to take place (or have already taken place) on e.g., 20 June 2025, 26 June 2025, and 26 September 2025. A 28 May 2025 webinar geared to EHTEL members and guests examined what can be done to implement electronic health records in the context of the European Health Data Space (EHDS).

While this was the second Laurel webinar organised by EHTEL, a first was held on 16 May 2024 about the digital transformation of long-term care. Its content was on innovations from the digital field. In addition, the Laurel project has a community which helps distribute information about I-LTC, including the use of digital tools to support integrated care.

EHTEL and Laurel will circulate more information about upcoming work and events on I-LTC, whether about health and care systems transformation or specifically digital skills and workforce training.