{
  "abstract": "Background: Telemedicine is widely promoted to improve access, quality and efficiency in health care. While several European countries have moved towards scaled and integrated digital services, system-level implementation remains uneven. Austria is often characterised as innovation-friendly but slow in translating digital initiatives into routine care. This study examines Austria’s telemedicine landscape from a system perspective, focusing on maturity, scalability and the introduction of a novel communication-based classification.\n\nMethods: We conducted a mixed-methods system analysis combining structured desk research, policy document review and expert validation. Telemedicine applications were identified and analysed using a communication-oriented framework distinguishing four types based on synchronous and asynchronous interactions between patients and healthcare providers and among providers. Applications in routine care, pilot phase and discontinued but policy-relevant initiatives were included.\n\nResults: A total of 76 telemedicine applications were identified across Austria, of which only 48 are in routine operation, indicating that many remain pilot-based or have been discontinued. Implementation is highly fragmented: 75% are regional, while only 13% operate nationwide. Telemedicine is mainly applied in cardiology, followed by general practice and dermatology. Overall, the landscape shows high activity but low integration, with no coherent nationwide service model.\n\nConclusions: Austria’s telemedicine landscape illustrates a broader European challenge: innovation without scale. It remains a set of loosely connected projects rather than a coordinated system. Scaling requires addressing governance, financing and infrastructure as core public health issues, not merely technological adoption. A system-level perspective is essential to translate digital innovation into population-level impact.\n\nKey messages: • High telemedicine activity does not translate into system-level scale, as many applications remain pilot based or are discontinued.\n\n• Scaling telemedicine requires coordinated governance and integration, not only technological innovation.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "abstract",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "name": "C Wegleitner-Kainz"
    },
    {
      "name": "A Laschkolnig"
    },
    {
      "name": "EF Tanriverdi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/63yhge3yysyq9.bib",
  "cited_by": 0,
  "doi": "10.1093/eurpub/ckag169.449",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13699103/",
  "id": "63yhge3yysyq9",
  "issns": [
    "1101-1262",
    "1464-360X"
  ],
  "landing_url": "https://doi.org/10.1093/eurpub/ckag169.449",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "3. PARALLEL PROGRAMME"
    ],
    [
      "heading",
      "AcademicSubjects/MED00860"
    ],
    [
      "heading",
      "AcademicSubjects/SOC01210"
    ],
    [
      "heading",
      "AcademicSubjects/SOC02610"
    ],
    [
      "openalex",
      "2739|Telemedicine and Telehealth Implementation"
    ]
  ],
  "openalex": "W7223704899",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13699103/pdf/?tool=EBI",
  "pmcid": "PMC13699103",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/63yhge3yysyq9.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:46Z",
      "native_id": "PMC13699103",
      "source": "pmc",
      "url": "https://doi.org/10.1093/eurpub/ckag169.449"
    },
    {
      "first_seen": "2026-10-30T12:21:44Z",
      "native_id": "PMC:PMC13699103",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13699103"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Telemedicine and Telehealth Implementation",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Innovation without scale: system-level lessons from Austria’s telemedicine landscape",
  "title_text": "Innovation without scale: system-level lessons from Austria’s telemedicine landscape",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:35:43Z",
  "url": "https://research.draconitic.com/paper/63yhge3yysyq9",
  "venue": "The European Journal of Public Health",
  "versions": []
}