It is now 20 years that the European Union supports research and development of information and communication technologies based tools for healthcare (eHealth). From 1989 till today, funding has continually been increased, initiating new research, complementing Member State initiatives, strengthening European industrial competitiveness, and tackling new health and social problems related to the free movement of people in the EU. By now, many of the earlier visions and dreams have been realised or are close to wider implementation. Accordingly, the European Commission is now providing strong support also for market validation and implementation of eHealth solutions and services, and at the health policy level. Examples are the recent eHealth Action Plan, annual High Level Ministerial Conferences, an upcoming Recommendation on European eHealth Interoperability, or the Member States-led Large Scale Pilot on a pan-European core patient summary and ePrescribing. This will be complemented by a Lead Market Initiative identifying eHealth as a core future innovation field. Growing cooperation with counterparts in the USA and elsewhere underline that eHealth is becoming a global reality. A more than 40 year old vision is now closer to global reality for the better of all citizens.