Rapid Realist Review of the Literature
A rapid realist review of post-2010 English-language literature identified 68 LTC-related frameworks, assessed against key policy dimensions such as governance, territorial equity, gender, stakeholder involvement, funding, social economy, life-course perspective, and digital technologies. Only seven frameworks covered four or more dimensions, with governance and stakeholder engagement being most common, and gender and digital technologies least addressed.
Strategy for Investigation and Analysis
The review informed a standardised strategy for data collection and analysis to support evidence-based I-LTC policymaking. Frameworks were reevaluated to exclude those under development, disease-specific, or too narrow for cross-national use were excluded. Fifteen robust frameworks were selected and analysed for recurring domains, leading to the creation of the European Framework for Long-term Integrated Care Services (FLINT).
FLINT consists of six domains: People and communities, Workforce and service delivery, Organisation of care, ICT and systems, Finance, and Governance, covering 35 items. Validated through expert surveys and focus groups, FLINT now guides an EU-wide field study mapping I-LTC initiatives across the 27 Member States.
The next step involves gathering insights from professional care providers and informal carers via targeted surveys and focus groups to identify enablers and barriers to I-LTC delivery. This research is ongoing.
Data will be deposited in CORA.RDR an open-access repository managed by the Catalan Open Research Area, in line with FAIR principles—Findable, Accessible, Interoperable, and Reusable. Submission and management protocols are established.
State-of-the-Art of Technologies Supporting I-LTC
The project assessed existing and emerging technologies relevant to I-LTC through reviews of the WHO LTC Framework, SELFIE Framework, Digital Care Horizon, and the ECDC Digital Technologies Review. Co-design workshops using persona-based scenarios identified stakeholder needs and mapped them to relevant technologies, highlighting adoption challenges, regulatory factors, and scaling considerations.
Assessment tools—including Technical, Service, and Business Readiness Levels (TRLs, SRLs, BRLs), Social Business Model Canvas, and Ethics Canvas—were used to evaluate technological maturity, sustainability, and ethical aspects.
The main output was a multi-dimensional quick assessment matrix to help policymakers map technologies to LTC functions, assess readiness, societal value, and ethical considerations, and guide adoption and scale-up.
Building on this, the Laurel Consortium developed the Digital Maturity Assessment Toolkit (DMAT) to assess digital readiness in I-LTC settings. Grounded in cutting-edge research, it evaluates technical, service, business, societal, and ethical dimensions. A structured process connects outcomes to tailored recommendations. Following a successful pilot, DMAT will be rolled out across further European I-LTC contexts.
Stakeholder Analysis Supporting I-LTC
To support policy recommendations and training tools, the project conducted a stakeholder analysis to prioritise engagement and communication.
Best practices such as the influence-interest matrix and value proposition canvas were applied in participatory sessions with project partners and stakeholders. Fourteen stakeholder types were identified and grouped into three priority clusters based on influence and interest in LTC policy.
A focus group applied the value proposition canvas to explore roles, challenges (pains), benefits (gains), and solutions for eleven stakeholder types. This resulted in tailored key messages for each group, to be delivered through appropriate communication channels.
The analysis outcomes will also support three additional activities within the Laurel project.
