This page documents the progress of the project ZiBeKo – Target Group-Specific Needs Assessment and Communication, carried out as part of Community Innovative Care (CIP) within the DATIpilot programme of the German Federal Ministry for Research, Technology and Space (BMFTR). All updates are listed in reverse chronological order – the latest news always appears at the top.

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ZiBeKo: Field Phase Complete – First Findings from Nine Expert Interviews

Reading time: approx. 7 minutes | June 2026

The qualitative research phase of the ZiBeKo sub-project is complete. Over the past weeks, we conducted nine expert interviews with actors from both ambulatory and inpatient long-term care, as well as with a national-level industry association representative. In parallel, we produced an extensive secondary analysis on the role of statutory health insurance (GKV) and the Social Care Insurance (SPV) in financing digital transformation. This post shares our core findings for the first time — fully anonymised, in line with the confidentiality commitments we made to all participants.

Who We Spoke With

Our sample includes five ambulatory care services and four inpatient care facilities, complemented by one association perspective at the federal level. On the ambulatory side, the spectrum ranges from small rural care services with a few dozen clients to a large multi-site operator with more than 25 locations and an ambulatory-residential care model. On the inpatient side, we spoke with facilities of varying size and ownership structure — including denominational associations, diaconal institutions, and non-profit organisations — with capacities ranging from 86 to approximately 500 nursing home places.

At the leadership level, we spoke with care directors, facility managers, and one home manager. This breadth was methodologically deliberate: we wanted to capture not only the operational care perspective, but also the strategic management level responsible for investment decisions and technology adoption.

What the Field Phase Taught Us: Four Cross-Cutting Findings

1. The Bottleneck Is Not Technology — It Is Implementation

The most consistent finding across all nine interviews: the technological solutions to care’s most pressing daily challenges already exist. Voice-based documentation, AI-supported care planning, route optimisation, digital physician communication — all of this is technically available today. What is missing is not the solution. What is missing is structured support in getting these solutions into practice.

An ambulatory care director articulated this as clearly as one could: “The bottleneck isn’t what’s possible. The bottleneck is that not enough solutions are actually reaching practice.”

This pattern aligns precisely with what Rogers’ Diffusion of Innovations describes as the implementation gap: most facilities sit at the knowledge or persuasion stage — but the step towards actual adoption fails because of time constraints, budget pressure, a lack of IT competence, and insufficient training support.

2. Inpatient and Ambulatory Care — Same Drivers, Different Logics

Staff shortages, documentation burden, and financial pressure are shared across both settings. But the two systems follow fundamentally different operating logics — and this has direct consequences for what digitisation actually needs to deliver.

In ambulatory care, reimbursement is tied to individual care packages with defined time allowances. Time gained through digitisation is therefore immediately measurable and economically relevant. Documentation accounts for roughly 20 percent of a qualified nurse’s working time — not trivial, but manageable.

In inpatient care, lump-sum reimbursement applies. Here, qualified nurses spend 70 to 80 percent of their working time on documentation, according to multiple interviews — time not spent with the people they trained to care for. One facility manager put it plainly: “Qualified nurses are almost exclusively tied up with documentation. They only spend brief moments with residents.” A project partner responded dryly: “That’s a bit the wrong way round, isn’t it?”

For CIP, this means: ambulatory and inpatient facilities need similar tools, but fundamentally different arguments.

3. Acceptance Fails Because of Poor Rollout — Not Because of Resistance

Not one of our nine interview partners fundamentally rejected digital solutions. On the contrary — openness was widespread, and in some cases remarkable. Robotics, wearables, AI-assisted diagnostics: we encountered little in the way of resistance in principle.

What we did hear consistently: technology fails not because people are unwilling, but because rollout is poorly structured. One facility manager offered a formulation we now use internally as the acceptance formula: leadership buy-in × training support × system usability = acceptance. If any of the three factors is missing, adoption fails — regardless of how good the product is.

One case was particularly striking. A voice-based documentation app was rejected by roughly half of a facility’s staff — not because the speech recognition didn’t work, but because the app failed to automatically transfer the dictated insulin value into the medication management system. Staff had to enter the same data in two places. The facility manager’s verdict was direct: “It made things worse, not better.” This was not a technology problem. It was an integration problem.

4. TI Frustration Has Damaged Trust — Far Beyond the TI Itself

The mandatory connection to the Telematikinfrastruktur (TI) digital health network, required by 1 July 2025, left a striking pattern across several of our interviews. Facilities that formally completed the connection report persistent error messages, absent support, and a sense of having been left on their own. One facility has been dealing with an unresolved error code for over a year — a technician visited but could not fix the problem, and the vendor has not responded since.

What concerns us most about this: the frustration spills over far beyond the TI itself. A federal-level association representative framed it this way: “The Telematikinfrastruktur has unfortunately cast a very negative shadow over digitisation as a whole.” Facilities that were disappointed once approach the next digitisation initiative with far more caution — and sometimes with outright reluctance.

Findings by Segment: A Summary

Beyond these cross-cutting findings, we documented specific results for each of the four segments our analysis covers.

Ambulatory Care — The most urgent issue is not technology, but implementability. Plug-and-play is not a marketing phrase here — it is a genuine operational requirement. Systems must work immediately, without complex configuration. Route planning remains largely manual in many services. Family communication is a chronic time drain for which technical solutions exist but are not used, because costs are considered disproportionate. And small ambulatory services without their own IT capacity structurally cannot unlock the potential of digital systems on their own.

Inpatient Care — Documentation dominates the daily work of qualified nurses. The new personnel benchmarking instrument (PeBeM) is reshaping staffing structures, but has not yet been fully implemented everywhere. The household community model — small resident groups with dedicated daily companions rather than large ward corridors — is described as a promising approach that creates new digitisation demands. Large care organisations have begun establishing internal AI departments as institutional innovation channels. This structure is absent in smaller providers — and is precisely the gap that CIP could fill.

Association and System Level — At the federal level, a picture emerges across hundreds of member organisations: roughly 10 percent of facilities still document on paper, around 60 percent are partially digitised, and approximately 30 percent are advanced — though this last figure may be optimistic. The existing digitisation subsidy mechanism under § 8 para. 8 SGB XI is expiring. New funding pathways from the planned Care Reorganisation Act (PNOG, draft published June 2026) are in sight, but not yet enacted.

Statutory Health Insurance and Social Care Insurance (GKV/SPV) — Since we did not conduct our own interviews with insurance representatives, we present this segment as a research and analysis document rather than an empirical results document. The core finding: GKV (health insurance) and SPV (care insurance) are structurally separate systems with separate budgets and separate negotiation logics — a distinction that frequently gets blurred in public debate. The SPV is in deep financial crisis: a 667 million euro deficit in the first quarter of 2026 alone, despite receiving a federal loan. In practice, there is no longer room for supplementary reimbursements for digitisation in care fee negotiations. At the same time, the SPV has funded concrete digitisation pilots, including a telecare model programme (12 projects, concluded end of 2025). The paradox: insurers want digitisation, but cannot finance it through reimbursement mechanisms. The planned PNOG digital investment fund (€1.6 billion) is a potential turning point — but only for ambulatory and partial inpatient facilities. Fully inpatient care homes are excluded.

What This Means for CIP

Our field phase has sharpened three roles for CIP as an innovation community, which we are now incorporating into our transfer models.

First: Technology orientation and curation. Facilities often do not know which solution fits their context. A neutral, filtered orientation offer — matched to facility size, budget, software environment, and interoperability requirements — would address a genuine gap.

Second: Plug-and-play implementation support. Solutions need to arrive pre-configured, pre-tested, and accompanied by training materials. “Like a smartphone — you buy it, switch it on, install the app, and it works” — that was how one of our practice partners described the ideal. CIP can provide this function for facilities without their own technical infrastructure.

Third: Funding navigation. The planned PNOG digital investment fund will remain out of reach for many ambulatory facilities if the application bureaucracy defeats them. “Here comes another funding application — we all know what those look like. It dies right there” — a comment from one of our conversations that captures the risk precisely. CIP can serve as a navigator.

What CIP should not be, we heard just as clearly: not another network that talks. Not a local platform that triggers competitive thinking. Not a pilot project that burdens facilities with effort rather than relieving them.

What Comes Next

Qualitative analysis will be completed in the coming weeks. Four structured results documents — covering ambulatory care, inpatient care, the system level, and technology providers — form the basis for the subsequent quantitative phase, in which we will validate our findings with a broader sample.

We will pay particular attention to the structural differences between ambulatory and inpatient settings — not only in terms of needs, but also regarding communication channels, decision-making logics, and funding access. An innovation community for care that takes both settings seriously must address them differently, support them differently, and make its case differently.

If you have practical experience from care settings to share, or can point us to relevant contacts: we welcome every perspective. Write to us at info@ecommerceinstitut.de.

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ZiBeKo: Methodology & First Insights into Care Innovation

Reading time: approx. 5 minutes

Over recent weeks, we have laid the groundwork for the scientific work in our ZiBeKo sub-project: a systematic desk research that maps the German care landscape, the state of care digitalisation, and the needs of our target groups. As a sub-project of Community Innovative Pflege (CIP) within the BMFTR’s DATIpilot programme, we are providing the empirical and theoretical basis for the upcoming field phase with stakeholder interviews from care practice, research, and industry.

This post offers a look into our methodological approach — and shares first insights that have sharpened some of our assumptions and surprised us with others.

Why desk research before field research?

Before we go into depth with care professionals, facility managers, or health insurers, we need to know what we are talking about. A robust needs assessment in practice-oriented care research builds on existing data — otherwise one risks asking questions whose answers have long been documented, or duplicating existing studies instead of using their findings as a springboard.

Our desk research therefore pursues three goals:

1. to structurally understand the care landscape — who is who, how is it organised, where are the tensions
2. to capture the current state of care digitalisation — what is working, what is stuck, what is missing
3. to sharpen our interview questions empirically and theoretically — so that we don’t ask blindly in the field, but close gaps systematically

Our methodology: Five blocks, one logic

We structured the desk research in five interlocking blocks.

Block A — Understanding the care landscape. Structural basis: numbers, distributions, trends. Key sources: care statistics from the Federal Statistical Office (Destatis), the RWI Essen care home rating report, the Bertelsmann Foundation’s care infrastructure study, and the DAA follow-up study 2022.

Block B — Digitalisation in care. Status quo of digital applications, funding programmes, and legal frameworks. In focus: DAA studies 2017 and 2022, position papers from the digitalisation-in-care alliance, digital care applications under § 40a SGB XI, mandatory connection to the telematics infrastructure (TI) since 1 July 2025, and the BMFTR’s “Pflegeinnovationen 2030” programme.

Block C — What moves the target groups. For each of our seven target group segments — from facility managers and outpatient care managers to software providers and health insurers — we reviewed segment-specific studies, industry reports, and needs surveys.

Block D — What already exists. Which innovations, initiatives, and funded projects are already in place? What can we learn from international best practice such as Buurtzorg in the Netherlands or digitalised care in Scandinavia? Where do we complement other DATIpilot communities and the Cluster Zukunft der Pflege?

Block E — Theoretical foundation. As a scientific sub-project, we anchor our needs assessment theoretically. We draw on three classics that describe precisely what a care innovation community such as CIP is currently living: Davis’s Technology Acceptance Model (1989) for care technology acceptance, Rogers’s Diffusion of Innovations (2003) for how new solutions spread within organisations, and Wenger’s concept of Communities of Practice for shared learning across practice communities.

First insights: What we found

We expected the care landscape to be under pressure. We did not expect how systematically and unanimously this diagnosis is documented.

The pressure is real and measurable. Three quarters of care professionals regularly work under high time pressure, and 71 percent do not expect to be able to work until retirement — compared to 42 percent in the general population (DAA follow-up 2022). Forecasts project a shortfall of 157,000 care professionals by 2040. The Bertelsmann study adds: no German district is expected to be spared from staffing shortages, with eastern Germany hit twice over — declining labour force potential meets sharply rising demand.

Digitalisation is progressing — but unevenly. Over 80 percent of facilities state that digitalisation has only been partially, hardly, or not at all implemented at their site. At the same time, the willingness is there: 47 percent of care professionals want voice recognition for documentation, 42 percent want mobile devices. The most desired technologies are precisely the least widespread. Germany ranks 16th out of 17 in international digitalisation comparisons.

The perception of policymaking is unambiguous. 95 percent of surveyed care professionals believe that politics has not understood the problems of the care sector — a figure that confirms our approach: a care innovation community like CIP starts not from the top, but with those who deliver care every day.

The outpatient market is large and under pressure. At the end of 2024, 17,769 outpatient care services were providing care to around 2.2 million patients — the number of services rose by 2.2 percent in 2024. Notably, providers are shifting investment from personnel to digitalisation because staff cannot scale. At the same time, financing rules for many digital innovations are still missing.

CIP does not stand alone, but in its own place. We are one of 20 consortia selected from 480 applications in the DATIpilot programme, with up to five million euros in funding for 2025–2029. Alongside us, the Cluster Zukunft der Pflege (BMBF, 2017–2029, phase 2), the telecare model programme under § 125a SGB XI, and international references such as Buurtzorg are also active. Where the cluster works technology-centred and scientifically, CIP is community-oriented and practice-driven — the two complement each other rather than competing.

What this means for the field phase

We draw three methodological consequences from these findings.

First, we have sharpened our sampling. The regional differences between East and West, urban and rural, are not cosmetic — they reflect structurally different starting points, as the Bertelsmann data show. We select our interview partners along four axes (region, setting, size, ownership) so that outpatient and inpatient digital care are captured from multiple perspectives.

Second, we have revised our interview guide. New probes on TI connection, DiPA under § 40a SGB XI, and voice recognition close gaps that had not been clear to us before. Acceptance questions now explicitly follow the logic of the Technology Acceptance Model — with items on perceived usefulness and ease of use.

Third — and perhaps most importantly — we enter the field with a sharpened hypothesis: care technology acceptance is often less a technology problem than a process problem. The desk research shows: there are tools, there is funding, there is demand. What is often missing is structured introduction and ongoing support — the “implementation gap” that Rogers’s diffusion theory describes precisely.

What comes next

In the coming weeks, we are continuing the interview series we started with our first conversation in Heidelberg. Focus: outpatient care managers, operational care professionals, software providers, and health insurers. After that, the quantitative phase will broadly validate the qualitative findings.

In our view, meaningful care innovation in Germany only succeeds when it is developed close to practice — and when voices that are rarely heard get a seat at the table. If you want to contribute your own experience or point us to relevant sources, you are warmly invited. More about the project on our project page.

Do you know studies, practice insights, or contacts we should be aware of? Get in touch — we welcome every perspective we may have missed so far.

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CIP Member Meeting April 2026: Looking Back and Heading Into Round Two

Reading time: approx. 4 minutes

On 16 April 2026, the Community Innovative Pflege (CIP) came together for its digital member meeting. Alongside around 30 participants from nursing practice, research, and industry, our ZiBeKo team reviewed the past year, discussed the results of the first funding round, and helped sharpen the topics for the second round.

An intensive morning – here are our key takeaways.

Looking Back at 2025 and Q1 2026: A Solid Foundation for Nursing Innovation in Germany

The past year was marked by tangible growth. The community has visibly connected with policymakers, professional associations, and other DATIpilot communities. Team Innovative Pflege e.V. also welcomed new members.

Key milestones in the digitalisation of nursing care include:

• Launch and relaunch of the website innovativepflege.de
• Building a LinkedIn presence
• Kick-off of the technical working groups (Facharbeitsgruppen, FAGs)
• Start of a total of five community projects

The team was also present at major industry events: the DATIpilot community meeting in Leipzig (October 2025), ProCare Hannover (February 2026), the admission of the Caritas associations of the Diocese of Mainz, and the DaKILP hackathon (February 2026). A strategy workshop in February set the course for what comes next – and today the preparation of the second project call was finalised.

Results of the First Funding Round: Four Projects + Starter Project

The selection process was structured and transparent. Of 17 submissions, 10 were not endorsed due to insufficient fit, 7 were admitted to the vote, 4 received a funding recommendation – and all 4 were approved. In addition, CIP is running its own starter project.

The starter project is building a dynamic, care-appropriate online catalogue for digital assistance systems, including a built-in evaluation system (CareTechSelect). It is complemented by a Mixed Reality application that lets nursing staff realistically assess the workload-relief potential of digital assistance systems.

The three other funded projects at a glance:

• DaKILP – Data foundation for AI solutions in nursing: a public-interest data base, process-oriented use cases, and tested AI prototypes. Partners include Diakonie, Caritas, Hof University of Applied Sciences, FINSOZ, and the Data Science Institute.
• DiPA – Digital Nursing Assistance: cutting roughly 60 minutes of daily coordination effort via AI-supported assessments at the point of care, DIHVA systems, and modern mobile diagnostics (digital otoscopy, stethoscopes, 6-lead ECG).
• Pflegekontour: AI-supported process digitalisation for wound management in both outpatient and inpatient nursing care – with Hof University, Awesome Technologies, Audience.AI, and C&S.

Current Status Q2/2026: Research and Practice in Dialogue

The starter project is currently in qualitative evaluation of focus groups and expert interviews with nursing staff from five facilities. Core questions: the burden of indirect nursing tasks and expectations toward digital assistance systems as workload relief.

In parallel, teams are developing the online catalogue and the MR application. From September 2026, initial results will be presented to nursing staff – for direct feedback and further iterations.

The approach is deliberately highly participatory: nursing staff are not only the target group, they are co-designers. That creates transparency in technology assessment and lays the groundwork for the association’s upcoming “nursing maturity level” (Pflegereifegrad) – an important building block for broader acceptance of nursing technology in the field.

Second Funding Round: These Topics Are in Focus

For the second funding call, the CIP management team has prioritised seven thematic areas:

1. Digital nursing & real-world labs
2. Technology integration
3. Pilot study on assistance systems
4. Nursing data use & the European Health Data Space (EHDS)
5. Interoperability & scaling (e.g. ePA, TIM)
6. Classification & maturity level
7. Process-innovation guidelines

The selection criteria remain clear: projects must contribute to digital assistance systems, involve at least two of the three stakeholder groups (nursing, research, industry), stay below the maximum funding amount of €300,000, and be completed by the end of 2028. The technology readiness level is typically TRL 6–7.

Our View from the ZiBeKo Team

For us as the ZiBeKo subproject (target-group-specific needs assessment and communication), the meeting was a real tailwind. It underlined how much nursing innovation in Germany depends on a dialogue that takes nursing professionals seriously. That is exactly what we are working on – through our ongoing interviews in inpatient care (starting March 2026 in the Heidelberg region) and our completed desk-research blocks A–E.

Join In

Will you be at DMEA on 21 April in Berlin or at the Altenpflege trade fair in Nuremberg? Come and connect – CIP is organising networking events on site, including a networking dinner on DMEA Tuesday around 19:30.

You can find more on our work on our ZiBeKo project page and in our kick-off blog post. Questions, ideas, or collaboration interest? We would love to hear from you.

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