PurposeThe article studies the utilization of ICT within healthcare at home in Sweden overlooking a perspective of 20 + years. Starting point are articles by the authors from 2002 and 2003. These outlined an already feasible ICT supported healthcare at home as a tool to address healthcare's identified challenges-a growing elderly population and general demand for more healthcare in combination with issues on financing and lack of human resources. Despite early signals the care transition has been unexpectedly slow. Why?MethodsWith the articles as take-off the journey for ICT based healthcare at home up to today is discussed. In the articles five areas considered as critical for a successful transition were pinpointed and are now used to support the authors considerations, reasoning, and conclusions.ResultsResults indicate that technology has never been a limiting factor. Nor has selected medical issues or expected benefits normally been a limitation. Instead limitations and hindrances are found in other areas and activities.ConclusionsTechnology is not the main challenge when it comes to implementation, instead a focus on business models, deployment, and scaling issues is now advocated. Initiatives also must make more use of gained knowledge and experience. Not doing so delays utilization and deployment. The impact on healthcare effects and expected savings may be over-optimistic. A thorough analysis of all associated costs, consequences, investments, and benefits is recommended. Non-digital alternatives must continue to be offered to these who cannot go digital. In communication improved medical outcome and patient satisfaction must be emphasised.