Austria plays a pioneering role in Europe with its e-card infrastructure. With the introduction of the e-card in 2005, the organisation of medical care in Austria was raised to a new level. RISE played a key role in this success with the architecture of the system and the development of the readers for the medical practices (11,000) as well as the VPN centres. Forward-looking hardware and software design, as well as unconventional approaches to architecture, allow the e-card to be widely and easily used in Austria and the EU. The system currently handles between 350,000 and 500,000 patient contacts per day. The system has replaced the old sick certificate, of which more than 40 million were completed and processed manually in 2005.