From pilots to integrated patient pathways: governing telemedicine scale-up in Austria
Abstract
Issue/problem: Austria’s national eHealth strategy (2024–2028) envisions digitally supported patient pathways under the principle “digital before ambulatory before inpatient”, aiming to ensure access to appropriate care through integrated digital and in-person services. Telemedicine is a key enabler of access, coordination and continuity. In practice, provision remains fragmented and largely pilot-driven across regions, providers and indications. This gap highlights a core policy challenge: telemedicine does not fail due to lack of technology, but due to the difficulty of scaling it into coordinated routine care.
Description of the problem: Within Austria’s joint governance framework (Zielsteuerung-Gesundheit), telemedicine is addressed through a cross-cutting patient pathway initiative. In a multistakeholder working group, federal, regional and social insurance actors co-create a shared basis for policy decisions. Building on a common definition, the process focuses on integrating digital services across all phases of a modern patient journey. The initial focus is physician-led teleconsultation for acute, non-life-threatening cases, defining concepts, roles and cornerstones.
Results: The main effect is the creation of a shared governance frame positioning telemedicine within patient pathways. As a first operational step, stakeholders prioritised physician-led teleconsultation as a nationwide, standardised entry point, translating a broad digital vision into a concrete implementation pathway.
Lessons: Telemedicine scales when governed as patient pathway infrastructure rather than implemented as stand-alone services. Scaling depends on negotiated alignment of stakeholders, workflows, responsibilities, reimbursement, legal frameworks and interoperable infrastructures. Public health action should prioritise staged co-creation, transforming fragmented initiatives into coordinated, integrated and equitable digital care.
Key messages: • Scaling telemedicine nationwide requires recognising its role across patient pathways and aligning stakeholders, workflows and incentives beyond isolated pilots.
• Telemedicine scale-up is a governance process in which stakeholders co-create and stabilise shared solutions across the health system.
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BibTeX
@article{wegleitnerkainz2026from,
title = {{From pilots to integrated patient pathways: governing telemedicine scale-up in Austria}},
author = {C Wegleitner-Kainz and A Laschkolnig and EF Tanriverdi},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1237},
url = {https://doi.org/10.1093/eurpub/ckag169.1237},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - From pilots to integrated patient pathways: governing telemedicine scale-up in Austria
AU - C Wegleitner-Kainz
AU - A Laschkolnig
AU - EF Tanriverdi
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1237
UR - https://doi.org/10.1093/eurpub/ckag169.1237
AB - Issue/problem: Austria’s national eHealth strategy (2024–2028) envisions digitally supported patient pathways under the principle “digital before ambulatory before inpatient”, aiming to ensure access to appropriate care through integrated digital and in-person services. Telemedicine is a key enabler of access, coordination and continuity. In practice, provision remains fragmented and largely pilot-driven across regions, providers and indications. This gap highlights a core policy challenge: telemedicine does not fail due to lack of technology, but due to the difficulty of scaling it into coordinated routine care. Description of the problem: Within Austria’s joint governance framework (Zielsteuerung-Gesundheit), telemedicine is addressed through a cross-cutting patient pathway initiative. In a multistakeholder working group, federal, regional and social insurance actors co-create a shared basis for policy decisions. Building on a common definition, the process focuses on integrating digital services across all phases of a modern patient journey. The initial focus is physician-led teleconsultation for acute, non-life-threatening cases, defining concepts, roles and cornerstones. Results: The main effect is the creation of a shared governance frame positioning telemedicine within patient pathways. As a first operational step, stakeholders prioritised physician-led teleconsultation as a nationwide, standardised entry point, translating a broad digital vision into a concrete implementation pathway. Lessons: Telemedicine scales when governed as patient pathway infrastructure rather than implemented as stand-alone services. Scaling depends on negotiated alignment of stakeholders, workflows, responsibilities, reimbursement, legal frameworks and interoperable infrastructures. Public health action should prioritise staged co-creation, transforming fragmented initiatives into coordinated, integrated and equitable digital care. Key messages: • Scaling telemedicine nationwide requires recognising its role across patient pathways and aligning stakeholders, workflows and incentives beyond isolated pilots. • Telemedicine scale-up is a governance process in which stakeholders co-create and stabilise shared solutions across the health system.
SN - 1101-1262
SN - 1464-360X
ER -