A lack of General Practicioners (GPs) and other health care providers is a growing problem in rural areas of the alpine countries. The problem is becoming even more acute with demographic change which results in a higher demand for basic health care services per inhabitant. With the long distances between patients and service providers, e-health can offer even greater benefits to the rural than in urban areas. Various initiatives have already started implementing e-health. The initiatives have a different focus and scope. In the rural areas, projects that address basic health care at the regional level and as a whole are particularly promising. This means that the services of pharmacies, gynaecologists, paediatricians, ophthalmologists, dentists, ambulant and stationary care are also included in the approach. When talking about outpatient care, the services of relatives and volunteers can also be included. The elaboration of digital tools in e-health should take into account the whole system.

The Corona-Virus pandemic in 2020 forced actors of all generations to implement digital solutions in situation where they have not been used before. It was shown that the actors accepted these solutions more quickly than expected. In many situations, the benefits obvious. But the experiences in the corona crisis of spring 2020 have also shown clear shortcomings. The example of Switzerland, where data still has to be transmitted by fax does not meet the requirements of the 21st century, but the digital systems and the processes improvement or even made available at all. Digitisation offers new possibilities for diagnosis and care of patients, especially in remote regions. Unfortunately, the potential of digitisation is not yet fully used in health care in the Alpine region. Digitisation can therefore help to achieve a breakthrough in the idea of a spatially integrated care strategy. Ultimately, however, digitisation cannot replace the necessary personal contact between patients and medical staff, especially in the health sector. The lack of doctors could, however, be at least partially compensated by the increased use of specialist nurses. With the help of digital tools, they can provide care on site with professional support and under the guidance of doctors who no longer necessarily have to be on site. However, this also requires sufficient qualified nursing staff and adapted policies. Whereas in some countries like the UK or Sweden «advanced practice nursing» is very developed, the alpine countries hardly apply this system. In some of the countries, appropriate adjustments have already been made to the training of the Master's course for nursing staff at individual training centers, but this is just a first step. After the corona crisis and with the development of the “advanced practice nursing” in whole Europe, it would be a good “window of opportunity” to introduce reliable digital e-health tools. They could be first tested in remote alpine areas where the benefits are the most important.

The present report gives examples of how the problem is being addressed in different regions. The report is based on a literature search and an assessment by AG5.