It is my great pleasure to introduce this special issue of LNSV comprising the sci- tific publications presented at ehealth 2009: The second Congress on Electronic Healthcare for the 21st Century, which took place in Istanbul, Turkey during September 23?25, 2009. Building on the first ehealth 2008 congress held in London, UK, the key topic of ehealth 2009 was investigating a realistic potential of the Internet in providing e- dence-based healthcare information and education to patients and global users. The proudly defined aim of ehealth 2009 ?? bringing together the three medical sectors: academia, industry and global healthcare institutions ?? was met and made the c- gress a truly unique event. The formal and informal discussions among the conference participants led to numerous stimuli for new collaborations. We accepted 26 full and 10 short technical presentations by speakers from all over the world, having received over 80 submissions. In addition to two keynotes, the commercial angle was provided by invited industrial speakers representing a wide range of healthcare IT companies including Corinne Marsolier of Cisco, Glenn Kenneth Bruun (CSAM Health), Luis Falcón (Thymbra) and Johan Muskens (Philips Research Europe), as well as international healthcare organizations such as Med-e-Tel represented by the international coordinator Frederic Lievens.