New requirements and expanded needs for apps and wearables in care

Demographic change poses a variety of challenges for the German care system. While politicians and associations are looking for sustainable financing models and technological progress is enabling new service and care concepts, digital customer centricity remains difficult. The aim is to use apps and wearables to digitally improve the independence and quality of life of the next generation of people in need of care and at the same time relieve the burden on relatives.

People in need of care and their relatives are not sufficiently digitally involved

People in need of care and their relatives are well provided for digitally. The challenges are manifold: lack of time, physical and emotional stress, financial worries and bureaucratic hurdles. According to aerzteblatt.de, there is a lot of stress among relatives and the feeling of being left alone.

Studies show that digital support for relatives of people in need of care is currently primarily intended to remedy information deficits, for example through articles or to-do lists.

Decisions about care are still rarely made digitally. Relatives often use the internet to find out about care services, with the websites of established providers such as the German Red Cross, Johanniter or Malteser playing an important role. However, more in-depth information and concrete decisions, such as the purchase of a home emergency call system, are often made in personal discussions with carers who act as trusted advisors.

Target group and options are changing

The next generation of people in need of care and their relatives

The number of people in need of care in Germany is 4.96 million. According to forecasts, this figure will rise by 27 per cent by 2035 and, according to care projections, 1.8 million more people in need of care are expected by 2055.

Everyday life is becoming increasingly digital and, above all, more mobile. In Germany, the use of smartphones is at 47 per cent, worldwide it is already at 60 per cent and therefore ahead of the desktop PC (37 per cent worldwide). The tablet is far behind at two per cent. According to a Bitkom study, 84 per cent of Germans aged 16 and over own a smartphone. That equates to around 58 million people. It can be assumed that this proportion will continue to rise in 2024 and that it will become an increasingly integral part of everyday life.

Solutions such as care apps have the potential to improve care. Gematik's TI Atlas makes this very clear: hopes for the digitalisation of the healthcare system - 90 percent want to have an active say in their treatment.

The technical hurdle for people in need of care poses a major challenge. Due to illnesses such as dementia or Alzheimer's, it is often difficult to reach this target group directly with digital solutions. However, automated wearables can provide effective support here. The situation is different for relatives: They have grown up with technology. They are the ones who actively search for information and make decisions. They also expect wearable and app solutions for those in need of care.

Healthcare must focus on customer benefits and participatory models

Healthcare apps are constantly evolving to increase customer benefits and improve the customer experience. Service apps for individual services also offer customers convenient access to information and services. But digital product innovations also play an important role. Behaviour-based and modular products with an individual focus increase customer benefits and customer loyalty.

In order to achieve these goals, consistent customer centricity is essential. By focussing on the individual needs and wishes of customers, tailor-made solutions can be developed and offered. Participation models in which customers are actively involved in the design of products and services, as well as preventive services that help to maintain and promote the health of customers, are further important building blocks for successful customer loyalty in the healthcare sector.

The legislator sets digital framework conditions

In June 2021, in addition to the financial aspects, the legislator also created important framework conditions in the area of digital care applications (DiPA). People in need of care can now receive subsidies for digital aids. In addition, the Digitalisation and Modernisation of Care Act (DVPMG) has created a framework to drive forward digitalisation in care.

DiPAs are intended to improve the quality of care by helping people in need of care to manage their own state of health and relieve the burden on family carers. The goals: Digital devices should make everyday life easier and digital networking in the healthcare sector should be strengthened to enable better communication and collaboration between all parties involved.

However, financial benefits for DiPas do not lead to concrete changes, which is why further measures have been taken. These emphasise the legislator's desire for sustainable improvement. For example, DiPAs must fulfil strict quality standards in order to even be considered for cost coverage. Data protection and data security must be observed, as sensitive health data is also involved. People in need of care and their relatives should also be informed transparently about the DiPAs available so that they can choose suitable solutions for themselves. To this end, up to 50 euros per month can be reimbursed for authorised DiPAs. A list from the Federal Institute for Drugs and Medical Devices (BfArM) ensures the quality and benefits of these applications after authorisation.

Users want safety, funding and time

There are various apps on the market that can support people in need of care as well as carers and caregiving relatives in their everyday lives. Digital apps for care and health focus on safety and well-being. They offer communication functions for direct contact with relatives or carers and could modernise the classic home emergency call system by automatically alerting help in an emergency.

The DiPA framework has been successfully established, but there is still a need to optimise the focus on the target group in terms of safety, financing and organisation.

Safety: This is a key concern for all of us, especially for people in need of care who want to live independently in their own four walls instead of moving into a care home. At the same time, they want to be sure that they can get help quickly if they need it. Family carers also want to know that their relatives are well looked after.

Financing: Transparent financing is also important. People in need of care and their relatives are often unsure about what financial benefits they are entitled to. To make matters worse, the information on the internet is often fragmented, incomplete or outdated. An app could act as an information aggregator here.

Time: Time is a scarce commodity, especially for family carers. Instead of spending hours searching for information, they would rather spend their time with family or friends. An app could provide support here by enabling direct communication with care insurance and allowing digital applications.

Challenges during implementation

One difficult example is the home emergency call system. There are currently three different types on the market. The traditional stationary home emergency call, the mobile emergency call for when travelling and the emergency call watch. Especially with safety applications such as emergency call systems, there are often hurdles in terms of presentation.

Haptics vs. digital

Traditionally, an emergency call is represented as a specific stationary device with a button. Haptics pose a challenge when introducing a new digital, smartphone-based solution and make implementation more difficult. For example, the trigger button must be at least 150 mm² in size.

Difficult authorisation

The authorisation requirements for home emergency call systems are very complex. Devices with a base station and a physical button are well suited to older generations (aged 70 and over) or people with mental illnesses such as dementia or Alzheimer's disease. Younger generations, on the other hand, are more tech-savvy. Technical implementation is a major challenge that needs to be resolved in future dialogues with authorities and, for example, the central association of statutory health insurers. Definitions and authorisation criteria need to be updated so that the next generation can use their smartphones or wearables.

Another problem arises when the app is applied for as a digital care application (DiPA). According to the article ‘DiPA: High hurdles make it difficult to get started’, a major hurdle is the lack of validation of measuring instruments in care. While validated questionnaires already exist in medicine that can prove that patients experience less pain as a result of an app, such instruments first have to be developed and validated in nursing care. Only then can the benefits of the app be proven in a further study. The costs and effort involved in such a study are considerable - around 100,000 to 150,000 euros and one year's labour.

Where should it go

The changing needs of those in need of care and their relatives must be taken into account in order to develop needs-orientated solutions for apps and wearables. A consistent focus on customer needs is crucial in order to design individualised care solutions.

However, regulatory hurdles and a lack of validation of measurement instruments hinder the development of new business models and make their implementation more difficult. A needs-based design of these framework conditions for the growing target group could facilitate the financing of innovative solutions and open up the market for progressive and profitable offers.

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