Care Navigation: How assistive device provision could work in the future

The HilfsmittelStudie 2026 portrays a sector that plays a central role in care provision, mobility, and independence, yet often feels that it does not receive sufficient political and public recognition. What does this study tell us about the state of our healthcare system?

From my perspective, the study reveals a fundamental contradiction within our healthcare system: The very areas that are particularly important to people's everyday lives are often not at the center of political attention. Assistive device provision is a very good example of this. It is still viewed too much in terms of products, prescriptions, approvals, and billing. In reality, however, it is about much more – mobility, independence, participation, dignity, and, very concretely, whether a person can live as independently as possible despite age, illness, or disability.

One of the core problems, in my view, is that our healthcare system is heavily organized around sectors, responsibilities, and cost categories. But people themselves experience care very differently. A patient does not experience the responsibilities of a particular sector – they experience their own everyday life. They experience whether a wheelchair arrives on time, whether a prosthesis works, whether a care bed is available, or how care at home is organized after discharge from the hospital. And it is precisely at these transitions that we see major weaknesses.

Our study highlights something that has been underestimated for far too long: The assistive device sector is not on the periphery of the healthcare system – it is in its engine room. It connects medical prescriptions with people's actual lives. It translates therapy into everyday life and helps make outpatient and home-based care possible in the first place.

At the same time, the sector is under enormous pressure. Bureaucracy, workforce shortages, cost pressures, and a lack of political recognition are placing a heavy burden on it. Above all, however, the need for care will increase significantly as our society ages. The crucial question is therefore: Will we still have the structures, professionals, and economic conditions needed to actually meet this demand in the future?

The lack of political recognition is particularly concerning: Depending on their area of work, more than 90 percent of respondents feel that their interests are not adequately represented in health policy. This is not merely an issue of recognition. Political visibility ultimately also affects funding, digitalization, workforce recruitment, and the role a sector can and should play in the future healthcare system.

We therefore also need to rethink our understanding of health economics. Good assistive device provision naturally costs money, but it can also prevent costs. If we maintain mobility, prevent hospital stays, delay the need for long-term care, or ease the burden on family members, this creates enormous social and economic value. Good care is therefore always also a form of prevention.

For me, the deeper message of the HilfsmittelStudie is this: Our healthcare system needs to learn to think less from the perspective of its institutions and more from the perspective of people's lives.

You describe "Care Navigation" as a model for the future of assistive device provision. What exactly do you mean by this, and why will simply providing products no longer be enough in the future?

For me, the term "Care Navigation" describes a fundamental change in perspective: We need to move away from the simple idea that care is complete once a product has been delivered. Of course, the assistive device itself remains important. But the crucial question is not only whether someone receives a wheelchair, prosthesis, orthosis, or care bed. What matters is whether that assistive device works in their everyday life.

Care Navigation therefore means guiding people through complex care situations. In the study, we define Care Navigation as the coordinated, interprofessional, data-supported, and person-centered guidance of individual care pathways. It connects medical, nursing, therapeutic, technical, digital, and social services. It organizes, explains, translates, and guides.

This is essential because care is becoming increasingly complex. People are getting older, chronic conditions are becoming more common, care pathways are becoming longer, and more and more stakeholders are involved. Today, a person often has to navigate between hospitals, specialists, primary care physicians, nursing care, therapy, health insurance providers, and assistive device providers at the same time. Each individual institution may have a clear understanding of its own responsibilities, but for the person concerned, this creates a highly complex and confusing system.

That is precisely why simply providing a product is no longer enough. Care does not fail because no suitable assistive device exists. It fails because responsibilities are unclear, approval processes take too long, information is missing, systems do not communicate with one another, or no one retains an overview of the entire process after the initial provision.

Medical supply stores and homecare providers are ideally positioned to take on this role because they work very closely with people in their everyday lives. A hospital may see a patient for a few days, while a medical practice may see them for only a few minutes or at longer intervals. Assistive device provision, by contrast, often accompanies people for months or years. This creates knowledge that cannot be fully captured in any single record. Professionals see whether a wheelchair actually fits through someone's home, whether family members are overwhelmed, whether an assistive device is being used or simply sits in a corner, and whether a particular form of care works in everyday life or fails.

That is why we speak of "Care Navigation". A traditional service provider becomes a care partner; a care partner can become a Care Navigator and, in the long term, perhaps even a care architect who connects different structures. For me, Care Navigation ultimately means something very simple: We must no longer send people through a complicated system on their own. We need to ensure that individual services actually come together to create care that works.

In the video, Prof. Dr. Thomas Druyen speaks at REHACARE 2026 about the HilfsmittelStudie, Care Navigation, and the importance of the assistive device sector for prevention, mobility, and quality of life.

Subtitles can be enabled if needed; the full transcript is available further down on this page.

Bureaucracy, cost pressures, workforce shortages, and an aging society all converge directly in assistive device provision. Where do you see the most urgent need for action to ensure that people can continue to live as independently as possible in the future?

From my perspective, the most urgent task is to free up care capacity that is currently being lost to unnecessary structures. Reducing bureaucracy therefore has to be at the top of the agenda. Assistive device provision relies on highly qualified professionals who spend far too much of their time on documentation, approvals, follow-up inquiries, corrections, and administrative processes. At a time when skilled professionals are already becoming scarce, we can no longer afford this. Every hour spent on unnecessary bureaucracy is an hour that cannot be spent with people.

This matters because workforce shortages are no longer simply an internal staffing problem for individual companies. Around 81 percent of respondents to our study expect workforce shortages to significantly affect assistive device provision over the next ten years – an almost industry-wide consensus. We therefore need to do two things at once: attract new professionals and retain those already working within the system over the long term. That means better working conditions, greater recognition, more opportunities for professional development, and, above all, more time for their actual professional work.

Then there is the question of funding. We need a reimbursement model that does not pay only for products but also recognizes the care surrounding them. Guidance, follow-up care, coordination, and prevention are not secondary activities. They are often crucial to whether care is successful. If only the product is funded while the accompanying services are barely reflected in reimbursement, we create entirely the wrong incentives.

In an aging society in particular, prevention therefore becomes a key issue. We must not wait until independence has already been lost before taking action. We need to do everything we can to preserve mobility, the ability to manage everyday life, and participation for as long as possible. And we must not make the mistake of confusing short-term cost-cutting with long-term economic sustainability. Weakening local care structures can result in much higher costs later on – for example, through hospital stays, the need for long-term care, or inappropriate provision.

For me, it is therefore crucial not to consider all of these issues in isolation. Bureaucracy, workforce shortages, funding, and demographic change are directly interconnected. If we relieve professionals of unnecessary administrative work, use digital processes intelligently, fund prevention more effectively, and strengthen care structures, we can create the conditions that allow people to live independently for longer.

Digitalization and artificial intelligence are often described as solutions to problems in healthcare. What role can digital technologies actually play in Care Navigation, and where does personal contact remain indispensable?

Digitalization and artificial intelligence can make a very significant contribution – but only if we understand them correctly. Technology is not an end in itself. What matters is not how much we can digitalize, but whether digitalization actually improves care. The findings of our study are very clear on this: Around 76 percent identify the digitalization of processes as a key area for the future, 67 percent cite AI-supported administration, and 61 percent cite telematics infrastructure and interoperability.

I initially see the greatest potential in reducing the burden of routine processes. Electronic prescriptions, digital approvals, automated documentation, structured data flows, and AI-supported administrative processes can save enormous amounts of time. And that is exactly the time we need for actual care provision. Artificial intelligence can help structure information, prepare documentation, identify irregularities, or prioritize processes. Sensors and digital systems can help detect changes in a person's health at an early stage. Telemedicine, in turn, can complement care and reduce the need for travel.

But we must not forget one crucial point: Data alone does not provide care. Data needs to be interpreted, translated into decisions, and those decisions need to work within the reality of a person's life. This is precisely where Care Navigation comes in. Technology provides information; Care Navigation turns it into care.

And that is exactly why people remain indispensable. Assistive device provision very often involves highly individual situations. Fitting a prosthesis, caring for a chronic wound, providing guidance for people with complex disabilities, or assessing a person's home environment cannot simply be fully automated. There is also something that technology can provide only to a very limited extent: building and maintaining trust. People facing difficult health situations need more than information. They need guidance, experience, and sometimes emotional support as well.

In my view, the best kind of digitalization is therefore the kind that gives professionals more time for other people. This is something our study demonstrates very clearly: Technology should stabilize human care, not replace it. Used correctly, digitalization can therefore be one of the conditions that make it possible to preserve human-centered care over the long term.

For the first time, the REHACARE Report presents the perspectives of more than 1,500 people with disabilities and chronic conditions, as well as family members, on assistive device provision. How do you assess these findings, particularly in light of the current debate on healthcare reform?

For me, this perspective is of central importance because it puts the focus on something that is often given too little attention in health policy debates: the actual experiences of the people our healthcare system is ultimately there to serve.

We very often discuss health policy in terms of funding, contribution rates, responsibilities, institutions, or legal structures. All of these are necessary topics, of course. But for a person with a disability or chronic condition, or for a family member, the first questions are much simpler: Does care work in my life? Does my assistive device reach me on time? Is there a person I can contact? Do I have to coordinate between different institutions myself? Am I receiving the support I actually need? From the perspective of those directly affected, these are the questions that determine the quality of care.

And this is where I see a very important connection between the REHACARE Report and our HilfsmittelStudie. Our study shows from the perspective of service providers that care often fails not because the right product is unavailable, but because of fragmentation – unclear responsibilities, lengthy approval processes, missing data, disconnected systems, and insufficient coordination. If, as the REHACARE Report now shows, these same problems are also reflected in the experiences of users, then we have a very powerful message: Both sides – those who organize care and those who need it – see the same structural weaknesses.

This would be highly relevant to the current healthcare reform debate. We should not assess reforms solely on whether they work financially or administratively. We need to ask whether they actually make care simpler, more reliable, and more human-centered.

The issue of self-determination is particularly important to me. Assistive device provision is not a secondary technical service. It often determines whether someone can live at home, remain mobile, work, maintain social connections, or whether they have to rely on help from others. Assistive device provision is therefore always also a matter of participation.

We also need to think differently from an economic perspective. If good care prevents hospital stays, delays the need for long-term care, or eases the burden on family members, it creates value that extends far beyond the price of an individual product.

My message for healthcare reform is therefore very clear: We should spend less time discussing how to move people more efficiently through existing structures and focus more on how to change those structures so that they serve people. The REHACARE Report provides an important impetus for doing exactly that.

Published on: October 02, 2026