Digital Health and Long-Term Care in Switzerland: Building a More Connected Care System

An older person can move from hospital to rehabilitation, return home with Spitex, see a family doctor, receive medicines from a pharmacy and later enter a nursing home. Every organisation may hold useful information, yet that does not mean the information follows the person smoothly.

This is the practical digital challenge sitting behind Switzerland’s wider health transformation. Within the Switzerland Ageing, Long-Term Care & Community Support Knowledge Hub, digital health matters because older people increasingly depend on multiple organisations at the same time. Better connectivity could reduce repeated assessments, missing information and avoidable administrative work. Poorly designed digitisation could simply reproduce fragmentation electronically.

Switzerland is now addressing this through several overlapping developments. The national DigiSanté programme began its operational phase in 2025 and is intended to run to 2034. The Electronic Patient Record, known in Switzerland as the EPD or DEP depending on language region, continues to operate while its future framework develops. National work on data standards, interoperability and the principle of collecting information once rather than repeatedly is also advancing.

Long-term care nevertheless presents a particular test. Nursing homes, Spitex, hospitals, doctors, insurers, cantons, municipalities and families do not operate through one national organisation. Digital transformation must work across this federal and organisational complexity without weakening privacy, professional responsibility or the older person’s control over information.

Digital health in Switzerland is moving from isolated projects towards infrastructure

Switzerland has used digital systems in healthcare for many years, but widespread digitisation has not always produced genuine digital integration.

Hospitals, medical practices, pharmacies, nursing homes and Spitex organisations commonly use electronic systems. The difficulty is that information can remain trapped within separate applications, organisations or technical standards. A document may exist digitally while still having to be printed, emailed, manually re-entered or requested again by another part of the care pathway.

DigiSanté represents an attempt to address this at system level. Developed by the Federal Office of Public Health and Federal Statistical Office, the national programme is designed to promote a health system in which relevant information can be exchanged more consistently and interpreted across systems.

Its implementation extends from 2025 to 2034 and includes work on standards, infrastructure, services and the secondary use of data. The intended direction is a move towards structured, reusable information rather than repeated collection of the same data in disconnected settings.

This is directly relevant to interoperability and system integration. For long-term care, interoperability should mean more than connecting software. It should allow clinically and operationally important information to move with the person while preserving clear responsibility for who records, updates, accesses and acts upon it.

DigiSanté should also be understood as a programme under implementation rather than a completed national digital environment. Its projects are phased, some are still being developed, and federal budget pressures announced in 2026 have required reprioritisation and delays to parts of the programme. Digital ambition therefore needs to be distinguished from current capability.

The Electronic Patient Record is important but does not solve coordination by itself

The Swiss Electronic Patient Record is one of the most visible components of digital health infrastructure. It allows health-related documents to be made accessible electronically through certified EPD communities and is intended to support continuity across organisational boundaries.

Certain healthcare providers, including hospitals and nursing homes, are required to connect under the Federal Act on the Electronic Patient Record, while participation requirements differ for other professional groups and have evolved over time.

By mid-2026, more than 140,000 electronic patient records had been opened nationally. That represents continuing adoption, but it remains a relatively small proportion of Switzerland’s population.

The distinction between connection and effective use is important. An organisation can be technically connected while the information needed by frontline practitioners remains difficult to find, incomplete, stored as static documents or poorly integrated with its everyday care system.

For an older person receiving long-term care, valuable information may include:

• current medicines and recent changes;
• diagnoses, allergies and relevant clinical history;
• hospital discharge information;
• care assessments and changing support needs;
• advance care information and important preferences;
• relevant contact and professional responsibilities.

If these elements remain scattered across systems, an electronic record can become another information location rather than the connective layer practitioners need.

The operational test is therefore not simply whether a provider has access to digital records. It is whether the right information is available at the right point in the pathway, sufficiently current to be trusted and presented in a format that can inform action.

Scenario: a hospital discharge arrives home before all the information does

An 84-year-old woman is discharged from an acute hospital following treatment for pneumonia. Her medicines have changed and her mobility has deteriorated. She lives alone and is due to receive increased Spitex support from that evening.

The hospital has electronic clinical records. The Spitex organisation also uses a digital care system. Both are digitally mature within their own organisations. Yet the systems do not exchange all relevant structured information automatically.

The discharge summary is available, but the nurse visiting the woman needs to confirm which medicine has been stopped, what mobility restrictions are temporary and when follow-up is expected. Her daughter has received part of the information verbally but is uncertain about the details.

The Spitex nurse contacts the hospital team and the family doctor. The missing information is clarified, but professional time is spent recreating a connection that technology should increasingly be able to support.

The organisation reviews the case as more than a communication error. It maps which information is required before the first post-discharge visit, where it should originate, what can be accessed digitally and which gaps continue to require telephone clarification.

The lesson is that digital care systems cannot be assessed only by whether they exist. Their value depends on whether they reduce uncertainty at transition points where uncertainty can become clinical risk.

Long-term care needs structured information rather than larger volumes of documents

Digital systems make it easy to generate information. They do not automatically make information usable.

A practitioner faced with dozens of uploaded documents may technically have access to everything while still struggling to identify the one recent change that matters. This becomes particularly important for older people with multimorbidity, polypharmacy, frailty or dementia, where health records may become extensive over time.

The stronger model is structured data supported by meaningful narrative.

Medicines, allergies, clinical observations, functional assessments and care needs can increasingly be recorded using agreed structures so that information can be exchanged, interpreted and reused. Narrative remains important where context cannot be reduced safely to a code or field.

DigiSanté’s direction towards shared standards therefore matters operationally. It creates the possibility of data that can move between systems without being repeatedly translated or manually re-entered.

This also supports stronger digital records and information governance. The objective should be a clearer information architecture rather than indiscriminate digitisation.

For long-term care providers, this means identifying which information needs to be structured, which remains narrative and which must be visible immediately during an urgent change in condition.

Spitex is a critical test of whether digital health works beyond institutions

Switzerland’s growing dependence on Spitex makes home care one of the most important environments for digital transformation.

A Spitex nurse works in people’s homes rather than within a hospital information environment. The worker may need access to assessment information, medicines, clinical instructions, previous observations and escalation contacts while travelling between clients.

Digital care records can strengthen this considerably. They can provide current information to mobile teams, improve documentation, support handovers and make changes visible more rapidly than paper systems.

HomeCareData demonstrates another dimension of the opportunity. Standardised information from interRAI assessments can support quality development, research and planning beyond the individual episode of care.

Yet Spitex also exposes the limits of digital connectivity. Home nursing may sit alongside family support, household assistance, specialist care, GP input and hospital services. Not every actor uses the same systems or has the same access rights.

A digital record designed around institutional episodes can therefore miss the continuous reality of home-based support.

Strong digital technology in home care must help mobile practitioners coordinate care rather than simply document that visits occurred.

It should also recognise that the person’s home is not a clinical institution. Technology needs to operate proportionately within a private domestic environment where the individual retains control over everyday life.

Nursing homes need connectivity with the wider health system

Nursing homes hold substantial clinical information of their own, but residents continue to interact with doctors, hospitals, pharmacies and other health services.

This means the nursing home should not become an information endpoint.

When a resident is transferred to hospital, clinicians need reliable information about medicines, allergies, cognition, mobility, communication, existing care needs and the person’s usual baseline. When the resident returns, the nursing home needs to know what changed.

The same principle applies to outpatient specialist appointments and medication review.

Digital connection can reduce dependence on paper transfer folders and repeated telephone calls, but only if records remain accurate and responsibilities are clear.

This matters especially where dementia is present. A hospital clinician may interpret agitation as a new presentation if information about the resident’s usual communication and behaviour does not accompany them. Conversely, a nursing home could assume a sudden change represents dementia progression if recent hospital information about infection or medication is incomplete.

The strongest digital model therefore connects clinical data with person-centred information. A diagnosis does not explain how someone communicates, what causes distress or which routines help them feel secure.

The principle of collecting data once could reduce a major administrative burden

One of the most significant directions within Swiss digital reform is the principle that information should be collected once and then reused where there is a legitimate purpose and appropriate access.

In February 2026, the Federal Council advanced proposed changes to the Federal Health Insurance Act intended to strengthen this “once-only” approach for administrative health data. The proposal was sent to Parliament and therefore should not be treated as fully implemented national practice.

The underlying principle is nevertheless important.

Healthcare and long-term care organisations currently provide overlapping information for treatment, insurance, statistics, quality reporting, cantonal requirements and other administrative processes. Repeated manual submission consumes professional and administrative capacity while introducing opportunities for inconsistent data.

A stronger national data architecture could allow valid information to be reused across authorised purposes.

This does not mean all information should automatically be shared with everyone. Purpose limitation, access control and data protection remain essential. The opportunity lies in reducing unnecessary recollection while preserving legitimate boundaries.

For providers, the operational implication is that data governance becomes more important as data become more reusable. Errors that once remained within one system may affect several downstream uses.

That makes data quality a frontline issue rather than an IT issue.

Digital continuity depends on responsibility as much as technology

Connecting organisations digitally does not answer a fundamental question: who is responsible for acting on the information?

Suppose a Spitex nurse records a significant deterioration in mobility. A family doctor can technically access the information, but does the system actively alert the doctor? Is the nurse expected to telephone as well? Who confirms that the message has been received?

The distinction between information availability and communication responsibility is critical.

Digital systems can create a false sense of security if professionals assume that entering information somewhere means another person has seen and acted upon it.

Strong digital governance therefore defines:

• which information triggers active escalation;
• who receives the escalation;
• how receipt is confirmed;
• what happens when the expected response does not occur;
• which organisation remains responsible while information is moving between services.

These rules are especially important in fragmented systems because no technology platform can remove professional accountability.

Organisations examining these interfaces can use the Governance Maturity Assessment as a generic framework for testing accountability, escalation and oversight. It does not determine Swiss legal responsibilities, but it can help leaders identify where apparently connected processes still contain gaps in ownership.

Scenario: the information is visible, but nobody owns the escalation

A Spitex team supporting an older man records several days of increasing breathlessness, reduced appetite and lower activity. Observations are entered correctly into the digital care system.

The organisation’s system can generate a summary for the family doctor, and an electronic update is sent. Because the information is available digitally, staff assume it will be reviewed.

The medical practice receives large volumes of electronic information every day. The message is not clearly identified as requiring prompt action and remains in a general workflow.

Two days later, the man deteriorates and is admitted to hospital.

The subsequent review does not conclude that digital communication itself was the problem. The weakness was the absence of a defined escalation protocol around the digital channel.

The Spitex organisation changes its process. Routine information can continue to flow electronically, but significant deterioration requires active communication and confirmation that a responsible clinician has received the concern. The digital record documents the escalation and response.

The medical practice also reviews how incoming information is prioritised.

The result is a clearer division between data exchange and urgent communication. The case illustrates a fundamental digital-governance principle: interoperability can make information available, but organisations still need operational rules that make people accountable for acting on it.

Privacy and autonomy become more important as connectivity improves

Health information is highly sensitive. Long-term care records can contain particularly intimate details about cognition, continence, family relationships, behaviour, daily routines and support needs.

Greater data exchange therefore creates legitimate questions about privacy and proportionality.

Switzerland’s digital-health infrastructure operates within federal data-protection requirements and sector-specific rules. Technical security, authentication and access control are essential, but privacy cannot be reduced to cyber security.

People also need to understand who may see their information and for what purpose.

This becomes more complex when an older person has cognitive impairment. Professionals may need to consider decision-making ability, representation and the person’s previously expressed preferences, while avoiding the assumption that dementia automatically removes meaningful involvement.

The wider principle aligns with dementia, consent and human-rights considerations: digital convenience should not silently displace personal control.

The strongest systems therefore build privacy into the workflow. They minimise unnecessary access, make permissions understandable, record legitimate use and maintain mechanisms for correcting inaccurate information.

Trust is not an optional extra in digital health. A system that people do not trust may remain technically sophisticated but practically underused.

Cyber resilience becomes part of continuity of care

The more dependent long-term care becomes on digital systems, the more disruptive system failure can become.

A nursing home may rely on electronic medication records, digital care planning, staff scheduling and communication systems. A Spitex organisation may depend on mobile access to visit schedules and clinical documentation.

If those systems become unavailable because of a cyber incident, technical failure or network outage, care still has to continue.

This makes cyber security and digital resilience part of operational safety.

Providers need contingency arrangements that answer practical questions. Can staff access critical medication information? Is there a current emergency contact list? How will visits be allocated if scheduling software is unavailable? How will retrospective records be reconciled when systems return?

Resilience also depends on suppliers. Long-term care organisations may rely on external software providers, hosting services and communications infrastructure that they do not control directly.

Digital procurement therefore needs to consider continuity, recovery capability, data portability and supplier support alongside functionality and price.

The underlying principle is straightforward: a service should not become less resilient merely because its records have become more sophisticated.

Digital transformation changes the workforce rather than simply saving labour

Digital health is often presented as a route to efficiency. It can reduce duplication and administrative work, but it also changes what staff need to know.

Spitex nurses, nursing-home staff, doctors and administrative teams need confidence using increasingly connected systems. They also need to recognise digital failure modes.

A practitioner must know what to do when information appears inconsistent, when a record has not updated, when the wrong patient information is displayed or when an apparently automated process has not completed.

This requires more than initial software training.

Strong digital skills and workforce adoption include understanding data quality, confidentiality, escalation, cyber risks and how digital information fits professional judgement.

The workforce burden also deserves attention. Poorly designed systems can increase documentation time through duplicate logins, repeated fields and awkward interfaces. Clinicians may compensate through workarounds, creating new risks.

The strongest digital transformation therefore examines workflow before adding technology.

Organisations can use the Digital Transformation Readiness Assessment to structure questions about leadership, workforce readiness, infrastructure, information governance and cyber resilience. Used internationally, it should support internal thinking rather than be treated as a Swiss compliance instrument.

Digital exclusion must remain visible

Digital health can improve access for some older people while creating barriers for others.

A person who is confident online may value electronic access, digital appointment information or remote communication. Someone with poor vision, cognitive impairment, limited digital confidence or no reliable device may experience the same process very differently.

Language and health literacy can create additional barriers.

Switzerland’s ageing population makes this particularly relevant. Digital transformation cannot assume that older people will adapt automatically to systems designed primarily around institutional efficiency.

The principle of digital inclusion and reducing exclusion therefore needs to sit alongside interoperability.

People should retain practical routes to support when they cannot or do not wish to manage care digitally themselves. Family members may help, but family support should not become an unofficial condition of access.

Digital design also needs to recognise cognitive change. Interfaces that were manageable at age 72 may become difficult at 82. A system built for long-term care should expect changing capability rather than treat it as exceptional.

Technology can strengthen independence without turning the home into a surveillance environment

Digital health increasingly overlaps with assistive technology, remote monitoring and connected devices.

Sensors can identify changes in movement. Medication systems can provide reminders. Digital communication can allow professionals to review some concerns remotely. Location technology may help a person with cognitive impairment remain active with greater confidence.

These developments can extend independence, but they raise different questions from electronic records.

Monitoring changes the relationship between care and privacy. Technology that records movement, routines or location may reduce one form of risk while increasing surveillance.

The appropriate question is therefore not simply whether a technology can monitor something. It is whether monitoring is proportionate to the person’s needs and preferences.

Scenario: remote monitoring prevents escalation without replacing human contact

An older woman with heart failure lives alone in a rural municipality. She wants to remain at home and receives regular Spitex nursing.

Her care team introduces a remote monitoring arrangement that helps track agreed health measures between visits. The purpose is not continuous surveillance but earlier recognition of deterioration.

One week, the information suggests a gradual change. A Spitex nurse reviews the data alongside the woman’s reported symptoms and contacts her doctor. Treatment is adjusted and an additional home visit is arranged.

The technology supports earlier action, but the provider deliberately avoids replacing all routine visits with remote contact. The woman values conversation and sometimes mentions concerns during visits that are not captured by monitoring equipment.

The care plan records which data are collected, who reviews them, what thresholds trigger action and how the arrangement will be reviewed with her.

This produces a more defensible model of digital support. Technology extends professional visibility between visits while the person retains meaningful human contact and understands the purpose of monitoring.

The example also illustrates why person-centred technology requires decisions about autonomy, not merely technical capability.

Data can support planning across cantons without eliminating local responsibility

Digital transformation also has implications beyond individual care.

Switzerland’s cantons need to plan health and long-term care capacity as the population ages. Providers need to understand changing demand. National agencies need reliable evidence about activity, cost, quality and workforce.

Better data architecture could reduce the separation between information used for care and information used for system planning.

Aggregated, appropriately governed data could help reveal changes in home-care demand, hospital use, nursing-home dependency, workforce pressure and regional variation. Over time, this could support more responsive capacity planning.

The opportunity is particularly strong if information can be reused rather than collected separately for every planning exercise.

However, national data cannot remove cantonal responsibility. Different cantons will continue to organise services differently, and local geography, workforce supply, provider markets and municipal arrangements influence what the data mean.

Digital transformation should therefore strengthen federalism’s information base rather than pretend that Switzerland has become a centralised health system.

The Digital Twin Scenario Modeller offers organisations examining similar capacity questions a generic way to model interactions between demand, workforce and service stability. It is not a Swiss planning model, but it illustrates how stronger data can support scenario testing rather than relying only on historic activity.

Artificial intelligence will depend on the quality of the digital foundation beneath it

Artificial intelligence is likely to play a larger role in healthcare and long-term care, but its value will be constrained by the quality of underlying information.

Potential applications include administrative automation, summarisation of records, risk identification, scheduling support and clinical decision assistance. Some uses are emerging internationally, while others remain experimental or dependent on regulatory development.

Switzerland should therefore avoid treating AI as a shortcut around unfinished interoperability.

If records remain fragmented, inconsistent or incomplete, an intelligent system may simply process fragmented information more quickly.

The stronger sequence is foundational:

• improve data quality;
• establish shared standards;
• strengthen secure interoperability;
• clarify accountability and consent;
• then introduce automation where it adds demonstrable value.

This is consistent with wider thinking on AI and automation in care. Technology should support professional work and reduce avoidable burden without obscuring responsibility for decisions that affect people.

For older people receiving long-term care, explainability matters particularly where digital tools influence risk assessment, prioritisation or access to professional attention.

Governance needs to follow information across organisational boundaries

The most difficult digital risks often sit between organisations rather than within them.

A hospital can govern its own record system effectively while still sending information that a nursing home cannot integrate. A Spitex provider can maintain high-quality records while a medical practice cannot receive them in usable form.

This means digital governance needs an interface perspective.

Leaders should be able to see where information changes format, where people manually re-enter it, where responsibility transfers and where staff routinely rely on telephone calls because systems do not connect.

These friction points create valuable improvement evidence.

A practical digital-assurance view might combine:

• record accuracy and completeness;
• information-transfer failures;
• delayed or missed digital communications;
• duplicate data entry;
• cyber and system-availability incidents;
• user experience from staff and people receiving care.

The aim is not to construct another reporting layer. It is to understand whether digital infrastructure is reducing or redistributing risk.

Providers can connect these measures to broader data quality and performance evidence, ensuring that digital maturity is assessed through outcomes rather than the number of systems purchased.

Scenario: a canton identifies digital duplication across a care pathway

A canton examines repeated complaints from providers about administrative workload surrounding older people moving between hospital, rehabilitation and home care.

No single organisation appears to have an obviously inefficient system. Each has digitised much of its own workflow.

A pathway review shows something different. The hospital records the person’s medication list electronically. Rehabilitation staff enter much of the same information into another platform. Spitex then verifies and records it again, while separate information is supplied for administrative and reimbursement purposes.

Digitalisation has reduced paper, but it has not reduced duplication.

The canton brings providers and system suppliers together to map the information flow. Rather than immediately purchasing a new platform, they identify which data should be exchanged in standardised form, where legal or technical barriers remain and which manual verification steps are genuinely necessary for safety.

A pilot interface is introduced for one part of the pathway. The canton monitors administrative time, information discrepancies and practitioner experience before deciding whether the approach should expand.

The value of the exercise lies in looking across organisational boundaries. Each provider had optimised its own digital process, but nobody had previously measured the combined burden experienced by the whole pathway.

Switzerland’s federal structure makes implementation as important as national strategy

Digital transformation is particularly demanding in Switzerland because responsibility is distributed.

The Confederation can legislate within its competence, establish national programmes, support standards and create shared infrastructure. Cantons retain major health-system responsibilities. Providers and professional organisations control substantial parts of operational implementation. Insurers, software suppliers and other actors also influence the digital environment.

This distribution can slow standardisation, but it also creates space for practical innovation.

The central challenge is preventing locally useful solutions from becoming nationally incompatible silos.

DigiSanté’s emphasis on standards and reusable infrastructure is therefore strategically important. The programme’s 2026 reprioritisation following federal budget reductions also demonstrates why digital reform needs realistic sequencing. Some initiatives can progress quickly; others depend on legislation, funding, technical standards and widespread adoption.

Long-term care organisations should not wait for a perfect national architecture before improving digital practice. They can strengthen records, reduce duplication, improve escalation, test interoperability and build workforce confidence now.

At the same time, providers should avoid investing so heavily in closed systems that future national integration becomes harder.

The international lesson is that digitisation and integration are different achievements

Switzerland illustrates a challenge shared by many health systems.

An organisation can be highly digitised while the wider care pathway remains poorly integrated. Electronic records can exist in every setting without creating a genuinely connected system.

The transferable lesson lies less in Switzerland’s particular institutions than in the distinction between digitisation and interoperability.

Digitisation converts processes and information into digital form. Integration allows organisations to use information coherently across boundaries. Digital transformation goes further by redesigning workflows, accountability and decision-making around those capabilities.

For long-term care, the final measure is whether the older person experiences greater continuity.

They should need to repeat less information. Professionals should spend less time reconstructing records. Medicines changes should follow the person. Deterioration should be visible to the right people. Family carers should not have to act as the principal information-transfer mechanism between professional services.

Other countries can adapt these principles without copying Swiss federal structures, the EPD or DigiSanté. The broader requirement is to treat information infrastructure as part of care infrastructure.

Conclusion

Switzerland has entered an important phase in the digital development of its health and long-term care system. DigiSanté provides a national direction towards 2034, the Electronic Patient Record has created shared infrastructure, and work on standards, interoperability and once-only data collection points towards a system in which information can be used more effectively across organisational boundaries.

The central challenge is now operational. Long-term care is delivered through a distributed network of hospitals, doctors, Spitex, nursing homes, pharmacies, insurers, cantons, municipalities and families. Digital connectivity will create value only if information becomes easier to use, responsibilities remain clear and people retain confidence in how their data are handled.

For older people, the strongest outcome is not the existence of more technology. It is better continuity: fewer repeated assessments, safer transitions, faster recognition of deterioration, clearer medicines information and support that follows the person rather than remaining trapped within organisational systems.

Switzerland’s federal structure means this development will remain iterative rather than uniform. National standards and infrastructure can create the conditions for connectivity, but implementation will still depend on cantons, providers, professionals and technology suppliers. The strongest future direction is therefore not digitisation for its own sake, but a connected information environment in which technology reduces fragmentation while strengthening professional judgement, personal autonomy and the practical quality of long-term care.