Care no longer takes place in a single location. Patients move between hospital care, general practice, home nursing, specialised care and digital follow-up. This evolution is no longer the exception but the norm. What remains constant is the need for a patient-centred approach in which healthcare professionals collaborate efficiently and rely on the same, trustworthy information. Yet care is still often organised around structures, institutions and care lines. Information too often remains confined within departments and systems, while the patient continues to move through the healthcare landscape.
Integrated, transmurally organised care therefore starts from the patient’s entire care journey. The key question is how information and decisions can follow the patient, regardless of where they are. In this article, Maarten De Gruyter and Rien Dieryckx show how this vision becomes tangible. From efficient and structured data within the hospital to targeted data sharing and collaboration across care lines, from systems to synergies.