E-health, health systems and social innovation: a cross-national study of telecare diffusion

This paper explores telecare as one of the practical applications in the field of e-health. Using 11 expert interviews the study evaluates development of cross-national analogies between the different institutional contexts of health systems in Germany, Austria, and Denmark. Telecare is treated as a set of ideas regarding future processes in health and home care services, involving technological solutions, starting to change stakeholders' behaviour, work practices, and social roles. A system-centric framework is proposed to evaluate the interdependencies between telecare, the changing relationships, and the institutional context. Complexity and documentation requirements were identified as major hindrances to the improvement of efficiency and quality of health outcomes in Austria and Germany. On the contrary, in Denmark, governmental guidance supporting patient-centered approaches was found to be driving socially innovative solutions. Implications for research and practice, as well as future research directions, are elaborated.