Successful transfer and adoption of Good Practices on digitally enabled integrated care across Europe, an implementation science approach

Health systems around the world are facing a perfect storm of challenges. Populations are aging, chronic diseases are becoming more common, and the cost of care is rising faster than budgets can handle. In response, many experts have turned to a concept called integrated care, which means connecting different parts of the health system so a patient receives a seamless journey of support rather than a series of disconnected visits. Adding digital tools to this mix—such as electronic records, video consultations, and data tracking—promises to make these connections stronger and more efficient. However, a major hurdle remains: a solution that works perfectly in one city or country often fails when moved to another. The unique culture, laws, and resources of a new location can break the delicate machinery of a successful program. The question facing health leaders is not just how to build a good system, but how to take a proven model and adapt it so it thrives in a completely different environment.

A large group of researchers and health officials from sixteen European countries set out to solve this puzzle through a project called JADECARE. Their goal was to move beyond theory and test a specific, step-by-step method for taking four successful digital health programs and transplanting them into twenty-one different healthcare systems across Europe. Instead of trying to copy these programs exactly as they were, the team treated them like a set of building blocks. They broke each complex program down into its smallest, most essential parts, which they called "core features." These features represented the fundamental actions that made the original programs work, stripped of the specific local details that might not fit elsewhere.

The process began by asking each of the twenty-one adopting sites to look honestly at their own weaknesses and needs. Using a structured analysis, they identified exactly where their systems were failing, such as a lack of coordination between hospitals and local clinics, or a shortage of tools to help patients manage their own health. Once these gaps were clear, the teams matched them against the list of available building blocks. This allowed them to pick and choose the specific features that would solve their local problems, a strategy the researchers called "mix and match." Some sites took a whole program from one country, while others combined elements from several different sources to create a custom solution.

After selecting the right pieces, the teams adapted them to their local reality. This was not a simple copy-paste job; it involved rewriting protocols, training staff, and ensuring the new tools fit with existing laws and hospital workflows. The teams then rolled out these new interventions in small, controlled cycles, testing them, measuring the results, and tweaking the approach before expanding. This method allowed them to learn from mistakes early without risking the entire system. The result was the creation of twenty-one new, tailored interventions that reached more than four million people. These ranged from national strategies for diabetes care in Portugal and Serbia to local telemedicine projects for remote patients in Estonia and Latvia.

The study found that this structured approach worked remarkably well. When the participants were asked to evaluate the process, the vast majority agreed that it helped them plan and implement their new systems effectively. They reported that the method helped them spot problems early and design solutions that were actually feasible for their specific settings. Perhaps most importantly, the participants felt the interventions they created were sustainable, meaning they could continue to operate long after the project ended. The researchers noted that while the process required a significant learning curve and some technical support, it was not overly complex and successfully bridged the gap between high-level research and the messy reality of daily hospital work.

This work demonstrates that transferring complex health innovations is possible, but only if the process respects the unique context of the new location. The success of the project did not come from finding a single "magic bullet" that works everywhere, but from a disciplined method of breaking down successful models and rebuilding them to fit local needs. By treating health systems as living, adaptable environments rather than static machines, the team showed that it is realistic to move from a one-size-fits-all approach to targeted, tailored solutions. The findings suggest that with the right framework, the digital tools and care models that work in one part of Europe can be successfully adapted to improve health for millions of people in others, provided the local needs are understood and the adaptation is done with care.