Table 2.

Trend characteristics from expert interviews in Germany.

Trend number	Core trend	Positive effects	Negative effects	Prerequisites	Trend drivers
1	Changing the patient role	Increasing transparency Growing patient autonomy Better participation opportunities Growth of self-competence	Risk of disinformation Overwhelming media diversity	Trust in institutions Public provision of information Comprehensive education	Health literacy Digital competencies Information access
2	Connected and integrated delivery of care	Better access to services Faster data exchange Reduction in interface problems	Additional competitive pressure between providers	Performance incentives Adjustment of reimbursement systems Data exchange interfaces	Easy market access Existing supply gaps Integrated planning tools
3	Data-driven resource allocation	Increasing efficiency Optimal use of resources Compensation for the shortages of skilled workers	Dependence on service providers Data protection risks Increasing complexity	Data availability Interface availability Specialist availability	Scarce resources High data density Public data platforms
4	Performance optimization in primary processes	Efficient provisioning Increasing quality Higher satisfaction (patients and staff)	Dependencies of many factors Constant change process	Investments in new systems Acceptance of new processes Permanent qualification	Medical progress Decreasing costs New professions
5	New information and communications media	Meeting the needs of patients Reduction in communication barriers Improving the availability of information Higher satisfaction	High expenditure for the maintenance and provision of the media Additional need for qualification	Acceptance of the parties involved Knowing and understanding needs Quality assurance	Digital skills (patients and staff) Demand for contemporary media from everyday social life
6	Increased technological intensity	Achieving advances in productivity Compensation for the lack of skilled workers Relief of the workforce	High effort for cybersecurity Increasing complexity Need for technical knowledge	Extensive investments Comprehensive qualification Acquisition of new areas of knowledge	Technical progress Patient expectations
7	Outcome improvement and personalized treatments	Increasing outcomes Development of new service areas Opportunities for specialization	Adjustment of the business model	Data quality and availability Market maturity of technologies Confidence in new treatment procedures	Medical progress Technical progress Competitors’ offers
8	Emergence of new ecosystems	Creation of customer-centric proposals Exploiting the potential of the platform economy Increasing customer value	Highly competitive pressure Inappropriate market power of some players Inadequate regulation	Understanding digitally controlled ecosystems Transparency of the service offering Fair conditions on platforms	Low barriers to market entry Minimal regulation High customer interest and demand