Technologies and Services in the Light of Demographic Changes. Trend Report 2008/2009 by Center for Digital Technology and Management

Technologies and Services in the Light of Demographic Changes Trend Report 2008/2009

Other CDTM print publications A. Buttermann, A. Franz, P. Sties, S. Vogel (Eds) Ad Hoc Networking Technology and Trends ISBN 978-3-8311-1732-1. 2001. 254 p. M. Huber, A. Franz, S. Vogel (Eds) Digitizing, Miniaturization and Convergence in Media and Entertainment Industry ISBN 978-3-8311-3544-8. 2002. 320 p. M. Huber, C. Bachmeier, A.Buttermann, S.Vogel, P. Dornbusch (Eds) Smart Dust ISBN 978-3-8311-4297-2. 2002. X, 280 p. M. Huber, A. Buttermann, L. Diaz Trigo, M. Möller, P. Dornbusch, M. Zündt (Eds) IT Security in Global Corporate Networks ISBN 978-3-8311-4297-2. 2002. X, 281 p. M. Huber, P. Dornbusch, J. Landgrebe, M. Möller, M. Zündt (Eds) Visions of Advanced Mobile Communications ISBN 978-3-9808842-0-4. 2003 VII, 272 p. P. Dornbusch, M. Huber, M. Möller, J. Landgrebe, M. Zündt (Eds) Leveraging Business with Web Services ISBN 978-3-9808842-1-1. 2003. VI, 238 p. M. Huber, P. Dornbusch, M. Möller, J. Landgrebe, M. Zündt, M. Müller (Eds) Mobile Application for the Soccer World Cup 2006 ISBN 978-3-937312-53-8. 2003. VII, 280 p. P. Dornbusch, M. Huber, J. Landgrebe, M. Möller, U. Sandner, M. Zündt (Eds) The Future of Telematics: New Business Concepts and Technologies ISBN 978-3-9808842-2-8. 2004. XII, 370 p. P. Dornbusch, M. Möller, J. Landgrebe, U. Sandner, M. Zündt (Eds) Generation 50 Plus - Products and Services in the TIME Sector ISBN 978-3-9808842-3-5. 2005. VII, 338 p.

P. Dornbusch, U. Sandner, P. Sties, M. Zündt (Eds) Fixed Mobile Convergence ISBN 978-3-9808842-4-2. 2005. V, 259 p. U. Sandner, B. Kirchmair, P. Mayrhofer, M. Zündt (Eds) RFID: Leveraging Global Commerce With Tracking & Tracing Technologies ISBN 978-3-9808842-5-9. 2006. VI, 357 p. E.-M. Kern, H.-G. Hegering, B. Brügge (Eds) Managing Development and Application of Digital Technologies ISBN 978-3-5403412-8-4. 2006. X, 341 p. B. Kirchmair, N. Konrad, P. Mayrhofer, P. Nepper, U. Sandner, M. Zündt (Eds) Seamless Context-Aware Services in Converged Mobile- and Enterprise-Networks ISBN 978-3-9808842-6-6. 2007. 344 p. A. Balevic, B. Bozionek, B. Kirchmair, N. Konrad, P. Mayrhofer, P. Nepper, U. Sandner (Eds) Effective Collaboration in Dynamic Communities with Service-oriented Architectures ISBN 978-3-9808842-7-3. 2007. VI, 150 p. P. Nepper, N. Konrad (Eds.) The Future of Social Commerce ISBN 978-3-9812203-1-5. 2009. XX, 320 p. P. Nepper, N. Konrad (Eds) The Future of the Web and its Value Creation for Telcos ISBN 978-3-9812203-2-2. 2009. XX, 286 p. M.-L. Lorenz, P. Nepper, N. Konrad (Eds) The Service Centric Car in 2020 ISBN 978-3-9812203-4-6. 2009. XXII, 304 p. M.-L. Lorenz, C. Menkens, N. Konrad (Eds.) E-Energy ISBN 978-3-9812203-5-3. 2009. XXVIII, 382 p.

Patrick Nepper 路 Marie-Luise Lorenz 路 Nikolaus Konrad (Editors)

Technologies and Services in the Light of Demographic Changes Trend Report 2008/2009

Class 2010 Summer Center for Digital Technology and Management

Technologies and Services in the Light of Demographic Changes. Trend Report 2008/2009 Edited by: Patrick Nepper, Marie-Luise Lorenz, Nikolaus Konrad

ISBN: 978-3-9812203-3-9 Biblografische Information der Deutschen Nationalbibliothek Die Deutsche Nationalbibliothek verzeichnet diese Publikation in der Deutschen Nationalbibliografie; detaillierte bibliografische Daten sind im Internet über http://dnb.d-nb.de abrufbar. © 2009 Center for Digital Technology and Management, Munich, Germany Printed in Germany This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitations, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from the Center for Digital Technology and Management. Violations are liable for prosecution under the German Copyright Law. The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and thereof free for general use. The Center for Digital Technology and Management (CDTM) is a joint institution of the Technische Universität München (TUM) and the Ludwig-Maximilians-Universität München (LMU). This report was created by CDTM students and is one element of a comprehensive research project at CDTM supported by the Federal Ministry of Education and Research (BMBF). The CDTM is part of the Elitenetzwerk Bayern. Board of Directors: Prof. Dr. Dr. h.c. Manfred Broy (TUM) Prof. Bernd Brügge, Ph.D. (TUM) Prof. Dr.-Ing. Klaus Diepold (TUM) Prof. Dr.-Ing. Jörg Eberspächer (TUM) Prof. Dietmar Harhoff, M.P.A. Ph.D. (LMU) Prof. Dr. Heinz-Gerd Hegering (LMU) Prof. Dr. Thomas Hess (LMU) Prof. Dr. Dieter Kranzlmüller (LMU) Prof. Dr. Tobias Kretschmer (LMU) Prof. Dr. Helmut Krcmar (TUM) Prof. Dr. Dres. h.c. Arnold Picot (LMU) Center for Digital Technology and Management Barerstr. 21, 80333 Munich, Germany E-Mail: info@cdtm.de Web: http://www.cdtm.de

Preface

Preface Demographic change has become a recent buzzword for the ongoing and upcoming challenges of a society that is increasingly changing in terms of its social integrity. Besides changes with respect to migration, population aging will become a dominant factor in demographic change. According to DeStatis and Eurostat the mean-age in Europe is expected to grow from age 39 in 2007 to 43 in 2020 with a fertility rate that is already below replacement levels in many EU member states, i.e. the population and especially the share of young people is shrinking. Although we have detailed knowledge about the upcoming challenges, little is known about possible solutions. This report reflects interdisciplinary futures research conducted by 20 students at the Center for Digital Technology and Management (CDTM) in summer 2008. It is based on a thorough scenario analysis which enabled the authors of the report to not only shed light on possible future scenarios, but also to come up with innovative ideas of products and services that might help us cope with demographic changes. The report contains two parts: The first part discusses political, economic, social, technological and legal trends that will have impact on future scenarios in the field. Based on this trend analysis, the second part offers a series of articles that discuss scenarios for 2020 in order to understand the framework for future innovations, namely a personal vital data monitor, concepts for an intelligent home, a health data platform, a social health community, and various health and lifestyle services. We invite you to read through the report and use it as an inspiration to take an active role for pushing forward technologies and services that are useful for our changing society. â&#x20AC;&#x17E;However good our futures research may be, we shall never be able to escape from the ultimate dilemma that all our knowledge is about the past, and all our decisions are about the futureâ&#x20AC;? (Ian Wilson) Munich, Fall 2008

Patrick Nepper CDTM Management Team

Marie-Luise Lorenz CDTM Management Team

Preface

For more information about the CDTM and its related projects, please visit http://www.cdtm.de The entire trend report was written by CDTM students in 2008. The papers compiled here do not claim to be scientifically accurate in every case; they are rather meant to give a structured and broad overview of trends relevant in the context of technologies and services for the support of elderly people. The work is also a predecessor for major research activities for which CDTM has set up a project consortium (“CrossGeneration”) together with dedicated companies and research institutions. Working on a project grant by the Federal Ministry for Education and Research (BMBF) supported by the project execution department (“Projektträger”) at the German Aerospace Center (DLR), the consortium will conduct research that aims at providing sensor-based services for improving the health and independence of elderly people.

Contents I

Trends

1 Technology Supporting Elderly’s Health Care and Lifestyle 1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2 State of the Art Devices supporting Elderly’s Health Care and Lifestyle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2.1 Devices in Hospitals and Nursing Homes . . . . . . . . . 1.2.1.1 Electrocardiogram Monitor . . . . . . . . . . . 1.2.1.2 Blood Pressure Monitoring Devices . . . . . . 1.2.2 Devices for Private Households . . . . . . . . . . . . . . 1.2.2.1 Devices Assisting Elderly in Need of Care . . . 1.2.2.2 Equipment Supporting an Active and Independent Lifestyle for the Elderly . . . . . . . . . . 1.3 Cutting Edge Applications and Devices supporting Elderly’s Health Care and Lifestyle . . . . . . . . . . . . . . . . . . . . . 1.3.1 Remote Monitoring Applications . . . . . . . . . . . . . 1.3.1.1 Electronic Tagging . . . . . . . . . . . . . . . . 1.3.1.2 Electronic Tracker . . . . . . . . . . . . . . . . 1.3.1.3 Decubitus Risk Monitoring . . . . . . . . . . . 1.3.1.4 Telemedical Monitoring of Elderly after Heart Operations . . . . . . . . . . . . . . . . . . . . 1.3.1.5 Blood Glucose Meters and Online Diary for Diabetics . . . . . . . . . . . . . . . . . . . . . 1.3.2 Intelligent Home . . . . . . . . . . . . . . . . . . . . . . 1.3.2.1 Video Communication Systems . . . . . . . . . 1.3.2.2 Fall Detection Systems . . . . . . . . . . . . . 1.3.2.3 Locking and Security systems . . . . . . . . . . 1.4 Driving Technology behind Product Developments for the Elderly 1.4.1 Microelectromechanical Systems . . . . . . . . . . . . . 1.4.1.1 Miniaturization of Electrical Components . . . 1.4.1.2 Integration to add Value and Speed up . . . . 1.4.1.3 Body Area Networks . . . . . . . . . . . . . . 1.4.2 Internet Technologies . . . . . . . . . . . . . . . . . . . 1.4.2.1 Web 2.0 . . . . . . . . . . . . . . . . . . . . . .

1 3 5 5 6 6 6 6 6 7 8 8 8 8 8 9 9 10 10 10 10 11 11 11 12 13 14 14

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1.4.2.2 Internet Telephony . . . . . . . . . . . . . Mobile Communications . . . . . . . . . . . . . . . 1.4.3.1 Transmission Technologies . . . . . . . . 1.4.3.2 Global Navigation Satellite Systems . . . 1.4.4 Software Applications . . . . . . . . . . . . . . . . 1.4.4.1 Tiny OS . . . . . . . . . . . . . . . . . . 1.4.4.2 Autonomous Context-Aware Applications Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . .

14 15 15 16 16 16 16 17

2 Generation 50plus - A New Customer Segment 2.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 Lifestyle of the Generation 50plus . . . . . . . . . . . . . . . 2.2.1 Education . . . . . . . . . . . . . . . . . . . . . . . . 2.2.2 Employment . . . . . . . . . . . . . . . . . . . . . . 2.2.3 Social Environment . . . . . . . . . . . . . . . . . . 2.2.3.1 Family . . . . . . . . . . . . . . . . . . . . 2.2.3.2 Hobbies . . . . . . . . . . . . . . . . . . . . 2.2.4 Health Condition . . . . . . . . . . . . . . . . . . . . 2.3 The Generation 50plus - An Economic Factor . . . . . . . . 2.3.1 Income Structure . . . . . . . . . . . . . . . . . . . . 2.3.1.1 Different Types of Income . . . . . . . . . . 2.3.1.2 Different Amounts of Income . . . . . . . . 2.3.1.3 Private Wealth of the Generation 50plus . 2.3.2 Consumer Behavior . . . . . . . . . . . . . . . . . . 2.3.2.1 Purchase Decision of the Generation 50plus 2.3.2.2 Consumer Spending . . . . . . . . . . . . . 2.4 Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.4.1 Conventional Media . . . . . . . . . . . . . . . . . . 2.4.2 Evolving Technologies . . . . . . . . . . . . . . . . . 2.4.2.1 Internet . . . . . . . . . . . . . . . . . . . . 2.4.2.2 Cell Phones . . . . . . . . . . . . . . . . . . 2.4.3 Needs and Perception of Technology . . . . . . . . . 2.5 Generation 50plus as a Heterogeneous Group . . . . . . . . 2.5.1 Segmenting the â&#x20AC;&#x153;Best Agersâ&#x20AC;? is Important . . . . . . 2.5.1.1 Segmenting by Age . . . . . . . . . . . . . 2.5.1.2 The Status Quo of Typologies . . . . . . . 2.5.2 Marketing Trends . . . . . . . . . . . . . . . . . . . 2.5.2.1 Segmenting on Two Levels . . . . . . . . . 2.5.2.2 Gap between Rich and Poor . . . . . . . . 2.5.2.3 Ageless Marketing . . . . . . . . . . . . . . 2.6 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

21 23 23 23 24 25 25 26 27 29 29 29 29 30 31 31 32 33 33 33 33 35 36 37 37 37 37 38 39 39 39 40

1.4.3

1.5

3 New Service Models and Players

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3.1 3.2

3.3

3.4

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Current Service Models . . . . . . . . . . . . . . . . . . . . . . 3.2.1 Services for the Active and Health Oriented Generation 50plus . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.2.1.1 Fitness Services . . . . . . . . . . . . . . . . . 3.2.1.2 Mental Training Services . . . . . . . . . . . . 3.2.1.3 Travel Program . . . . . . . . . . . . . . . . . 3.2.2 Services for People Dependant on Help and Care at Home 3.2.2.1 Home Support Services . . . . . . . . . . . . . 3.2.2.2 Personal Care Services . . . . . . . . . . . . . 3.2.2.3 Mobility Services . . . . . . . . . . . . . . . . . 3.2.2.4 Care Management . . . . . . . . . . . . . . . . 3.2.3 Market for Backing Family Member Carers . . . . . . . 3.2.3.1 Home Care Courses for Non-Professionals . . . 3.2.3.2 Respite Care Services . . . . . . . . . . . . . . Future Service Models . . . . . . . . . . . . . . . . . . . . . . . 3.3.1 Trends from Demand Side . . . . . . . . . . . . . . . . . 3.3.1.1 Quantitative Changes of the Demand for Home and Health Care Services . . . . . . . . . . . . 3.3.1.2 Qualitative Changes of the Demand for Home and Health Care Services . . . . . . . . . . . . 3.3.2 Trends from Provider Side . . . . . . . . . . . . . . . . . 3.3.2.1 Impulse from Established Providers . . . . . . 3.3.2.2 Influence of New Market Players . . . . . . . . 3.3.3 Process Related Innovations . . . . . . . . . . . . . . . . 3.3.3.1 Value Chain Optimization . . . . . . . . . . . 3.3.3.2 Telemedicine and Quality of Service . . . . . . Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4 Legal Framework and Standardization in eHealth 4.1 Introduction: Demographic Change Affects the Health Sector . 4.2 EU Strategies: Developments and Correlations . . . . . . . . . 4.2.1 The Lisbon-Strategy - Turning Europe in the Most Competitive Economy . . . . . . . . . . . . . . . . . . . . . . 4.2.2 The Seventh Framework Programme and the Interrelation of Funded Projects . . . . . . . . . . . . . . . . . . 4.2.3 eHealth - The Modernization of the Health Sector . . . 4.2.3.1 Definition and Short Explanation of eHealth . 4.2.3.2 Targets and Milestones of the eHealth Action Plan . . . . . . . . . . . . . . . . . . . . . . . . 4.3 Developing a Border-Crossing eHealth System . . . . . . . . . . 4.3.1 Impulse for a Border-Crossing Health Information System . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ix 45 45 46 46 47 48 48 48 49 50 50 51 51 52 52 52 52 53 54 54 55 56 56 57 58 65 67 67 67 68 70 70 70 71 71

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4.3.2

4.4

4.5

Crucial Requirements for eHealth interoperability . . . . 4.3.2.1 eHealth Architecture and Network . . . . . . . 4.3.2.2 Standardization . . . . . . . . . . . . . . . . . 4.3.2.3 Cooperation of participating stakeholders . . . 4.3.3 eHealth Service and Accessibility Standardization . . . . 4.3.3.1 Patient driven health care . . . . . . . . . . . . 4.3.3.2 Initiatives introduced by the EU . . . . . . . . Legal Framework . . . . . . . . . . . . . . . . . . . . . . . . . . 4.4.1 Drivers for a New Legal Framework . . . . . . . . . . . 4.4.2 The eHealth Action Plan and the Legally eHealth Project 4.4.2.1 Privacy, Data Protection and Security . . . . . 4.4.2.2 Product and Service Liability . . . . . . . . . . 4.4.2.3 Trade and Competition . . . . . . . . . . . . . 4.4.3 eHealth Innovation Inhibited by Current Law . . . . . Conclusion: Different Requirements for EU and USA . . . . . .

5 Changes and Challenges in the Social System 5.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.2 Principles of the Social State . . . . . . . . . . . . . . . . . . 5.2.1 Social State Germany . . . . . . . . . . . . . . . . . . 5.2.1.1 Definition Social State . . . . . . . . . . . . . 5.2.1.2 Principles . . . . . . . . . . . . . . . . . . . . 5.2.1.3 Sectors and Supporting Organization . . . . 5.2.1.4 Benefits . . . . . . . . . . . . . . . . . . . . . 5.2.2 Influence of Demographic Change on Social Insurance 5.2.2.1 Effects on Number of Contributors . . . . . . 5.2.2.2 Effects on Number of Insured People . . . . 5.3 German Social System . . . . . . . . . . . . . . . . . . . . . . 5.3.1 Unemployment Insurance . . . . . . . . . . . . . . . . 5.3.1.1 Status Quo . . . . . . . . . . . . . . . . . . . 5.3.1.2 Trends . . . . . . . . . . . . . . . . . . . . . 5.3.2 Accident Insurance . . . . . . . . . . . . . . . . . . . . 5.3.2.1 Status Quo . . . . . . . . . . . . . . . . . . . 5.3.2.2 Trends . . . . . . . . . . . . . . . . . . . . . 5.3.3 Pension Insurance . . . . . . . . . . . . . . . . . . . . 5.3.3.1 Status Quo . . . . . . . . . . . . . . . . . . . 5.3.3.2 Trends . . . . . . . . . . . . . . . . . . . . . 5.3.4 Health Insurance . . . . . . . . . . . . . . . . . . . . . 5.3.4.1 Statutory Health Insurances . . . . . . . . . 5.3.4.2 Private Health Insurances . . . . . . . . . . . 5.3.4.3 Trends . . . . . . . . . . . . . . . . . . . . . 5.3.5 Nursing Care Insurance . . . . . . . . . . . . . . . . . 5.3.5.1 Status Quo . . . . . . . . . . . . . . . . . . .

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71 72 72 74 74 74 75 78 78 78 79 80 80 81 82 85 87 87 87 87 87 87 88 88 88 89 90 90 90 90 91 91 92 93 93 94 94 94 95 96 98 98

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5.4

5.3.5.2 Trends . . . . . . . . . . . . . . . . . . . . . . 98 5.3.5.3 Ambulatory and Non-Ambulatory Home Care 100 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100

II Scenarios and Business Ideas

107

6 VITI - Vital Monitoring Device 109 6.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 6.2 Driver Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 6.2.1 Importance of a Driver Analysis . . . . . . . . . . . . . 112 6.2.2 Analysis of Stable Drivers . . . . . . . . . . . . . . . . 112 6.2.2.1 Legal Entrance Barriers . . . . . . . . . . . . . 112 6.2.2.2 Customers . . . . . . . . . . . . . . . . . . . . 113 6.2.2.3 Technological Advance . . . . . . . . . . . . . 114 6.2.2.4 Cost Bearers . . . . . . . . . . . . . . . . . . . 115 6.2.2.5 Infrastructure . . . . . . . . . . . . . . . . . . 116 6.2.3 Analysis of Key Drivers . . . . . . . . . . . . . . . . . . 117 6.2.3.1 Attitude towards Privacy . . . . . . . . . . . . 117 6.2.3.2 Technology Acceptance . . . . . . . . . . . . . 118 6.2.3.3 Standardization in Data . . . . . . . . . . . . . 119 6.2.3.4 Degree of Technological Intelligence . . . . . . 120 6.3 Scenario Building . . . . . . . . . . . . . . . . . . . . . . . . . . 121 6.3.1 Process of Scenario Building . . . . . . . . . . . . . . . 121 6.3.2 Different Possible Scenarios . . . . . . . . . . . . . . . . 121 6.3.2.1 Scenario 1 - Conservative Estimation . . . . . 121 6.3.2.2 Scenario 2 - Optimistic Estimation . . . . . . . 122 6.3.2.3 Scenario 3 - Most Likely . . . . . . . . . . . . 123 6.3.3 Consequences of the Scenarios for a Vital Monitoring Device . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 6.3.4 Selection of the Third Scenario . . . . . . . . . . . . . . 126 6.4 Viti - The Vital Monitor in 2020 . . . . . . . . . . . . . . . . . 127 6.4.1 Product and Service . . . . . . . . . . . . . . . . . . . . 127 6.4.1.1 Challenge in 2020 . . . . . . . . . . . . . . . . 127 6.4.1.2 Viti - The Solution . . . . . . . . . . . . . . . 127 6.4.1.3 Overview and Structure of the Viti . . . . . . 128 6.4.1.4 Sensor Technology in the Viti . . . . . . . . . . 129 6.4.1.5 Intelligent Software to Process Data . . . . . . 130 6.4.1.6 Human Machine Interface of the Viti . . . . . 131 6.4.1.7 External Communication Interface of the Viti 133 6.4.1.8 New Possibilities through New Technologies and Value Added Services . . . . . . . . . . . . 134 6.4.2 Value Chain . . . . . . . . . . . . . . . . . . . . . . . . 135

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6.5

6.4.2.1 Value Creation . . . . . . . . . . . 6.4.2.2 Upstream Processes . . . . . . . . 6.4.2.3 Internal Value Creation . . . . . . 6.4.2.4 Downstream Processes . . . . . . 6.4.3 Market and Players . . . . . . . . . . . . . 6.4.3.1 Methodology of a Market Analysis 6.4.3.2 Analysis of the Driving Forces . . 6.4.3.3 Market size . . . . . . . . . . . . . 6.4.4 Positioning of the Product . . . . . . . . . . Conclusion . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . .

135 135 136 137 138 138 138 140 141 141

7 PROCURA - A Platform for Management of Real-Time Vital Parameters 145 7.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 7.2 Trend and Driver Analysis . . . . . . . . . . . . . . . . . . . . . 147 7.2.1 Definition . . . . . . . . . . . . . . . . . . . . . . . . . . 147 7.2.2 Demographical and Social . . . . . . . . . . . . . . . . . 147 7.2.2.1 Aging Population . . . . . . . . . . . . . . . . 147 7.2.2.2 Decreasing Population . . . . . . . . . . . . . . 147 7.2.2.3 Single-Person Households . . . . . . . . . . . . 148 7.2.2.4 Mobile Lifestyle . . . . . . . . . . . . . . . . . 148 7.2.2.5 Increasing Use of Mobile High Tech Devices . . 148 7.2.2.6 Increasing Acceptance of Technology among the Elderly . . . . . . . . . . . . . . . . . . . . 149 7.2.2.7 Relocation of Everyday Activities to Virtual Places . . . . . . . . . . . . . . . . . . . . . . . 149 7.2.2.8 Virtual Networks . . . . . . . . . . . . . . . . . 149 7.2.2.9 Increasing Privacy Awareness . . . . . . . . . . 150 7.2.2.10 Highly Cooperative Communication between Health Institutions . . . . . . . . . . . . . . . . 150 7.2.3 Economical . . . . . . . . . . . . . . . . . . . . . . . . . 150 7.2.3.1 Purchasing Power of Generation 50plus . . . . 150 7.2.3.2 Bipolar Wealth Distribution . . . . . . . . . . 151 7.2.4 Political and Legal . . . . . . . . . . . . . . . . . . . . . 151 7.2.4.1 Reorganization of the German Social State . . 151 7.2.4.2 Financing Health Care . . . . . . . . . . . . . 151 7.2.4.3 Data Protection . . . . . . . . . . . . . . . . . 152 7.2.4.4 EU Expansion . . . . . . . . . . . . . . . . . . 153 7.2.4.5 EU Financial Aid . . . . . . . . . . . . . . . . 153 7.2.5 Technological . . . . . . . . . . . . . . . . . . . . . . . . 153 7.2.5.1 Processor Speed, Data Storage and Network Bandwith . . . . . . . . . . . . . . . . . . . . . 153

Table of Contents

7.2.5.2

7.3

7.4

7.5

Attention Shift of HCI towards System Architecture . . . . . . . . . . . . . . . . . . . . . . 7.2.5.3 Digitalization . . . . . . . . . . . . . . . . . . . 7.2.5.4 Convergence of Telecommunications and the Internet . . . . . . . . . . . . . . . . . . . . . . 7.2.5.5 Wide-Area Wireless Communications . . . . . 7.2.5.6 Standardization Efforts . . . . . . . . . . . . . 7.2.5.7 Increasing Data Flow and Its Risks . . . . . . 7.2.5.8 Ubiquitous Computing . . . . . . . . . . . . . Key Driver Analysis . . . . . . . . . . . . . . . . . . . . . . . . 7.3.1 Definition . . . . . . . . . . . . . . . . . . . . . . . . . . 7.3.2 Description of the Most Important Key Drivers . . . . . 7.3.2.1 eGK-Project Realization . . . . . . . . . . . . 7.3.2.2 Acceptance of Personalized Online Services . . 7.3.2.3 Increasing Automation and the Intelligence of Systems . . . . . . . . . . . . . . . . . . . . . . Scenario Building . . . . . . . . . . . . . . . . . . . . . . . . . . 7.4.1 Definition . . . . . . . . . . . . . . . . . . . . . . . . . . 7.4.2 General Environment . . . . . . . . . . . . . . . . . . . 7.4.3 Scenario 1 - Emerging Market of Privately Managed Health Platforms . . . . . . . . . . . . . . . . . . . . . . 7.4.4 Scenario 2 - Local Platform Networks between Hospitals and Research Centers . . . . . . . . . . . . . . . . . . . 7.4.5 Scenario 3 - Health Insurance-Managed Data Platforms and Value-Adding Services . . . . . . . . . . . . . . . . 7.4.6 Evaluation and Further Specification of the Most Probable Scenario . . . . . . . . . . . . . . . . . . . . . . . . Procura - the Health Data Platform . . . . . . . . . . . . . . . 7.5.1 Product Description . . . . . . . . . . . . . . . . . . . . 7.5.1.1 Product Idea . . . . . . . . . . . . . . . . . . . 7.5.1.2 Stakeholders, Their Needs and Generated Benefits . . . . . . . . . . . . . . . . . . . . . . . . 7.5.1.3 Unique Selling Propositions . . . . . . . . . . . 7.5.2 Market and Competition . . . . . . . . . . . . . . . . . 7.5.2.1 Market Research . . . . . . . . . . . . . . . . . 7.5.2.2 Market Strategy . . . . . . . . . . . . . . . . . 7.5.2.3 Market Analysis . . . . . . . . . . . . . . . . . 7.5.3 Organization and Sales . . . . . . . . . . . . . . . . . . 7.5.3.1 Value Chain . . . . . . . . . . . . . . . . . . . 7.5.3.2 Revenue Model . . . . . . . . . . . . . . . . . . 7.5.4 Opportunities and Risks . . . . . . . . . . . . . . . . . . 7.5.4.1 Strengths . . . . . . . . . . . . . . . . . . . . . 7.5.4.2 Weakness . . . . . . . . . . . . . . . . . . . . .

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154 154 154 155 155 155 156 156 156 156 156 157 157 158 158 158 160 160 161 162 163 163 163 164 168 168 168 169 169 171 171 172 172 173 173

xiv

Table of Contents

7.6

7.7

7.5.4.3 Opportunities . . . . . . . . . . . . . . . . . 7.5.4.4 Threats . . . . . . . . . . . . . . . . . . . . . Technical Implementation of the Solution . . . . . . . . . . . 7.6.1 Platform Core . . . . . . . . . . . . . . . . . . . . . . 7.6.1.1 Tier 1 - Textual and Binary Data Storage . . 7.6.1.2 Tier 2 - Business Logic and Service-Oriented Architecture . . . . . . . . . . . . . . . . . . 7.6.1.3 Tier 3 - Applications . . . . . . . . . . . . . 7.6.1.4 Electronic Health Record . . . . . . . . . . . 7.6.1.5 Data Privacy . . . . . . . . . . . . . . . . . . 7.6.2 Sub-Platform “Hospital” . . . . . . . . . . . . . . . . . 7.6.3 Sub-Platform “Remote Monitoring” . . . . . . . . . . Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . .

173 174 175 176 176

. . . . . . .

178 179 180 181 182 182 183

8 Demando - A Social Health Community 189 8.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191 8.2 Driver Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 8.2.1 Political and Legal Framework . . . . . . . . . . . . . . 193 8.2.1.1 Privacy Policy . . . . . . . . . . . . . . . . . . 193 8.2.1.2 Changing Social Health Care System . . . . . 194 8.2.1.3 Health Campaigning . . . . . . . . . . . . . . . 195 8.2.1.4 Public Procurement and Regulation . . . . . . 195 8.2.2 Economic Factors . . . . . . . . . . . . . . . . . . . . . . 197 8.2.2.1 Quality Management and Efficiency Seeking . 197 8.2.2.2 Customer Needs and Perceived Value . . . . . 198 8.2.2.3 Business Process Harmonization . . . . . . . . 199 8.2.3 Social Factors . . . . . . . . . . . . . . . . . . . . . . . . 199 8.2.3.1 Lifestyle Pattern Compatibility . . . . . . . . . 200 8.2.3.2 Increased Health Consciousness . . . . . . . . 200 8.2.3.3 Technology and Service Acceptance . . . . . . 201 8.2.4 Technological Trends in Social Media . . . . . . . . . . . 202 8.2.4.1 Trends in E-health and Web 2.0 . . . . . . . . 202 8.2.4.2 Aging Services Technology . . . . . . . . . . . 203 8.2.4.3 Integration of the Electronic Health Card . . . 204 8.3 Market Environment and Competition in 2020 . . . . . . . . . 205 8.3.1 Stable Drivers . . . . . . . . . . . . . . . . . . . . . . . . 205 8.3.2 Socialization Scenario . . . . . . . . . . . . . . . . . . . 206 8.3.3 Commercialization Scenario . . . . . . . . . . . . . . . . 207 8.3.4 Private Public Cooperation Scenario . . . . . . . . . . . 208 8.4 Business Model for an Online Social Health Community in 2020 211 8.4.1 Description of the Provided Services . . . . . . . . . . . 211 8.4.2 Target Groups . . . . . . . . . . . . . . . . . . . . . . . 214 8.4.2.1 Health Care Customers and Generation 50plus 215

Table of Contents

8.5

8.4.2.2 Health Care Professionals . . . . . . . . . . . . 8.4.2.3 Relatives of Cared-for and Social Volunteers . 8.4.3 Customer Benefit . . . . . . . . . . . . . . . . . . . . . . 8.4.3.1 Target Group: Health Care Customers and Generation 50plus . . . . . . . . . . . . . . . . 8.4.3.2 Target Group: Health Care Professionals . . . 8.4.3.3 Target Group: Relatives of Cared-for and Social Volunteers . . . . . . . . . . . . . . . . . . 8.4.4 Competition Analysis . . . . . . . . . . . . . . . . . . . 8.4.4.1 Direct Competition . . . . . . . . . . . . . . . 8.4.4.2 Indirect Competition and Substitutes . . . . . 8.4.5 Revenue Sources and Revenue Sharing . . . . . . . . . . 8.4.6 Competitive Strategy . . . . . . . . . . . . . . . . . . . 8.4.6.1 Positioning and Unique Selling Proposition . . 8.4.6.2 Strategic Partnerships . . . . . . . . . . . . . . 8.4.7 Value Added Services . . . . . . . . . . . . . . . . . . . 8.4.7.1 Implementation of the Electronic Health Card 8.4.7.2 Provision or Integration of an Online Health Record . . . . . . . . . . . . . . . . . . . . . . 8.4.7.3 Interface for Vital Monitoring Services . . . . . Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

xv 215 216 216 217 218 218 219 219 220 220 222 222 223 225 225 226 226 226

9 Health and Lifestyle - New Services for the Needs of Seniors in 2020 231 9.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233 9.2 Driver Analyses . . . . . . . . . . . . . . . . . . . . . . . . . . 233 9.2.1 Drivers in the Lifestyle and Health Industry . . . . . . 233 9.2.1.1 Trends in Society . . . . . . . . . . . . . . . . 234 9.2.1.2 Trends in the Population Group of Seniors . . 235 9.2.1.3 Trends in Technology . . . . . . . . . . . . . . 236 9.2.2 Ranking of the Drivers . . . . . . . . . . . . . . . . . . 238 9.2.2.1 Certain Drivers . . . . . . . . . . . . . . . . . 238 9.2.2.2 Uncertain Drivers . . . . . . . . . . . . . . . . 240 9.3 Scenario Analysis . . . . . . . . . . . . . . . . . . . . . . . . . 242 9.3.1 From Drivers to Scenarios . . . . . . . . . . . . . . . . 242 9.3.1.1 Basic Scenario . . . . . . . . . . . . . . . . . . 242 9.3.1.2 Key Drivers . . . . . . . . . . . . . . . . . . . 243 9.3.2 Key Scenarios . . . . . . . . . . . . . . . . . . . . . . . 247 9.3.2.1 Scenario 1 - Less Spending Power . . . . . . . 247 9.3.2.2 Scenario 2 - More Spending Power, High Acceptance of Virtual Social Networks . . . . . . 248 9.3.2.3 Scenario 3 - More Spending Power, Low Acceptance of Virtual Social Networks . . . . . . 249

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Table of Contents

. . . . . . . . . . . . .

250 251 251 251 257 259 260 262 262 265 267 268 269

10 M.I.A. - Living in a Thinking and Assisting Environment in 2020 10.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.2 Driver Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . 10.2.1 Technological Impact . . . . . . . . . . . . . . . . . . . 10.2.1.1 Advance of Performance . . . . . . . . . . . . 10.2.1.2 Integration of Artificial Intelligence . . . . . 10.2.1.3 Trend of the Price Performance Ratio . . . . 10.2.1.4 Development of Broadband Connections . . . 10.2.1.5 Trend of wireless Communication . . . . . . 10.2.1.6 Deployment in Cryptography . . . . . . . . . 10.2.1.7 Development of Power Consumption . . . . . 10.2.1.8 Design of Holovideo . . . . . . . . . . . . . . 10.2.2 Social Impact . . . . . . . . . . . . . . . . . . . . . . 10.2.2.1 Life Quality Standards . . . . . . . . . . . . 10.2.2.2 Desire for Staying at Home . . . . . . . . . . 10.2.2.3 Provision of Private Data . . . . . . . . . . . 10.2.2.4 Concern about Health Condition . . . . . . 10.2.2.5 Acceptance of Technologies . . . . . . . . . . 10.2.2.6 Security Needs . . . . . . . . . . . . . . . . . 10.2.2.7 Desire to Connect . . . . . . . . . . . . . . . 10.2.3 Economic Impact . . . . . . . . . . . . . . . . . . . . . 10.2.3.1 Emerging Attractive Markets for Industries . 10.2.3.2 Profit Possibilities . . . . . . . . . . . . . . . 10.2.3.3 Cost Development of Health Services . . . . 10.2.3.4 Purchasing Power of the Customers . . . . . 10.2.4 Evaluation of the Impact . . . . . . . . . . . . . . . . 10.2.4.1 Certainty and Importance of Drivers . . . . . 10.2.4.2 Correlation of Drivers . . . . . . . . . . . . . 10.2.4.3 Common Drivers . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . .

273 275 275 275 276 277 279 279 281 282 283 283 283 284 284 284 285 286 286 286 287 287 287 288 289 289 290 291 293

9.4

9.5

9.3.3 Selection of the Most Probable Scenario Service Models based on Selected Scenario . . 9.4.1 Service 1 - iDoc . . . . . . . . . . . . . 9.4.1.1 Introduction of the Service . . 9.4.1.2 Market and Players . . . . . . 9.4.1.3 Value Added Services . . . . . 9.4.1.4 Business Model . . . . . . . . 9.4.2 Service 2 - Health Care Vacation . . . . 9.4.2.1 Service and Opportunities . . 9.4.2.2 Market and Players . . . . . . 9.4.2.3 Value Added Service . . . . . 9.4.2.4 Business Model . . . . . . . . Conclusion . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . .

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10.3 Future Scenarios . . . . . . . . . . . . . . . . . . . . . . 10.3.1 Scenario 1 - Pessimistic Scenario . . . . . . . . . 10.3.2 Scenario 2 - Optimistic Scenario . . . . . . . . . 10.3.3 Scenario 3 - Main Scenario . . . . . . . . . . . . 10.4 The iHome . . . . . . . . . . . . . . . . . . . . . . . . . 10.4.1 Product Features . . . . . . . . . . . . . . . . . . 10.4.1.1 Main Features . . . . . . . . . . . . . . 10.4.1.2 Security Devices . . . . . . . . . . . . . 10.4.1.3 Control Devices . . . . . . . . . . . . . 10.4.1.4 Integration of the Devices in the iHome 10.4.1.5 Special Devices for Elderly People . . . 10.4.2 Market Environment . . . . . . . . . . . . . . . . 10.4.3 Value Chain . . . . . . . . . . . . . . . . . . . . . 10.5 Visualization of the iHome . . . . . . . . . . . . . . . . . 10.6 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . .

. . . . . . . . . . . . . . .

293 293 294 296 297 298 298 299 299 300 301 303 304 305 309

xviii

List of Figures

List of Figures 1.1 1.2

MPR400 Block Diagram . . . . . . . . . . . . . . . . . . . . . 12 Body Area Network . . . . . . . . . . . . . . . . . . . . . . . . 13

2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8

Levels of eduction . . . . . . . . . . . . . Percentage of men and women with jobs Percentage of people in need of care . . . Distribution of nursing types (at home vs. Private assets in Germany (2002) . . . . Conventional media usage . . . . . . . . . Online and offline internet usage . . . . . Cell phone users distribution . . . . . . .

4.1 4.2 4.3 4.4 4.5

Framework programme budget . . . . . . . . . Filling the gap . . . . . . . . . . . . . . . . . . The breakdown of FP7 . . . . . . . . . . . . . . Crucial points of the health system . . . . . . . Interconnection between health information and legal issues and relevant stakeholders . . . . . .

5.1 5.2

The five Sectors of the German Social Insurance System . . . . 88 Development of total population and percentage of paid workers over time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89

6.1 6.2 6.3

Real Life Mockup of the Viti . . . . . . . . . . . . . . . . . . . 128 Structural Overview . . . . . . . . . . . . . . . . . . . . . . . . 129 User Interface Prototype of the Viti . . . . . . . . . . . . . . . 132

7.1 7.2 7.3 7.4

Top Spacial View of the Health Data Platform The Database Layer . . . . . . . . . . . . . . . The Database and The Business Logic Layer . 3-Tier Architecture . . . . . . . . . . . . . . . .

8.1 8.2 8.3 8.4

The 4-Rings-Model . . . . . . . . . . . . . . . . . . . . . . . . . 191 Forms of Public Procurement . . . . . . . . . . . . . . . . . . . 196 Functionalities of Demando - an Online Social Health Community212 Visualization of the user interface . . . . . . . . . . . . . . . . . 214

. . . . . . . . . . . . . . . in foster . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . home) . . . . . . . . . . . . . . . .

. . . 24 . . . 25 . . . 27 . . 28 . . . 31 . . . 34 . . . 35 . . . 36

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . eHealth tools, . . . . . . . . .

. . . .

68 69 69 72 79

175 177 178 180

List of Figures

8.5

Elderly people using Demando . . . . . . . . . . . . . . . . . . 217

9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9

Population pyramid . . . . . . . . . . . Ranking of the drivers . . . . . . . . . . The doctor’s interface . . . . . . . . . . A doctor woking at iDoc . . . . . . . . . An exemplary profile of a patient . . . . Mobile interface . . . . . . . . . . . . . . Patient’s interface during a consultation A senior during an iDoc consultation . . Exemplary poster for the service . . . .

. . . . . . . . .

234 238 253 254 255 255 256 256 264

10.1 Moore’s Law and the Processing Power . . . . . . . 10.2 Development of Broadband Connections 2006 - 2015 10.3 Development of Broadband Bandwidth 2006 - 2015 . 10.4 Wireless Connection Scopes . . . . . . . . . . . . . . 10.5 Importancy and Certainty of Drivers . . . . . . . . . 10.6 M.I.A. - My Intelligent Assistant . . . . . . . . . . . 10.7 M.I.A. Bathroom Interface . . . . . . . . . . . . . . . 10.8 M.I.A. Office Interface . . . . . . . . . . . . . . . . . 10.9 M.I.A. Entrance Interface . . . . . . . . . . . . . . . 10.10M.I.A. Dining Room Interface . . . . . . . . . . . . . 10.11M.I.A. Bedroom Interface . . . . . . . . . . . . . . . 10.12M.I.A. Kitchen Interface . . . . . . . . . . . . . . . .

. . . . . . . . . . . .

276 280 281 282 290 305 306 306 307 307 308 309

List of Tables 2.1 2.2

Expected development in income up to 2050 . . . . . . . . . . . 30 Assumed consumption in Germany (based on the demographic change) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

9.1

Spending power in Germany . . . . . . . . . . . . . . . . . . . . 236

10.1 Typical Characteristics of Computers from 1994 and 2004 . . . 279

xxii

Nomenclature

Abbreviations BAN

Body Area Networks

CMOS

Complementary Metal-Oxide Semiconductor

Computed Tomography

DNA

Desoxyribonucleic Acid

DOS

Denial of Service

eGK

Elektronische Gesundheitskarte

EHC

Electronic Health Card

EHR

Electronic Health Record

European Union

FP7

Seventh Framework Programme

GDP

Gross Domestic Product

General Practitioner

GPS

Global Positioning System

GSM

Global System for Mobile Communications

HCI

Human-Computer Interaction

Integrated Circuits

ICT

Information and Communication Technology

Identication

Information Technology

MEMS

Micoelectomechanical Systems

Patient Box

PHR

Personal Health Record

SOA

Service-Oriented Architecture

SWOT

Strenghts, Weaknesses, Opportunities, Threats

UMTS

Universal Mobile Telecommunications System

Nomenclature

VoIP

Voice-over-IP

VPN

Virtual Private Network

WLAN

Wireless Local Area Network

WWII

World War II

xxiii

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  

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