The European eHealth Strategies study analyzed policy development and strategy planning, implementation measures as well as progress achieved with respect to national and regional eHealth solutions in 34 European countries, with emphasis on barriers and enablers beyond technology. The focus was on infrastructure elements and selected solutions emphasized in the European Union eHealth Action Plan of 2004. At the governance level, issues around administrative responsibility and competence centers, stakeholder engagement, legal and regulatory facilitators, financing and reimbursement, and evaluation activities were surveyed. Solutions analyzed included patient summaries and electronic health records, ePrescription, telehealth, electronic identifiers, eCards as well standardization aspects. Results indicate that across Europe eHealth has matured from a policy debate to a very tangible, implementation oriented endeavor.