Digital technologies are becoming more important in regional health policies and services. They improve the quality, efficiency and accessibility of services and are key in the reform of health systems across Europe. The operation Inco-Health - Interregional Cooperation for a Trans-European Electronic Health Cards Strategy focuses on e-health strategies and services and the corresponding re-organisation of European health systems. Most of Member States now have developed e-health plans; even regional administrations have adopted e-health strategies, coherent with these national plans and the European framework (eEurope 2005, 6FP). Among others, electronic health and insurance cards (EHIC) deployment and integration represents one of the major challenges at EU level. Objectives Starting from the experience of the participating regional authorities and public bodies, the projects aim is the definition of a common operational framework for digital services and the introduction of the electronic European Health Insurance Card (EHIC). The geographic coverage is aimed at achieving a critical mass suited to identify a common set of novel approaches that are transferable to the EU level. Results The operation results in increased expertise of participants of needs and requirements for EHIC deployment in a regional context. Based on the establishment of a durable network, participating regions support European e-health objectives and facilitate integration of these objectives on a regional level. The operation results further in an improved capacity of the regional authorities to design and implement EHIC action plans and programmes and, in the long term, in increased efficiency and cost-effectiveness of the regional healthcare systems. Activities include an inventory of existing strategies and initiatives and the identification of operational, organizational and technological factors facilitating or constraining the adoption of a EHIC. Partners develop a set of tools and services to support regional authorities in developing policies and launching EHIC strategies. Each region implements a pilot project and acts as a multiplier of knowledge.