Digital rehabilitation is no longer just a promising area of innovation. Across Europe, it is becoming a strategic response to growing pressure on healthcare systems. Ageing populations, rising chronic disease, workforce shortages and regional inequalities are increasing the need for scalable rehabilitation models that can work across hospitals, community services and patients’ homes.
The TeleRehaB DSS Market Access Report provides a detailed picture of this changing landscape. By analysing key European markets, clinical needs, reimbursement pathways and digital health readiness, the report offers a strategic framework for understanding how AI-enabled telerehabilitation can move from research and development to real-world implementation.
For the European project TeleRehaB DSS, this is a crucial step. The project is developing an AI-based Decision Support System to support balance rehabilitation training and promote the adoption of artificial intelligence in everyday clinical practice. Its ambition is not only to develop a technological solution, but to ensure that this solution responds to the needs of clinicians, patients and healthcare systems.
Why market access matters in rehabilitation
In healthcare innovation, good technology is not enough. To reach patients, digital solutions must fit into clinical workflows, demonstrate value, meet regulatory requirements, align with reimbursement systems and gain the trust of professionals and decision-makers.
This is especially true in rehabilitation. Across Europe, rehabilitation services are organised differently from country to country. Some systems rely heavily on public provision, others on insurance-based models, regional authorities or mixed public-private structures. Procurement, reimbursement and clinical adoption pathways vary widely.
The Market Access Report focuses on five key countries: France, Germany, Italy, the Netherlands and the United Kingdom. These markets were selected because of their demographic need, healthcare expenditure, digital infrastructure, market size and access potential. Together, they represent different European healthcare models and provide valuable insights into how telerehabilitation solutions can be adapted to different national contexts.
Five markets, one shared challenge
Although each country has its own healthcare structure, the report identifies a common challenge: rehabilitation demand is rising, while traditional care models are increasingly under strain.
Germany stands out as Europe’s largest healthcare market, with €500.8 billion in healthcare expenditure in 2023 and one of the strongest reimbursement environments for digital health applications. Its Digital Healthcare Act and DiGA pathway create opportunities for certified digital health solutions, although decentralised procurement and the need for local evidence remain important barriers to adoption.
France combines high healthcare expenditure with a growing ageing population and a structured public health system. Its digital health roadmap, together with reimbursement initiatives such as PECAN and LATM, offers promising entry points for digital therapeutics and remote monitoring solutions. At the same time, regional disparities, workforce shortages and care fragmentation continue to create pressure on rehabilitation services.
Italy presents a different kind of opportunity. It has one of Europe’s oldest populations, with 22.8% of citizens aged over 65, but comparatively lower healthcare expenditure per capita than several Western European markets. This combination points to a strong need for scalable, cost-efficient rehabilitation models, particularly those that can support home-based care and reduce pressure on regional health systems.
The Netherlands is a digitally mature healthcare market with high telehealth adoption and strong policy support for remote monitoring and home-based care. Its patient-centred care models, health IT integration and community-based services make it a promising environment for piloting and scaling telerehabilitation solutions.
The United Kingdom offers digital-first NHS policies, a strong research ecosystem and innovation pathways through organisations such as NIHR, Innovate UK and Health Innovation Networks. However, budget constraints, workforce shortages and fragmented commissioning across Integrated Care Systems mean that new solutions must demonstrate clear clinical and economic value.
The conclusion is clear: Europe presents strong opportunities for AI- and VR-enabled telerehabilitation, but adoption will require evidence, partnerships and localised strategies.
Evidence as the bridge between innovation and adoption
One of the report’s central messages is that successful deployment of telerehabilitation will depend on robust evidence generation. Healthcare systems need to understand not only whether a digital tool works, but how it improves outcomes, supports professionals and creates value.
For TeleRehaB DSS, this means generating data on patient outcomes, cost-effectiveness and workforce impact. Indicators such as quality-adjusted life years, staff time saved, improved access to rehabilitation and patient benefit will be essential for future health technology assessment and procurement decisions.
This evidence-based approach is particularly important because telerehabilitation must compete in a growing market. The report identifies several digital rehabilitation solutions already active across Europe, including virtual reality systems, remote monitoring platforms, robotic rehabilitation tools, wearable sensors and app-based rehabilitation programmes. In this context, TeleRehaB DSS must clearly demonstrate what makes its AI-supported balance rehabilitation approach clinically meaningful and valuable.
A strategic role for clinical and academic partnerships
The report recommends establishing early academic and clinical partnerships in key European markets, especially the United Kingdom, Germany and France. These relationships are essential for local credibility, clinical validation and alignment with national evaluation frameworks.
In the UK, ongoing clinical trials and a supportive innovation landscape can help anchor early validation. In Germany, engagement with clinical sites, academic partners and sickness funds will be important for navigating decentralised procurement and potential reimbursement routes. In France, collaboration with academic centres, regulatory stakeholders and procurement networks can support alignment with national evaluation and reimbursement pathways.
Italy and the Netherlands are also highlighted as promising environments for targeted pilots or co-development. Italy offers strong unmet need, particularly in regions with more advanced digital health infrastructure. The Netherlands offers a favourable setting for community-based telerehabilitation pilots and integration into home-care models.
For TeleRehaB DSS, these recommendations are not abstract market considerations. They are directly connected to the project’s long-term ambition: to support the adoption of AI in rehabilitation practice and ensure that the project’s results can be used beyond the research setting.
Supporting the shift towards home-based rehabilitation
Another important conclusion of the report is the growing relevance of home-based rehabilitation. Healthcare systems are increasingly looking for ways to reduce hospital pressure, support earlier discharge, improve continuity of care and reach patients who face access barriers.
This shift aligns closely with TeleRehaB DSS. Balance rehabilitation often requires continuity, monitoring and adaptation over time. Digital and AI-supported tools can help clinicians personalise interventions, follow patient progress and support rehabilitation beyond the clinic.
For patients at risk of falling, this can be particularly valuable. Falls can have serious consequences for older adults, including injury, loss of confidence, hospitalisation and reduced independence. By supporting balance rehabilitation in a more flexible and personalised way, TeleRehaB DSS aims to contribute to prevention, recovery and long-term wellbeing.
Towards sustainable adoption of AI in rehabilitation
The Market Access Report shows that AI-enabled telerehabilitation has a strong opportunity in Europe, but also that its future depends on responsible implementation. Solutions must be evidence-based, clinically integrated, accessible and aligned with national healthcare priorities.
TeleRehaB DSS is positioned within this transformation. The project brings together artificial intelligence, clinical knowledge and rehabilitation practice to explore how digital tools can support better decision-making and more personalised care.
Its contribution is not only technological. It is strategic and clinical. By connecting market access analysis with evidence generation and patient-centred rehabilitation, TeleRehaB DSS is helping to build the foundations for sustainable AI adoption in European healthcare.
As rehabilitation demand continues to rise, the question is no longer whether digital tools will have a role in care. The question is how they can be designed, validated and implemented in a way that genuinely supports clinicians and improves patient outcomes.
TeleRehaB DSS is working to answer that question.
