COMMISSION STAFF WORKING DOCUMENT Impact assessment Accompanying the document Proposal for a decision of the European Parliament and of the Council on the participation of the Union in the Active and Assisted Living Research and Development Programme jointly undertaken by several Member States
Date: 2013-07-10
Institutions: European Commission
Subjects: EU market, EU programme, industrial investment, information technology, innovation, population ageing, quality of life, research and development, small and medium-sized enterprises













EUR-Lex - 52013SC0251 - EN











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52013SC0251

COMMISSION STAFF WORKING DOCUMENT Impact assessment Accompanying the document Proposal for a decision of the European Parliament and of the Council on the participation of the Union in the Active and Assisted Living Research and Development Programme jointly undertaken by several Member States /* SWD/2013/0251 final */









COMMISSION STAFF WORKING DOCUMENT
Impact assessment
Accompanying the document
Proposal for a decision of the
European Parliament and of the Council
on the participation of the Union in the Active and Assisted Living Research and Development Programme jointly
undertaken by several Member States
Table of Contents
Introduction. 5
1........... Procedural
Issues and Consultation of Interested Parties. 7
1.1.        Organisation and Timing. 7
1.2.        Consultation of the IA
Board. 7
1.3.        Inter-service Impact
Assessment Steering Group (IASG) 7
1.4.        Consultation and
Expertise. 7
1.4.1.     Consultation for the EIP AHA.. 8
1.4.2.     Interim evaluation of the
AAL JP. 9
1.4.3.     Public online consultation
on the AAL JP. 10
1.4.4.     Consultation of the
participating countries through the General Assembly AAL JP. 11
1.4.5.     Consultation of AAL JP
participants on impacts and programme benefits. 12
1.4.6.     Consultation findings. 12
2........... Problem
definition. 13
2.1.        Responding to the
Demographic Challenge. 13
2.2.        Key problems and their
drivers. 15
2.2.1.     Low market availability of
innovative ICT products and services for Ageing Well 15
2.2.2.     Fragmentation of Research
Development & Innovation at European level 16
2.2.3.     Limited adoption of
innovation. 16
2.3.        Achievements and lessons
learned from the current AAL JP. 17
2.4.        Baseline scenario. 19
2.5.        Changing EU Policy
context 19
3........... Objectives. 21
3.1.        General Objectives. 21
3.2.        Specific Objectives. 21
3.3.        Operational Objectives. 22
3.4.        How do objectives compare
to the existing programme. 22
4........... Policy
Options. 23
4.1.        Options. 23
4.1.1.     Option 1 - AAL JP2 identical
to AAL JP1. 23
4.1.2.     Option 2 - No AAL JP2. 23
4.1.3.     Option 3 - AAL JP2 as
reinforced and improved AAL JP1. 24
4.2.        Discarded options. 24
4.2.1.     No financial commitment EU
to the ICT and ageing field. 24
4.2.2.     No financial commitment EU:
just light coordination. 24
4.2.3.     AAL JP2 combined with JPI
"More Years, Better Lives" 24
4.2.4.     AAL JP2 combined with the
follow-up Art. 185 EUROSTARs Initiative. 25
4.3.        The right to act 25
4.4.        Subsidiarity. 25
4.5.        Sensitivity and risk
analysis. 25
5........... Analysis
of the Impacts of the Options. 27
5.1.        Option 1 - AAL JP2
identical to AAL JP1. 27
5.1.1.     Economic impacts of the Option
1. 27
5.1.2.     Social impacts of the Option
1. 30
5.1.3.     Environmental impacts of the
Option 1. 31
5.1.4.     Other impacts of the
Option 1. 32
5.2.        Option 2 - No AAL JP2. 32
5.2.1.     Economic impacts of the
Option 2. 32
5.2.2.     Social impacts of the Option
2. 34
5.2.3.     Environmental impacts of the
Option 2. 35
5.3.        Option 3 - AAL JP2, as
reinforced and improved AAL JP1. 35
5.3.1.     Economic impacts of the
Option 3. 35
5.3.2.     Social impacts of the Option
3. 37
5.3.3.     Environmental impacts of the
Option 3. 39
5.3.4.     Other impacts of the
Option 3. 39
5.4.        Assessment of the
administrative costs. 40
5.5.        Assessments of the
simplification potential 40
6........... Comparison
of Options. 40
6.1.        Comparison by the costs
and benefits. 40
6.2.        Comparison by mix of the
project participants. 41
6.3.        Comparison by the
distance to the market of the project results. 42
6.4.        Comparison by the impact
on the EIP AHA.. 42
6.5.        Overall comparison of the
options. 42
6.6.        Preferred option. 43
7........... Monitoring
and Evaluation. 43
7.1.        Monitoring. 43
7.2.        Evaluation. 45
8........... Annexes. 46
8.1.        Annex I: Table of figures. 46
8.2.        Annex II: List of current
national public sources for the co-financing of the AAL JP calls in 2012  47
8.3.        Annex III: Examples of
AAL projects and their business plans. 48
              Introduction
This impact assessment (IA) report
accompanies the Commission proposal for a decision on the participation by the
European Union in the follow-up to the Ambient Assisted Living Joint Programme
(AAL JP2). It details the findings of the impact assessment required for
legislative proposals and represents the ex-ante evaluation[1]
of proposals for spending programmes occasioning budgetary expenditure. More
specifically, this report addresses the EU participation in AAL JP2, including
the renewal of the EU’s mandate and, funding, as requested by the participating
EU Member States and European countries associated to the Framework Programme.
The current Ambient Assisted Living Joint Programme[2] has been established in 2008
jointly between 20 Member States and 3 countries associated to the 7th
Framework Programme for Research and Technological Development (FP7). 
AAL JP aims to create a critical mass of applied
research, development and innovation at EU level for innovative ICT-based
products, services and systems for ageing well. The time to market is 2 to 3
years. Each of the currently 100 funded projects involves at least three
countries, one small or medium enterprise (SME), one research body and one
organization representing older people. Thus a triple win is pursued: a higher
quality of life for elderly people, lower cost and higher sustainability for
health and social care systems, and innovation, growth and jobs for the
economy. To improve conditions for industrial exploitation, AAL JP facilitates
common solutions which are adaptable to varying social preferences and
regulatory conditions across Europe. The application process is organised at
national level, which substantially lowers the participation barrier for local
organisations and SMEs.
Ambient assisted living
solutions can play an important role in dealing with the challenges of an
ageing Europe. They can help elderly adapt their personal lifestyle, health
management, and workplace to their ageing, so that they can participate in the economy
and society for higher number of years, and live longer at home, rather than in
institutional settings. ambient assisted living solutions can help carers spend
more time with their clients, by cutting red tape, facilitating data sharing
and ensuring effective workflows. Up to now six calls have been issued within
the AAL JP on topics such as ICT based solutions for prevention and management
of chronic conditions, social interaction, independence and participation in
the “Self-Serve Society", mobility, home care and solutions for supporting
occupation in life – all for older persons. To give an impression of the type
of projects that are being funded: 
·       
Older people living by themselves run the risk
of becoming lonely and isolated. The HOMEdotOLD project helps them stay in
touch with the world around them and have a social life, even if they are not
able to easily go out of the house. They can share a 'remote dinner' with
distant friends, or exchange photos with relatives. They can keep their
calendar and receive personalised news. All is done via their own trusted TV. 
·       
Older people need care, but carers can't always
be there. The ExCITE project allows an experience close to the real thing. A
remotely controlled robot with videoconferencing system allows caregivers to
virtually visit older people, move about and look around in their house, and
talk with them. 
·       
Ageing healthy and actively can become hard
work, once you get older. Dietary constraints or an exercise regime do not
sound like a lot of fun. The A2e2 project[3]
takes care of that. It is an easy-to-use and “fun-to-be-with” virtual coach
that inspires and helps older people to keep up a healthy and active lifestyle.
It reminds and admonishes them, and challenges them with digital gaming. 
The current AAL
JP engages 19 EU Member States and 3 associated countries[4]. It is financed by
participating countries, the EU, and the organisations participating in the AAL
JP projects (approximately 25%, 25% and 50% respectively). The current
programme will run from 2008 to 2013 and has a minimum total public budget of €
300 million and a total minimum budget of € 600 million. This includes up to €
150 million from the EU FP7, through Art. 185 of the Treaty on the Functioning
of the European Union (TFEU)[5].

The AAL JP is governed
by the participating countries through a dedicated implementation structure,
the AAL Association (AALA), with a Central Management Unit (CMU) for daily
programme operations and a network of national contact points (see Figure 1). The supreme decision making body is
the General Assembly, with representatives from all Partner Countries. It
elects an Executive Board as the official legal representative of the
Association, responsible for staffing, contracting and budget planning.
Technical advice is provided by an Advisory Board of renowned people from
business, innovative technology, research or politics. The Commission’s role in
the AAL JP includes handling the EU co-financing, programme evaluation and an
observer role in the AAL General Assembly, with a veto on the AAL JP annual
work programme.
Figure 1- AAL JP governance and operational
structure
1.           Procedural
Issues and Consultation of Interested Parties 
1.1.        Organisation and Timing
In 2011, the consultation for the launch of
the European Innovation Partnership on Active and Healthy Ageing (EIP AHA) covering
topics relevant to the AAL was conducted. In 2010, the Interim
Evaluation of the AAL JP was carried out and it included an online public
consultation. In 2012, General Assembly, the
AAL participants and the Inter-service Impact Assessment Steering Group (IASG
was based on the EIP AHA inter-service group) were consulted. 
1.2.        Consultation
of the IA Board
[This section is reserved for including
the opinion received from the IAB]
1.3.        Inter-service
Impact Assessment Steering Group (IASG)
Two IASG meetings in 2012 contributed at
large to the planning and roadmap for the preparation of the Impact assessment
report, in particular concerning the problem statement and the relevance of the
AAL JP to other DGs. The Art. 185 Coordination Group lead by DG RTD contributed
to the structure and argumentation of this report. 
1.4.        Consultation and Expertise
A comprehensive set of consultations with
relevant stakeholders have been carried out at different stages of the
preparation of this impact assessment (see Table 1). This
impact assessment regards the follow up to an already existing programme. The
consultations have been focussed on involving the key stakeholders and
participants of the projects. Care has been taken to map the different
consultation activities to involve stakeholders from industry, SME, civil
society, citizens and decision makers from all levels of government. Care was
also taken to avoid biased inputs because of an overrepresentation of
non-stakeholder respondents.
 Consultation || Date || Respondents 
 Public consultation on the EIP AHA || Nov 2010 – Jan 2011 || 524 
 Interim Evaluation on the AAL JP || May-Aug 2010 || 40 
 Public online consultation on the AAL JP, || Jun-Jul 2010 || 37 
 Consultation of the participating countries through the General Assembly AAL JP || Nov 2012 –Jun 2012 || 23 
 Consultation of AAL JP participants on impacts and programme benefits, || 2010-2011 || 23 
 Consultation by Finland on national participation in the AAL JP || 2011 || 64 
Table 1 – Overview
of the consultations relevant to the impact assessment
1.4.1.     Consultation
for the EIP AHA
The online
Public Consultation on the EIP-AHA aimed to map the existing national,
regional and local initiatives for active and healthy ageing; seek views on the
weaknesses and barriers in the European innovation system and to suggest policy
actions. The Synthesis report on the public consultation was published
in 2011[6] and analyses the 524 contributions. This report and its large
response from across the whole spectrum of EU stakeholders provides a good
basis to assess where and how the Innovation Partnership and the Joint
Programme can reinforce and complement each other. About 38% responses came
from government institutions (G), 23% from the industry including SMEs (I), 7%
from the health and social care sector (H/S), 17% from the research and
academia (R/A) and 15% from the organisation representing the older people (O).
See Figure 2:
Figure 2 - Representation of different stakeholders
in the consultation on the EIP-AHA
The EIP-consultation is of high relevance
to the AAL Joint Programme as it sought to identify trends, barriers and
opportunities for innovative applications and services in the EU for ageing
well. It provides a thorough assessment of existing barriers that confirmed
that the AAL JP is addressing the relevant problems in an effective way. 
The consultation showed (Figure 3) that insufficient
involvement of end-users in the development stage was identified as the most
significant barrier to innovation in ICT and ageing. This view was mainly
supported by the organizations representing the elderly and patients'
organizations. The health and social care sector highlighted the lack of
funding, while industry flagged the problem of selling the novel solutions to
the public authorities. Research and academia found that the funding only
covers part of the innovation process. Additionally, in
the course of 2011 ideas for the EIP were collected through workshops,
submissions of activities and commitments by stakeholders and the consultation,
many of these directly relevant to AAL. All in all over 130 detailed work
proposals have been received. 
Figure 3 - Significance of the barriers to the
innovation in the area ICT and ageing according to the stakeholders
(percentage)
1.4.2.     Interim evaluation of the
AAL JP
An interim evaluation of the AAL JP[7] was conducted two years after
the start of the programme by a panel of five high level experts headed by former
Commissioner M. Kuneva. The report was submitted to the Council in December
2010 and included interviews over 40 selected stakeholders
across Europe directly involved in the AAL JP value-chain. About 33% of the
stakeholders came from government institutions, 27% from the industry including
SMEs, 2% from the health and social care sector, 27% from the research and
academia and 11% from the organization representing the older people (Figure 4).
 
Figure 4 - Representation of different stakeholders in
the interviews of the Interim evaluation of the AAL JP
The questionnaire covered six main areas:
progress towards the objectives; financing measures by countries; integration
with national programmes, European added value. The evaluation
concluded that the programme was successfully
meeting its objectives and stated that: "The AAL JP should be continued
into FP8, as part of a coherent overall approach to research and innovation for
demographic ageing." Most of the 45 recommendations are addressed in the
options of this this Impact Assessment highlighting the following ones: 
·         
ensure high operational performance 
·         
further increase focus on technology in real
life situations – implying a higher involvement of users in all stages of the
R&D process.
·         
promote technology for carers and intermediaries
as well as end-users – implying more focus on services and applications supporting
(formal and informal) carers. 
·         
focus more on broadly targeted solutions, usable
by all; 
·         
strengthen links with users and ensure deployment
activities.
None of the options includes the
recommendations concerning the harmonization of the financing and participation
conditions as well as of project management. 
1.4.3.     Public online consultation on the AAL JP
The interim evaluation was complemented by
an online public consultation from 1st June to 1st July
2010, to reach out to the wider public and other relevant stakeholders. Thirty-nine
submissions were received (see Figure 5) of which 5% came from government
institutions, 46% from the industry (e.g. Telephonica, Orange) including SMEs,
5% from the health and social care sector, 26% from the research and academia
and 18% from the organisation representing the older people (e.g. AGE platform,
European Federation of Retired and Elderly People, ONCE). 
 
Figure 5 -
Number of submissions to Public online consultation on the AAL JP by country
Key findings were that there is strong interest in participation in the programme and that 
more emphasis is needed on end-user
participation.
1.4.4.     Consultation of the participating countries through the
General Assembly AAL JP
As a follow-up to the
Council conclusions[8]
on the Interim evaluation, a working group, was established to consult with participating
countries on the options for a possible follow-up to the AAL JP under Horizon
2020. In February 2012 the AAL JP General Assembly in February 2012 concluded
by vote that continuing the programme is of strategic importance, for the
engagement of SMEs in the provision of effective solutions for active and
healthy ageing, and as a major contribution to implementation of the EIP-AHA. In
particular, 15 out of 23 currently participating countries expressed their
preferred scenario recommended to improve the follow-up to the AAL JP with
aligning its scope with that of the EIP-AHA, by broadening
the basis of funding to all actors, and by improving the operational
performance. The second preferred option was to
continue the programme in its current form. Both of these options assumed
co-financing from the EC. Only two countries would not support neither of these
two options. As regards their ability to pay, it depends on the development of
public finances. Nonetheless, so far only one of the AAL MSs had to withdraw
from the calls. The current wave of consolidations of public finances in the EU
seems to affect the level of financing in the AAL JP only marginally as the
over-commitment by the MSs dropped to 30% this year.
1.4.5.     Consultation
of AAL JP participants on impacts and programme benefits
Two further consultations on the projects
funded under the AAL JP (from end of 2010 and 2011) provide an early assessment
of the projects, especially regarding the industrial sector. The first is an
impact assessment provided by Finland on the rationale for national
participation,[9]
based on contributions by 14 companies participating in AAL projects. The
respondents to this consultation mainly stated that the AAL JP provides access
to international market knowledge and partnerships, supports cooperation
between demand and supply actors for innovation in ageing well, helps to
develop new things and formulate the strategy of the participating
organisations[10].
The second consultation of AAL JP participants was carried out in 2011. A specific
survey was conducted on the key indicators of 50 AAL JP projects from the first
two calls, which were approaching the end of their funding cycle. It showed
mainly that 25 % of respondents had gained access to funding beyond the project
to commercialise the results and 50% of respondents had secured the IPR of
their results for further exploitation. Further details are to be found in the
section 5.1.1. 
1.4.6.     Consultation findings
The
consultations and assessments gathered information across the whole AAL JP
value chain: industry, SMEs, user associations, policy makers, research centres
and universities, private individuals, project participants, and Member States.
They all appreciated the added value of the AAL JP in balancing international governance and national needs, while increasing the
critical mass of research on innovative ICT-based
products and services for
ageing well at the European level. The programme has reduced duplication of
R&D efforts and improved the conditions for
industry participation, in particular SMEs, -  a key factor in establishing a
critical mass in research at the European level. 
The consultation
process also helped to identify
a number of barriers to innovation, especially regarding the possibility to
participate for users and their organisations, the third sector and SMEs. These
are: 
·       
Lack of funding for trans-European innovation in
the field
·       
Lack of (not locally limited) trans-European
vision from participating SMEs 
·       
Market fragmentation in terms of
interoperability and standards; 
·       
Legal uncertainty arising from the different
national legal contexts; 
·       
Fragmentation and insufficient coordination of
the different financial instruments, eligibility rules and reimbursement
systems. 
·       
Insufficient user participation in two respects:
their spread across EU (users came mainly from 4 MS) because of national
funding restrictions, and user involvement in earlier phases of research,
development and design of the applications and services. 
·       
National funding criteria leading to non-eligibility
for funding for users and their representative organisations in many Member
States.
·       
A too long time-to-contract (9 weeks in the call
2) and time-to-pay (13 weeks in the call 2) for the AAL JP to be effective for
some of the companies in the active and healthy ageing technology sector.
On the whole,
the consultations generated several recommendations: 
1.     
Continue the Programme as it provides clear
added value, in particular for SMEs, by creating the necessary critical mass in
research at European level to help relevant products and services enter the
market;
2.     
Focus on how (mostly SME) regional innovation
actors can understand and address the European market; 
3.     
Improve the operational efficiency, in
particular regarding time to contracts and payments;
4.     
Improve the involvement of users, service
providers and in particular end users in call specification and evaluation, from
the early stages of the project design.
The results of the consultations were taken
into the account to shape the AAL JP2.
2.           Problem
definition 
2.1.        Responding
to the Demographic Challenge
Demographic ageing accounts for an imminent
and significant change in society and economy for which the EU is still not
well-prepared. The age-dependency ratio (people under 19 or over 65 versus
people between 20 and 64) is expected to rise from 63% to 95%."[11] The resulting projected shortage
of up to 2 million jobs in care and health by 2020 implies that 15% of work in
the general healthcare sector is not covered.[12]
Ageing will significantly impact public as well as private finances.[13] For the EU, it is projected
that total government spending on pensions, healthcare, long-term care,
unemployment benefits and education will increase by almost 20 per cent between
2010 and 2060.[14]
The actual costs for 2012 are already considerably higher than their
projections in 2009. The expenditures for long-term care (1.8 % of GDP in 2010)
would almost double between 2012 and 2060, including nursing and social care as
well as medical components of long-term care. The AAL JP mainly focusses on
these care segments. 
 EU-27 || % of GDP || growth % || GDP 
   || 2010 || 2060 || 2010-2060 || 2010 
 Pensions || 11,3 || 12,9 || 22,5 || 1.384.045 
 Healthcare || 7,1 || 8,5 || 20,6 || 869.621 
 Long-term care || 1,8 || 3,4 || 84,6 || 220.467 
 Unemployment benefits and education || 5,7 || 5,2 || -4,1 || 694.472 
 Total || 25,9 || 30,0 || 19,8 || 3.168.605 
Table 2 - EU
government spending on pensions, healthcare, long-term care, unemployment
benefits and education 2010 – 2060
Complementary to the ageing challenge are also
the missed or underexploited market-opportunities. The markets for ICT-enabled
products and services for ageing well are not mature enough to assess the full
potential of their deployment. As an example, probably the most developed market
is for social alarms and telecare. The highest penetration of such solutions
among people over 65 years in 2010 was achieved in the UK and Ireland (16, resp. 14 %). Figure 6, covers
those countries in which the market research was carried out. 
Figure 6 - Penetration of social alarms among
people over 65 years old in %
There are no projections available of the full potential take up. Many
solutions are still subject to research and development. Those that are actually
deployed are most likely substantially more expensive than a fully realised
market would allow, due to non-realisation of economies of scale. As monetary estimates
would be too hypothetical, only the number of potential users has been
estimated. According to Eurostat's population projections there were 87 million
people over 65 years in the EU-27 in 2010. Two thirds of the causes of death of
this cohort are diseases of the circulatory and the respiratory system,
cerebrovascular diseases and diabetes. For all 56 million people suffering from
these chronic conditions home telehealth solutions are available (from
treatment to relieving the burden of living with such a condition). Experts
however estimate that at present only 25% to 60% of this population might
benefit from telehealth[15].
The high spread is due to the varying levels of educational attainment and the
legal environment across the EU Member States. The analysis also assumes that
health conditions of some elderly allow the use of telehealth solutions. The
estimated take up  results in a potential market size of 14 to 33 million patients
for 2010 in the EU-27, with an outlook to reach 24 to 59 million in 2060. This
is only a lower bound as this is an example of telehealth and there are other
types of solutions for the elderly. With more solutions becoming available, not
only for telehealth, but also e.g. telecare and independent living, the market
will grow further.
Figure 7 - Potential take-up of home telehealth
solutions for the years 2010 to 2060 in millions of users
2.2.        Key
problems and their drivers
The findings on the key
problems and their drivers have been corroborated during the Interim Evaluation
and other consultations (see section 1.4). 
2.2.1.     Low
market availability of innovative ICT products and services for Ageing Well
The actual scaling up of the take up and
mainstreaming of innovative and relevant ICT-based products and services for
ageing well in the EU market is low, and as a result prices stay high. Many
players are SMEs that are mainly focussed on small scale solutions catering to
local demand, enhancing the existing EU market fragmentation. According to the
Interim Evaluation: most R&D and innovations of AAL JP appear also still to
be taking place at the national rather than at European level and thus involve
mostly actors with a national orientation and "There is still lack of real
focus on a large scale European market […], there are still attitude barriers
that limit progress as many actors remain orientated to national or local
markets only."[16]

The institutional embedding of ICT-based
products and services for ageing well has not yet been established properly at
national - let alone at a European - level. The required structures, prices and
networks for trade to develop are hardly there and there is a lack of scalable
business models and models for financing and reimbursement. Also lacking are
international agreements on interoperability and international standards. These
factors contribute to a fragmented AAL-market with high prices, high risks and
consequently high transaction costs on the demand as well as supply side. 
The immaturity of the market can also in
part be attributed to a mismatch between supply and demand. Producers,
companies and representative organisations lack information on the needs and
demands of elderly. According to the Interim Evaluation Report (p.27) there is
some concern, especially from SMEs and service providers that AAL JP is
"too research-driven." To that can be added that this target group is
rapidly changing as regards consuming habits, purchase power and technical
capabilities. Main drivers of this problem are the fragmentation of the
European market for ICT-based products and services for ageing well, a lack of
real focus and vision on a large scale European or global market, and a lack of
user involvement, especially in earlier stages of R&D and product
development. 
2.2.2.      Fragmentation
of Research Development & Innovation at European level
Also in the field of
research and innovation at EU level on ICT for Ageing Well there is widespread
fragmentation, with many local initiatives and a fragmented dissemination of
results and unnecessary duplication or research endeavours. Current RTD efforts
are not based on a comprehensive research agenda with critical mass, in spite of
initiatives like BRAID[17]
and Futurage[18].
The first is an EU-funded program to develop a comprehensive Research and
Technological Development (RTD) roadmap for active ageing. Futurage was a
Commission funded project to create the definitive road map for ageing research
in Europe for the next 10 to 15 years, which was presented in October
2011.Especially SMEs can benefit from a well-established exchange of knowledge
and R&D-results, as they do not have the means to accumulate this knowledge
themselves. 
Drivers of this problem
are the high barriers for SMEs to participate in funding schemes, a lack of
efficient dissemination of R&D results and the absence of a shared R&D
agenda. 
2.2.3.     Limited
adoption of innovation
For a wider adaptation and societal adoption
of ICT based products and services for ageing well, it is necessary to overcome
the lack of technical culture and low acceptance of new technologies by users
(the primary users and other possible user groups). Their willingness to accept
and accommodate new developments may also falter because of uncertainties
around privacy, personal autonomy and information integrity. To solve this
problem, AAL JP projects should involve users in the whole process (from
research definition to system testing and dissemination). 
In particular the role of the SMEs is a
problem here. Their participation is high, but they lack a European perspective.
As a consequence they do not deploy their products or services at a European
scale and do not develop beyond small scale applications, often based on
already existing technology. For AAL JP products and services to be competitive
in global markets participants should engage in European-wide deployment,
concentrating on high-quality sophisticated technologies and product concepts. 
Finally the evidence on the results and
effects of ICT for Ageing Well projects is not convincingly or sufficiently
presented to the public authorities and insurance companies. As a consequence
procurement or support for large scale market introduction is lagging. 
Drivers for this problem are a lack of
evidence building and sharing, the limited integration of SMEs in the business
cycle (from RTD to market introduction), the lack of a European vision and the
low acceptance of new technologies by users.
2.3.        Achievements and lessons learned from the current AAL JP
The AAL JP has been designed to complement longer-term EU research on
ageing in the upstream FP7, which focuses on advanced research with a time to
market of 5-10 years. AAL JP addresses applied research on independent living
systems and applications with a short-to-medium term horizon and a time to
market of 2-3 years. The specific objectives of the current AAL JP are
to:
1.    Foster the emergence of innovative ICT-based products, services and
systems for ageing well at home, in the community,
and at work, thus increasing the quality of life, autonomy, participation in
social life, skills and employability of elderly, and reducing the costs of
health and social care.
2.    Create a critical mass of research, development and innovation at EU
level in technologies and services for ageing well
in the information society, including the establishment of a favourable
environment for participation by small and medium-sized enterprises (SMEs).
3.    Improve conditions for industrial exploitation by providing a coherent European framework for developing common
approaches and facilitating the localisation and adaptation of common solutions
which are compatible with varying social preferences and regulatory aspects at
national or regional level across Europe. 
The Interim Evaluation of 2010 showed a
clear impact of the AAL JP in progress on its operational goals:
1.    A substantial progress to the development of innovative ICT-based
products and services. Over 100 projects on ICT based solutions for older
people and their carers have been launched.
2.    Extremely efficient leverage of financial means, with national
financial contributions for the first 4 calls on average 36% above the required
minimum of 50%, in spite of budgetary consolidations. 
3.    High SME-participation of around 50% in the AAL JP in 2011 (compared
to some 25%[19],
in the FP7 ICT-programme), ensuring better support of economic growth. Under the
first four calls 350 SMEs (of 1400 SMEs applying) were supported. The involvement
of user organisations is also higher than in FP7, in spite of some Member
States currently not allowing them to be eligible for funding.
 Programme || AAL JP || FP7[20] 
 Call || 1 - 2008 || 2 - 2009 || 3 - 2010 || 4 - 2011 || 7 - 2011 
 Large enterprises || 9% || 7% || 10% || 10% || 10% 
 SMEs || 38% || 46% || 49% || 52% || 25% 
 User and other organisations || 18% || 14% || 11% || 11% || 6% 
 Research organisations || 19% || 21% || 19% || 14% || 35% 
 Universities and other || 16% || 12% || 11% || 13% || 24% 
Table 3 - Shares
of organisation types in proposals submitted[21]
4.      The network of AAL JP participants is a key factor in establishing a
critical mass of research at European level. This new community has developed
across Europe since the start of AAL JP, providing many contacts and
opportunities for dissemination and commercialisation. The first four annual
AAL JP Fora have gathered between 600 and 1200 participants and have become a
major mobilisation of the actors in the value chain of ICT for Ageing Well. 
5.      The volume of research and innovation generated across FP7, AAL JP
and CIP (over one billion € from 2008 – 2013) makes the European ICT for Ageing
Well initiative the world's largest in this area.
 Call || 1 (2008) || 2 (2009) || 3 (2010) || 4 (2011) || 5 (2012) || Average 
 AAL MS (Mio. €) || 35 || 38 || 32 || 31 || 29 || 33 
 EC (Mio. €) || 24 || 23 || 23 || 23 || 23 || 23 
 Private (Mio. €) || 38 || 39 || 35 || 35 || 33 || 36 
 Total funding (Mio. €) || 97 || 100 || 90 || 89 || 85 || 92 
 AAL MS % || 36 || 38 || 35 || 35 || 34 || 36 
 EC % || 25 || 23 || 26 || 26 || 27 || 25 
 Private % || 39 || 39 || 39 || 39 || 39 || 39 
Table 4 - The amounts and shares of
financing of AAL JP calls from 2008 to 2012
A total co-financing of approximately 180 M
€ was committed by the participants in the first five AAL JP calls.
6.      Countries participating in AAL JP have developed an important set of
good practices in open coordination and cooperation in innovation for ageing
well. A number of national programmes and initiatives focused on ambient
assisted living have emerged as a direct result of, or stimulated by, the AAL
JP. These include the German national AAL programme, the Hungarian eVITA
initiative for innovation opportunities in the healthcare system, the Spanish
EVIA innovation platform and the UK Technology Strategy Board Assisted Living
Innovation Platform (ALIP). For complete overview of national programmes
co-financing the AAL JP see Annex II. 
Apart from the achievements the Interim
Evaluation provided some relevant lessons learned which have been taken into
consideration when shaping the options (see section 4). Others will be
covered by other initiatives on active ageing, in particular the EIP AHA. See
section 2.5 on the Changing European Policy Context for a more extensive
overview, and section 1.4 on consultations for lessons learned and
recommendations.
2.4.        Baseline
scenario
The baseline or
business as usual scenario is an AAL JP2 (follow-up of the AAL JP) for the
period 2014 – 2020 identical to AAL JP1 (the current AAL JP) during the years
2008 – 2013. It entails a joint programme on innovation in ICT for ageing well,
co-financed by the national participants and the EC under Horizon 2020. The
scope of the AAL JP2 programme would remain the same as during the current
period i.e. new ICT solutions supporting assisted and active ageing of older
people. Continuation of the initiative beyond the current AAL JP co-decision
would further accelerate the availability of innovative products and services
for ageing well for citizens and public and private care providers. It would
help scaling up the market and it would help Member States to attract European
knowledge to their innovation environments, in particular for SMEs. It will
help Europe to find new ways of tackling the ageing challenge through
technological and social innovation. Continuation would prevent the emerging EU
market for the technologies for ageing well from falling apart; as no other
initiative to date helps sustain the eco-system for such a market to be viable
and vital. The European Innovation Partnership on Active and Healthy Ageing
would benefit from the AAL JP contribution to the delivery of innovative ICT
based products and services ageing well, but only up to an extent, because only
part of it area would be covered. 
2.5.        Changing EU Policy context
Since the launch of the AAL JP the ageing
challenge has been put higher on the European policy agenda.
In 2010 demographic ageing has been
identified in the Europe 2020 Strategy[22]
as both a challenge and an opportunity for smart, sustainable, and inclusive
growth. The flagship initiatives “A Digital Agenda for Europe” and “Innovation
Union”[23]
both address demographic ageing as a priority. The Digital Agenda focuses on
ICT-enabled innovative services, products and processes, and includes several
actions on eHealth and a specific action on reinforcing the AAL JP. 
In the European Innovation Partnership on
Active and Health Ageing (EIP AHA) digital solutions are to play an important
role. Its Strategic Implementation Plan (SIP) sets out priorities for
accelerating and scaling up innovation in active and healthy ageing across
Europe, in the three domains prevention and health promotion, care and cure,
and independent living and social inclusion. The launch by the Council of the EIP
AHA enhances the future relevance of the AAL JP and it's follow up. AAL JP is a
major component for implementing the SIP, as it focuses on the "Valley of Death" part of the innovation chain. Europe is usually weak in this segment
and in particular SMEs have a clear need for public support in order to bridge
the gap from research to market. The AAL JP-2 will also benefit from the EIP,
because it contributes to market creation, large scale uptake and also to improved
boundary conditions for the market: standardisation and interoperability for
example, which are not covered by the AAL JP, but are mentioned in evaluation
and consultations as barriers to deployment. For both initiatives to benefit
from each other as much as possible a logical step is to align the scope of the
AAL JP to that of the EIP AHA, as far as it is ICT and health-related. 
Europe has a
globally unique strength in ICT for ageing well with these inter-related
programmes that jointly cover a significant part of the research and innovation
‘chain’. 
With several
research and innovation initiatives synergies can be further strengthened. Upstream,
with the 7th Framework Programme’s ICT advanced research programme
and the ICT Policy Support Programme of the Competitiveness and Innovation
Programme (CIP ICT PSP), for which the AAL JP provides input for its innovation
and market validation activities. 
"More Years, Better Lives" is a Joint
Programming Initiative (JPI)[24]
on demographic change that brings together 13 European Countries, to address
new science based knowledge for future policy making on ageing, based on a wide
range of research disciplines. The AAL JP can provide an application context
for the JPI’s multi-disciplinary research and feed the JPI research agenda with
user experience, while sharing research methodologies such as the life course
approach.
In the Commission proposal for a Decision
on the Strategic Innovation Agenda of the European Institute of Innovation and
Technology (EIT) 2014-2020, "Innovation for healthy living and active
ageing" is one of the priority themes for the EIT Knowledge and Innovation
Communities (KICs) wave in 2014-2015. 
Taken together, these initiatives cover a
large part of the chain from fundamental research to market uptake, as
recommended by a number of independent assessments on EU research and
innovation programmes, as well as EU policy documents. This is further
complemented by major national initiatives, like a major national initiative on
AAL and ageing in Germany, an Assisted Living Innovation Platform in the UK and a platform on innovation in ageing in France.
The Commission's proposal for Horizon 2020,
the Research Framework Programme for 2014-2020, has a specific section for
societal challenges, with Health, Demographic Change and Wellbeing as one of
the priorities. AAL JP is mentioned as one of the Article 185-initiatives that
might get further support, if they meet a given set of criteria. In this
respect the  relevance of the AAL JP 2 objectives to Horizon 2020 are argued in
section 3.1, while relevant information on EU added value, the efficiency of
the art. 185-format (SME entrance barriers and leverage effect), as well as financial
commitments and the critical mass of the programmes, is presented in the sections
1.4.2 and 1.4.6 on consultation findings. The sections 2.2.1 and 2.3 provide
additional arguments on entrance barriers and critical mass. 
3.           Objectives 
In line with the Europe 2020
strategy and its flagships Innovation Union and Digital Agenda for
Europe and Horizon 2020, the overarching goal of the present
initiative is to help address the ageing challenge and turn it into an
opportunity for Europe. Thus the general objectives of the follow up to the AAL
JP are: 
3.1.        General Objectives
In line with the Europe 2020
strategy and its flagships Innovation Union and Digital Agenda for
Europe, as well as Horizon 2020, the overarching goal of the present
initiative is to help address the ageing challenge and turn it into an
opportunity for Europe. Thus the general objectives of the follow up to the AAL
JP are: 
·       
GO1: To improve conditions for the EU
competitiveness in the field of ICT based products and services for active and
healthy ageing by better exploiting the industrial potential of policies of innovation,
research and technological development;
·       
GO2: To contribute to sound public finances and
smart, sustainable and inclusive growth;
·       
GO3: To contribute to increasing R&D
spending to 3% of GDP by 2020 (EU 2020 / H2020), as well as strengthening the European
Research Area and scientific and technological bases in Europe;
·       
GO4: To focus future Union funding programmes
more on Europe 2020 priorities by addressing societal challenges, in particular
health and demographic ageing.
3.2.        Specific Objectives
In order to meet the general objectives and
help implementing the European Innovation Partnership on Active and Healthy
Ageing, the following objectives must be pursued:
·       
SO1: Improve the quality of life for the elderly
and their carers (and by doing so also benefit other people, in particular
those with disabilities) and help increase the sustainability of care systems,
by enhancing the availability of ICT based products and services for active and
healthy ageing;
·       
SO2: Create a critical mass of trans-European
research and innovation for ICT based products and services addressing active
and healthy ageing, in particular involving SMEs and users;
·       
 SO3: Leverage private investments and improve
industrial growth potential by providing a framework for developing European
approaches and solutions that meets varying national and regional social
preferences and regulatory aspects. 
3.3.        Operational Objectives
In order to meet the specific objectives,
the following operational objectives of the follow up to the AAL JP need to be
applied:
·       
OO1: Further improve operational excellence and
accountability for the programme; 
·       
OO2: Reduce time to market, by facilitating user
and industry-driven research
·       
OO3: Facilitate participation for all actors in
the innovation chain, in particular SME, end-users and service providers, from
the start and in all stages of the projects (e.g. through iterative and design
and development approaches);
·       
OO4: To increase the number of participating
Member States and to leverage private and national co-financing;
·       
OO5: To ensure complementarity with national
programmes and EU level initiatives such as Horizon 2020, and align with the
Strategic Implementation Plan of the European Innovation Partnership on Active
and Healthy Ageing (EIP AHA). 
3.4.        How
do objectives compare to the existing programme
The objectives continue
those of the current AAL JP, but with some important additions:
·       
SO1 and SO3: implies looking into options for
improving the continuation of projects downstream after funding has ended as
well as looking for other funding options for projects with different times to
market;
·       
SO2: implies improving the calls and projects to
enhance their contribution to creating a trans-European vision on the products
and services that are being developed or assessed;
·       
SO2 and OO3: implies including more end-users
and service providers in all stages of the projects, en to ensure that all
relevant stakeholders including end-user organisations are eligible for funding
in all Member States.
·       
OO5: implies widening the scope of the Programme
to match with the full scope of the EIP AHA (with a focus on ICT support). 
 Figure
8: Problems, drivers and objectives for the AAL JP2  
4.           Policy Options 
4.1.        Options
4.1.1.     Option
1 - AAL JP2 identical to AAL JP1 
This business as usual option is the
continuation of the AAL JP for the years 2014 – 2020, just as it has been done
from 2008 to 2013. This option is set as a baseline as prescribed by the
principles of consistency among all Article 185 initiatives. 
4.1.2.     Option
2 - No AAL JP2
This option would entail that there is no dedicated
effort to bring together national programmes in the field of ICT for ageing
well at the EU level for the years 2014-2020. The European dimension of actions
in this field would have to be covered within the Horizon 2020 programme, while
the leverage of the national and participant's including SME's co-funding would
disappear.
4.1.3.     Option
3 - AAL JP2 as reinforced and improved AAL JP1
This option of the follow-up to AAL JP1
would comprise adapted scope and improved implementation. It will be
co-financed by the national participants and the EC (Horizon 2020). The scope
of the AAL JP2 programme would be aligned to the full scope of the EIP on
Active and Healthy Ageing i.e. covering the full range of ICT based innovation
in active ageing and independent living and also eHealth care, including
prevention. The implementation would be improved based on the recommendations
of the Interim evaluation (see section 1.4.6) such as looking for other funding
options for projects with different times to market or higher user-involvement.
Due to the change of the scope, the name of the programme would change from Ambient
Assisted Living JP to Active and Assisted Living JP. 
4.2.                  Discarded options
4.2.1.     No
financial commitment EU to the ICT and ageing field
This option would mean that the EC would no
longer dedicate financial resources to the ICT and ageing field, as neither AAL
JP2 nor H2020 would foresee financing of the area. This would leave the financing
of research to national and regional level authorities in the Member States,
which would enhance the impact on the public finances and other aspects in the
field of ageing. As in H 2020 financing for ICT and ageing has already been
foreseen, this option is purely hypothetical. It has been introduced for the
sake of consistency among all Article 185 initiatives. 
4.2.2.     No
financial commitment EU: just light coordination
This option would require an ERA-net to
coordinate of research activities on ICT and ageing in the Member States. This
would be done through the networking of research activities, including the
development of joint activities. This option was discarded as it would not
offer a proper alternative to the actual running of a research programme. 
4.2.3.     AAL
JP2 combined with JPI "More Years, Better Lives" 
This option would combine the coordination
activities of the existing Joint Programming Initiative "More Years,
Better Lives" (JPI MYBL) and the AAL JP1. This option was discarded,
because there are currently only 13 countries participating (11 EU Member
States) to MYBL. Furthermore, the objective of MYBL is to produce new
scientific knowledge on ageing related policy issues based on
multi-disciplinary research being very different from AAL JP. This would
require widening of the scope far beyond the AAL JP objectives. As the Member
States organisations for MYBL are mostly very different from those involved in
AAL JP, the combination of the two would require a far more complex governance
structure. In their June 2012 meeting the AAL participating Member States have
indicated that this is not their preferred option. 
4.2.4.     AAL
JP2 combined with the follow-up Art. 185 EUROSTARs Initiative
This option would entail a merger between
AAL JP and Eurostars JP. The Eurostars programme aims to stimulate R&D
performing SMEs to lead international collaborative research and innovation
projects, by easing access to support and funding. It is jointly funded by the
EC and 33 EUREKA member countries. This option would offer SMEs an alternative
to research-financing. However, the option was discarded as there would be no
possibility to define any topic, so there would be no guarantee that research
on ageing well would be funded. Up to now over 100 projects have been funded
under the Eurostars Joint Programme. Although 40 % of the budget has been
devoted to electronics, IT and telecoms technology, only one project can be
identified as related to Ambient Assisted Living or ageing well.[25] Furthermore, the projects financed
under Eurostars would not offer the option to include 'big industry' players,
academia, user organisations, and service providers. This mix is important to
deliver results in a cross-cutting field like ICT and ageing, as has also been
confirmed by the outcomes of the Interim Evaluation and consultations. The
option was therefore discarded.
4.3.        The
right to act
Option 1 and improved
AAL JP2 would require the preparation of a new co-decision by the European
Parliament and the Council under Art 185 TFEU in order to provide for the
continuity between the FP7/CIP and Horizon 2020 funding 
4.4.        Subsidiarity
The current AAL JP has
provided a major opportunity to cooperate across Europe, to create critical
mass and leverage investments. Technological barriers also have to be overcome
by the development of interoperability standards at European international
level. The Interim Evaluation strongly recommended continuing a similar
programme beyond the FP7 timeframe as the ageing challenge and related opportunities
require continuous efforts to be dealt with.
AAL JP2 would respect
the proportionality principle, as the Member States themselves will be
responsible for developing a joint strategic work programme and all operational
aspects. The role of the Community is limited to providing incentives for
improved coordination, as well as ensuring synergy with the relevant
complementary activities in FP7 and the CIP. In the current AAL JP Member
States have proven that a lightweight governance approach can be deployed with
a large catalytic effect.
The budgetary impact and
EU contribution of this initiative are already part of the Horizon 2020
proposal and budget. The actual budget allocation will be subject to the
outcome of the H2020 decision and the financial commitments by participating
countries.
4.5.        Sensitivity
and risk analysis
The sensitivity
analysis takes into consideration the development of the crisis of the public
finances in the EU as the major factor. The table 5 presents the various
scenarios depending on the availability of the yearly funding of the AAL Member
states for the period 2014 to 2020. 
 Scenario || AAL MSs || EC || Private || Total 
 Positive (Mio. €) || 50 || 23 || 49 || 122 
 Positive % || 41 || 19 || 40 ||   
 Baseline (Mio. €) || 33 || 23 || 36 || 91 
 Baseline % || 35 || 25 || 40 ||   
 Reference (Mio. €) || 23 || 23 || 31 || 77 
 Reference % || 30 || 30 || 40 ||   
 Negative (Mio. €) || 12 || 12 || 16 || 40 
 Negative % || 30 || 30 || 40 ||   
Table 5 - Sensitivity analysis of contribution
of the AAL Member states
The baseline
scenario assumes that the willingness of the AAL Member states to contribute
to the AAL JP2 would remain the same: 35% of the costs of the calls and
projects. The EC contribution would remain 25% as stated in the Regulation. The
remaining 40% would be private investment by project participants, which is the
current pattern. The overall amount of financing would reach € 91 million.
The positive
scenario assumes that the AAL Member states increase their contributions
from the current € 33 million to 50 million. This would reduce the EC financing
share to 19% as it is capped to € 23 million per year, which would increase the
overall amount of financing to € 122 million. 
The reference
scenario assumes an equal share of financing by MS and EC, while utilising
the maximum amount from the EC side, which is EUR 23 mil. Such scenario would
generate an overall amount of financing of EUR 77 mil.
In the negative
scenario the AAL Member states would be pressed by the consolidation of
public finances to such an extent that they would have to halve their
contributions. This would be comparable to the withdrawal from the call or
programme of some half of the AAL Member states .That would reduce the overall
amount of financing to € 40 million. 
The sensitivity analysis of the impact of
the economic crisis on the willingness of the programme participant to
co-finance the projects was discarded, due to the great oversubscription of the
proposals compared to the funds available. The calls of the AAL JP have been
financing on  the average one out of four projects. The economic crises even
pronounced the interest in public funding which is confirmed in the call 5 of
2012, which allowed for financing of only one project out of five. Therefore
the analysis is assuming in fact that there would be always some project
participants that could afford and would be motivated to participate in the AAL
JP call. 
5.           Analysis
of the Impacts of the Options 
5.1.        Option
1 - AAL JP2 identical to AAL JP1 
The Option 1 presents a baseline scenario,
which assumes the AAL JP2 is implemented in the same form as AAL JP 2008-2013. 
5.1.1.     Economic
impacts of the Option 1
Public authorities 
GO2: To contribute to sound public
finances and smart, sustainable and inclusive growth 
ICT based products and services for active
and healthy ageing can make care systems more efficient and sustainable.
Evidence from the Scottish Telecare Development Programme[26] suggests that telecare has
resulted in the reduction of admissions to care homes and hospitals, and
earlier discharges from the hospital, thus potential annual cost savings are
substantial. As described in Section 2.1, especially long-term care costs are
projected to rise dramatically in the future due to demographic ageing. ICT
solutions could contribute to the containment of these costs and thus improve
the long-term outlook for the sustainability of public finances. 
SO1: Improve the quality of life for the
elderly and their carers (and other people, in particular those with
disabilities) and help increase the sustainability of care systems, by
enhancing the availability of ICT based products and services for active and
healthy ageing;
The current AAL JP generates fruitful
approaches adopted by many industrial partners, service providers and user
organisations to develop innovative ICT-based solutions, for example through
integration into objects that elderly people already have and like to use. The
focus is often on adapting simple and existing technology, like the TV, or a
standard PC, and work with age-friendly interfaces like touch screen or talking
to a camera. However, this does not mean that appropriate technology is
necessarily available off the shelf. It often requires adaption in terms of
reliability, interoperability and price. In addition, new ICT tools like smart
phones for eHealth applications and tablets are being considered. Option 1 would
support the further development of innovative ICT based products and services
for the elderly, which might prove useful to other people, in particular those
with disabilities. User involvement however would not improve, which would
negatively impact the potential uptake. 
Innovation and research        
GO3: To contribute to increasing R&D
spending to 3% of GDP by 2020 (EU 2020 / H2020), as well as strengthening the
European Research Area and scientific and technological bases in Europe;
The Option 1 presents continued support to
the research for ICT based products and services addressing active and healthy
ageing. Besides leveraging public funding from the national level it also
attracts a high share of private co-financing. 
SO2: Create a critical mass of
trans-European research and innovation for ICT based products and services
addressing active and healthy ageing, in particular involving SMEs and users;
A critical mass of R&D and innovation implies
a sufficient number of participants, sufficient cooperation, and sufficient
total R&D and innovation activity to initiate a self-sustaining, productive
and viable research environment. The current AAL JP booked progress mainly in
already existing social or health care provision of professional carers. Much
less research was related to the informal care sector or to new approaches such
as community- or private-sector based care provision. As most R&D and
innovation took place at the national rather than European level, mostly participants
with a national orientation took part. The AAL JP 2 would attract new players
and capacities for research and innovation. Convincing results would trigger more
interest from policy makers and investors and thus enable larger scale
deployment. It would be uncertain in case also new approaches would be part of
it.
Competitiveness, trade and investment
flows          
SO3: Leverage private investments and
improve industrial growth potential by providing a framework for developing
European approaches and solutions that meets varying national and regional
needs. 
ICT for ageing offers huge opportunities
for European industry and especially SMEs, as ageing has very predictable
patterns, thus the long-term entrepreneurial risk is low. The development of
ageing related markets across EU Member States is very asymmetric. Taking a closer
look at the most developed markets can provide a picture of other markets in
the foreseeable future. Early 2011 the market-readiness
of the results of AAL JP projects of the first two calls was assessed. Given a
2 to 3 years time to market, it is still premature to conclude on the results.
Nonetheless, the consultation of AAL JP participants carried out in 2011, provides
indicators of the potential impacts of the projects: 
 Indicator || Findings 
 Industry as leader of AAL projects || On average 40% of projects are led by an industrial partner 
 SME participation || Over 50% of the project participants are SMEs 
 IPR secured || Nearly 50% of the projects have already secured IPR for results from the projects. 
 Financing secured for going to the market after the project end || Some 25% of the projects have already secured financing for going to the market 
 AAL related products and services emerging in the market || Many AAL projects intend to deliver new ICT products and services to the market, see Annex III 
Table 6:Findings on the industrial
exploitation of the AAL JP projects
The key indicators prove that the programme
supports knowledge and experience sharing across sectors and borders, which stimulates
larger scale industrial exploitation. They also indicate
that AAL JP attracts many new entrants into the field,
which contribute to create sufficient supply for mass deployment. However, the
ageing outlook has worsened since the initial establishment of the Joint Programme,
thus the research needs to advance to deliver results earlier (see Table 2 - EU government spending on pensions, healthcare, long-term
care, unemployment benefits and education 2010 – 2060,
and the accompanying comments).
The focus on market exploitation would however not be strengthened under this
option. 
Functioning of the internal market and
the competition      
OO3: Facilitate participation for all
actors in the innovation chain, in particular SME, end-users and service
providers, in all stages of the projects;
The AAL JP has initialized establishing
links among the key players in the field. The projects support cooperation
among user organisations, policy makers, carer and user organisations,
emergency services, venture companies, designers and ICT suppliers and
producers. The AALA organises a whole set of workshops and seminars for
interested professionals or those directly working the field of ageing. The growing
number of participants to the annual AAL Forums since 2009 (from 600 to  1200)
indicate  that a genuine AAL community has formed. AAL JP2 would continue the
annual forums and also the annual investment forums facilitating discussions
between the solutions providers and funders. Still, these links are not mature
enough to add up to a self-supporting working framework for financing the
currently available solutions. 
In the AAL JP 2 the programme participants
would be encouraged to sustain this network. However the interim evaluation has
pointed that users and service providers have not been sufficiently involved in
all stages of the project and that the projects are probably too much technology
driven. Under Option 1 these shortcomings would persist. Additionally, the
current programme is marked by a lower participation of end-user organisations,
due to their non-eligibility for funding under a research oriented programme in
some Member States. Option 1 would not address this issue. 
Consumers and households   
OO2: To reduce further time to market,
by facilitating user and industry-driven research.
The Joint
Programme is based on co-financing. Initially half of the project costs should
be financed by the project participants. As the Programme is driven by national
participation rules, the funding rates can vary across the Member States. This has
resulted in a lower level of financing as initially expected. The statistics for
the first three calls show that the participants on average contribute 39% of
the project costs. The current Programme would sustain that pattern, as it
wouldn't impact any national rules. 
Another aspect would be to support
activities which help to exploit the project results in the market, by linking
with Business Angels (e.g. the European Business Angel Network, EBAN), venture capitalists
and institutional investors (like the EIB). For this purpose in 2011 the AALA
launched the project AAL to business (AAL2B), which organised already five workshops
attended with great interest. This project would be continued under the AAL
JP2.
5.1.2.     Social
impacts of the Option 1
Employment and labour markets      
GO1: To improve conditions for the EU
competitiveness in the field of ICT based products and services for active and
healthy ageing by better exploiting the industrial potential of policies of
innovation, research and technological development 
The field of ICT and ageing can have
substantial effect on the job creation as it attracts professions with high added
value. The direct impact of the AAL JP funding for the projects of the first
three calls corresponds to 500 jobs for three years. There is a good perspective
of these jobs being sustained beyond the project duration. If activities are
terminated there is a high probability that project participants will be able
to find another job, due to their enhanced educational or professional level. An
indirect job creation effect stems from the employment related to large scale
deployment of the solutions from the AAL JP projects. 
Public health and safety         
GO4: To focus future Union funding
programmes more on Europe 2020 priorities by addressing societal challenges, in
particular health and demographic ageing and OO5: To ensure complementarity
with national programmes and EU level initiatives such as Horizon 2020, and
align with the Strategic Implementation Plan of the European Innovation
Partnership on Active and Healthy Ageing (EIP AHA), Under option 1, the scope of the AAL JP2 programme would
remain the same. AAL JP2 would definitely contribute to the EIP AHA, but
limited. AAL JP2 would continue to support ICT solutions for Alzheimer and
other dementia diseases (see also section 2.1). Also the research of
independent living solutions, telecare and smart environments that could
mitigate costs associated with cognitive impairments would be continued.
Secondly, the programme would support open and personalised solutions for the
extension of active and independent living, thus improving their quality of
life and employability. Thirdly, the programme would continue to support
innovation, which improves the social inclusion of the elderly with the help of
ICT solutions like communication applications or social networking.
Nonetheless, the option to exploit synergies with the health care sector,
including on prevention, would not be realized under this option.
Governance, participation, good
administration, access to justice, media and ethics
OO4: To increase the number of
participating Member States and to leverage private and national co-financing;
The AALA organised in 2012 an event for the
Permanent Representations of the EU Member States to explain the benefits of
participating in the AAL JP and thus stimulate their interest in the
membership. AALA will dedicate a supporting measure to enlarging  the AAL JP
Membership. According to the design of the AAL programme National Funding Authorities
(NFAs) and the European Commission should each provide a quarter of the project
costs. The public funding should therefore caps to one half of the costs, which
is much lower than the 75% FP7 financing rate. During the first five calls the
average rate of national contribution has been substantially surpassing the EC
contribution, showing strong support to the programme. The second half of the
project budget should be financed by the project participants themselves. For
the years 2014 to 2020 the annual EC contribution of € 25 million would remain
the same as in the current AAL JP. As AAL JP2 would run for 7 years instead off
6, the EC contribution would amount to € 175 million. The current wave of
consolidations of public finances in the EU will affect the level of financing
in the AAL JP only marginally, as is evident from Figure 9. This is most likely due to the fact
that research of new approaches in the long-term care canpotentially bring
savings. If this distribution pattern of public financing is sustained, the
Member States contribution could be expected to amount to more than € 200 million
for the whole period. The AAL Member States contribution is part of the
Sensitivity analysis in section 4.5.
Figure 9 - The
share of total costs of the financing of AAL JP projects by calls
5.1.3.     Environmental
impacts of the Option 1
Transport and the use of energy
SO1: Improve the quality of life for the
elderly and their carers (and other people, in particular those with
disabilities) and help increase the sustainability of care systems, by
enhancing the availability of ICT based products and services for active and
healthy ageing;
The deployed telecare and telehealth
solutions imply less travel of patients and carers/doctors between homes,
hospitals and institutions due to remote services like telemonitoring.
5.1.4.     Other
impacts of the Option 1
OO1: To achieve operational excellence
and accountability for the programme; 
The AAL
Association (AALA) has set up a Central Management Unit (CMU) for daily
programme operations. After the Interim evaluation has pointed to the
understaffing and recruitment related delays, CMU staff has been doubled in 2012
and the post of director has been filled as well. This appears to be sufficient
for its tasks. The CMU is further supported by the Executive and Advisory Board
members, which are seconded and, in effect, paid for by their own
organisations. The evaluation also indicated that times to contract and time to
pay the projects were sometimes problematically long. The baseline scenario
does not present a workable solution to this issue. 
5.2.        Option
2 - No AAL JP2 
Option 2 would entail that there will be no
dedicated effort to bring together national programmes in the field of ICT for
ageing well at the EU level for the years 2014-2020. The leverage of the
national funding would disappear, and actions with a European dimension would
have to be covered within the Horizon 2020 programme. 
5.2.1.     Economic
impacts of the Option 2
Public authorities
GO2: To contribute to sound public
finances and smart, sustainable and inclusive growth 
If the AAL JP is terminated, the progress of
research related to cost saving with ICT solutions, especially in long-term
care, would slow down. This would have an adverse effect on the long-term
outlook for the sustainability of public finances. 
SO1: Improve the quality of life for the
elderly and their carers (and other people, in particular those with
disabilities) and help increase the sustainability of care systems, by
enhancing the availability of ICT based products and services for active and
healthy ageing;
The quality of life of the elderly would
improve later as the development of the new solutions would slow down. 
Innovation and research        
GO3: To contribute to increasing R&D
spending to 3% of GDP by 2020 (EU 2020 / H2020), as well as strengthening the
European Research Area and scientific and technological bases in Europe;
Under Option 2 the support for research on
ICT based products and services for ageing well would stop. This would reduce
substantially the overall amount of the finances available for the research
projects (see section 6.1). There would be no leveraging of public funding from
the national level and the share of private co-financing within the Horizon
2020 funded projects would be substantially lower. 
SO2: Create a critical mass of
trans-European research and innovation for ICT based products and services
addressing active and healthy ageing, in particular involving SMEs and users;
The programme has built up a substantial
community of participants, many of them currently cooperating on research projects.
With termination of the AAL JP the links between the stakeholders across
sectors and countries would weaken or disappear. This would have a detrimental
effect on the field of ICT and ageing, especially regarding SME involvement.
The EU would be left with a patchwork of local, regional and national
initiatives on ambient assisted living, which would not be able to acquire the
scope and scale needed for a structural contribution to tackling the ageing
challenge and the creation of economic growth and jobs.
Competitiveness, trade and investment
flows          
SO3: Leverage private investments and
improve industrial growth potential by providing a framework for developing
European approaches and solutions that meets varying national and regional
needs. 
Presently the exploitation of ICT based
products and services for active and healthy ageing only takes place in social
alarms and telecare. Though earlier generations of social alarm systems are
well-established in several Member States, the development of more advanced ICT
solutions for an ageing population is still seen as a high risk field. Without
a follow up to the AAL JP on many topics the step from research to more market
and deployment-oriented activities will not be made. This is especially the
case with respect to the transition to the service sector, while NGOs And SMEs
which may find it difficult to grow beyond specific and local markets. 
Functioning of the internal market and
the competition      
OO3: Facilitate participation for all
actors in the innovation chain, in particular SME, end-users and service
providers, in all stages of the projects;
The AAL JP has been organising annual AAL
Forums since 2009, which gathered from 600 to 1200 participants. If no
alternative to these events could be found, the links between participants
would weaken. As the AALA would not organise workshops and seminars for professionals
interested or directly working in the field of ageing, lots of fruitful
cooperation could weaken or disappear. AAL JP projects would no longer serve as
a platform for the multi-disciplinary discussions, which a field like ambient
assisted living needs. In particular the participation of the SMEs was valued
due to its potential for deployment. The termination of the AAL JP would
negatively affect user-driven innovation. The feedback from older people is a necessary part of the design process, as they do
not represent a homogeneous population group with regards to aspects like their
health situation, personal needs, aspirations and living circumstances. 
Consumers and households   
OO2: To reduce further time to market,
by facilitating user and industry-driven research.
The deployment
of the ICT for active ageing products would be delayed as there would be fewer money
and efforts invested into their research and development. 
5.2.2.     Social
impacts of the Option 2
Employment and labour markets      
GO1: To improve conditions for the EU
competitiveness in the field of ICT based products and services for active and
healthy ageing by better exploiting the industrial potential of policies of
innovation, research and technological development
Much lower effect on the employment
compared to the Option 1 due to the much lower level of funding available for
the ICT based products and services for active and healthy ageing.
Public health and safety         
GO4: To focus future Union funding
programmes more on Europe 2020 priorities by addressing societal challenges, in
particular health and demographic ageing.
Option 1 would address the health and
demographic ageing by supporting research in this area with the employment of
the ICT only at the EU level. 
OO5: To
ensure complementarity with national programmes and EU level initiatives such
as Horizon 2020, and align with the Strategic Implementation Plan of the
European Innovation Partnership on Active and Healthy Ageing (EIP AHA),
The AAL JP is
currently based on pooling national and EU resources for joint calls, which enhances
the coherence of strategy development on the national level. The national
programmes in their turn bring the programme participants closer to national
innovation clusters, getting them more involved. The benefits of joint calls as
well as of build-up of the critical mass would weaken substantially if the
programme were discontinued. Given the current economic climate, the AAL Member
States would be unlikely to continue the trans European cooperation. Without follow-up
of the AAL JP, one of the main providers of building blocks for the EIP AHA
would disappear. EU level research and innovation on active and independent
living, and also prevention and other synergies with the health care would have
to be covered by other funding schemes like H2020, Structural Funds or Public
Private Partnerships. Even if national funding would provide support to these
topics, the European dimension would be lacking. 
Governance, participation, good
administration, access to justice, media and ethics
OO4: To increase the number of
participating Member States and to leverage private and national co-financing;
Participation and leverage would be reduced
to zero.
5.2.3.     Environmental
impacts of the Option 2
Transport and the use of energy       
SO1: Improve the quality of life for the
elderly and their carers and help increase the sustainability of care systems,
by enhancing the availability of ICT based products and services for active and
healthy ageing;
The deployed telecare and telehealth
solutions imply less travel of patients and carers/doctors between homes and
hospitals due to remote services like health monitoring. Under option 2 these
savings would be limited compared to other options. 
5.3.        Option
3 - AAL JP2, as reinforced and improved AAL JP1 
Under Option 3 the AAL JP2 would be
continued with an adapted scope (to align with the EIP AHA) and an improved
implementation. The Option 3 would be co-financed by the national participants
and the EC (Horizon 2020). The scope of the AAL JP2 programme would widen
compared to AAL JP1, and would cover the full range of ICT based innovation in
active ageing and independent living and would also seek synergies with the
health care sector including prevention. The name of the Joint Programme under
this option could be changed to Active and Assisted Living, to accentuate this
change of scope. The implementation would be improved in the light of the
recommendations of the Interim evaluation (see sections 1.4.2 and 1.4.6). 
5.3.1.     Economic
impacts of the Option 3
Public authorities       
GO2: To contribute to sound public
finances and smart, sustainable and inclusive growth 
The positive impact of Option 3 on the
long-term sustainability of public finances would be at least the same, but probably
larger than under Option 1. 
SO1: Improve the quality of life for the
elderly and their carers (and other people, in particular those with
disabilities) and help increase the sustainability of care systems, by
enhancing the availability of ICT based products and services for active and
healthy ageing;
See GO2 under this Option. 
Innovation and research        
GO3: To contribute to increasing R&D
spending to 3% of GDP by 2020 (EU 2020 / H2020), as well as strengthening the
European Research Area and scientific and technological bases in Europe;
Same as in Option 1. 
SO2: Create a critical mass of
trans-European research and innovation for ICT based products and services
addressing active and healthy ageing, in particular involving SMEs and users;
The evaluation suggests that under the
current AAL JP most progress takes place in already existing professional
social or health care provision, as that is the everyday reality of
professionals. There appears to be currently rather less progress in the
informal care sector or in new approaches to elderly care and elderly services
such as community- or private-sector based ones. Most R&D and innovation
appear also still to be taking place at the national rather than at European
level and thus involve mostly actors with a national orientation.
Building on the often successful community
development at national level, research and development community development
at European level should be further addressed. The AAL JP will continue
organising conferences, workshops and support to the Programme users. Focus will
be put on collaboration of different stakeholders in innovation also in view of
the alignment to the EIP AHA.
Competitiveness, trade and investment
flows          
SO3: Leverage private investments and
improve industrial growth potential by providing a framework for developing
European approaches and solutions that meets varying national and regional
needs. 
Same as in Option 1
Functioning of the internal market and
the competition      
OO3: Facilitate participation for all
actors in the innovation chain, in particular SME, end-users and service
providers, in all stages of the projects;
The AAL JP serves as a platform for sharing
experiences and disseminating research results as described in the baseline.
The Programme would continue organisation of annual AAL-forums, as well as
workshops to sustain the current level of fruitful cooperation, while the Investment
Forum has opened the discussion with stakeholders important for the deployment.
As the links are still not mature enough (see sections 1.4.4 and 1.4.5), Option 3 would strive for strengthening
them. The mix of project participants has been improving throughout the
Programme, with SME participation surpassing 50% in the fourth call, which
seems to be optimal share for the deployment and exploitation of the project impacts.
The programme participants would then be encouraged to sustain this level. 
The interim evaluation (see sections 1.4.2
and 1.4.6)has pointed out the that the Programme does not sufficiently involve
users and service providers in all relevant stages of the projects. The Option 3 would focus more on technologies
developed in real life situations, possibly also in a living labs context.
Appropriate technologies have to match technological and ambient assisted
solutions with the actual ability of elderly people to use them in their daily
routines. The AAL JP2 will stress working more closely with users in
real life situations, while products and services should be developed with real
user involvement to avoid missing the market. Appropriate technology will have
to take account of real life and factor this into the development from the
start of the project. 
Consumers and households   
OO2: To reduce further time to market,
by facilitating user and industry-driven research.
The
co-financing principle would be sustained in the AAL JP2 in order to ensure
continued sufficient involvement of the industry. As the funding rates vary
across the Member States, the Programme would sustain the current pattern of
60% of public and 40% of private funding. The AALA's supporting action AAL2B
will continue supporting introduction of their results into the market. 
5.3.2.     Social
impacts of the Option 3
Employment and labour markets      
GO1: To improve conditions for the EU
competitiveness in the field of ICT based products and services for active and
healthy ageing by better exploiting the industrial potential of policies of
innovation, research and technological development
Same impacts as in the Option 1.
Public health and safety         
GO4: To focus future Union funding
programmes more on Europe 2020 priorities by addressing societal challenges, in
particular health and demographic ageing.
Under option 3 the health and demographic
ageing challenge would be addressed earlier of more effective than under Option
1, as it aims at a closer time to market. 
OO5: To ensure complementarity with
national programmes and EU level initiatives such as Horizon 2020, and align
with the Strategic Implementation Plan of the European Innovation Partnership
on Active and Healthy Ageing (EIP AHA), 
The scope of AAL JP2 under Option 3
programme widens compared to the business as usual option. This re-focussing would
make the best use of synergies between the experiences from the current AAL JP
activities and the new areas of intervention. This option would then cover the
full scope of EIP AHA with regard to ICT solutions in the following way: 
1) Active Ageing and Independent Living
theme would be covered same as under Option 1. 
2) The Option 3
could additionally cover the ICT support to the Theme Prevention, screening
and early diagnosis. This includes topics like health
literacy, patient empowerment, ethics and adherence programmes, using
innovative tools and services The WHO suggests that additional costs of limited
health literacy range from 3-5% of the total health care cost per year.[27] The Option 3 could focus on support to innovative tools and applications for
delivering a prescription and adherence action at
regional level as well as promotion of health literacy and patient empowerment
for informed lifestyle choices. The programme could also contribute to a
pan-European online community using ICT based solutions and social marketing
methods. Furthermore, there would be attention paid to personalised health
management Recent UK-based research, exploring outcomes of a range of
co-produced interventions, demonstrated that the health-related quality of life
of older people improved by between 3-12%, whilst reducing hospital stays by
47%[28].
The Option 3 could contribute to the implementation of validated and operational
programmes for prevention and early diagnosis of specific chronic conditions
e.g. cardiovascular, diabetes, Alzheimer’s/dementia, Parkinson’s Disease and
fall prevention. Lastly, prevention and early diagnosis
of functional decline, both physical and cognitive, in older people could be
supported as the prevalence of disabilities increases dramatically with age,
from 30% in those aged 65 to 74 to 50% in the 75-84 age group and 80% for those
over 85.[29]
The Option 3 could support validation
of programmes for prevention of functional decline and frailty (with first
action focused on physiological frailty and malnutrition) among older people
supported by tools, networks and information reaching care providers across the
EU. 
3) The
Option 3 would additionally cover the
ICT support to the Theme Care
and Cure
This includes
protocols, education and training programmes for health professionals, care
personnel, informal/family carers. Chronic conditions, such as heart failure,
respiratory and sleep disorders, diabetes, obesity, depression, pain, dementia,
and hypertension affect 80% of people over 65, and often occur simultaneously
(multimorbidity)[30].
The Option 3 could support
projects focused on developing protocols for management of co-morbidities
including polypharmacy. Furthermore it could facilitate the implementation of
education and training programmes and dissemination of teaching manuals for
health professionals, care personnel and informal/family carers with special
attention to emerging roles and case management programmes, for example on
frailty, multi-morbidity and remote monitoring. There could be also training
for end-users like carers and patients on how to use new tools for personalised
case management. Furthermore, the Option 3 could support research and development in order to explore
personalised case management and chronic care models which represent individual
patients' profile and support self-care, based on optimal management and
personalisation tools. This could include the exploration of IT support for
patients and providers such as artificial intelligence for complex situations,
including evidence based cost-effective/efficient assessment. Finally, the Option 3 could be also dedicated to replicating and tutoring integrated care for chronic
diseases, including disease/case management models with remote monitoring at
regional level. It could support the development of new generations of tools
and services for more effective chronic conditions management, assisted
self-management for home and integrated care.
Governance, participation, good
administration, access to justice, media and ethics
OO4: To increase the number of
participating Member States and to leverage private and national co-financing;
Same as in the option 1
5.3.3.     Environmental
impacts of the Option 3
Transport and the use of energy       
SO1: Improve the quality of life for the
elderly and their carers (and other people, in particular those with
disabilities) and help increase the sustainability of care systems, by
enhancing the availability of ICT based products and services for active and
healthy ageing;
The deployed telecare and telehealth
solutions imply less travel of patients and carers/doctors between homes and
hospitals due to remote services like health monitoring.
5.3.4.     Other
impacts of the Option 3
As regards to shortening the time to
contract and time to pay, under the improved AAL JP2 Member States will be
asked to comply with the agreed performance targets for which will be regular monitoring.
Regular check on the performance would be brought to the attention of the
General Assembly of the AALA and to the EC for corrective action.
5.4.        Assessment
of the administrative costs
The AAL JP could serve
for the EC as a model for outsourcing by using the indirect centralized
management modality. The administration of the AALA accounts currently for
seven employees with a budget composed of 6% of the EC contribution as well as
AAL Member States membership contribution. The administration of EC dedicated
to the AAL JP assumes two part-time employees which are also involved in other
tasks. 
5.5.        Assessments
of the simplification potential
The AAL JP is simple to use to for the
project participants namely the SMEs compared to the FP7 and CIP as they have
to follow the national rules. According to a study of the EC, more than half of
the FP7 participants think that the national rules for participation in
research and innovation programmes are less complex and difficult than the
European ones (Table 7). As the AAL JP is based on the national rules of
participation in the research programmes, it effectively lowers barriers for
access to funding, especially for SMEs, with the added benefit that
participating via national programs brings them in closer contact with national
innovation clusters.
 Complexity || 2008 || 2009 
 FP7 is less complex compared to the national rules of participation || 17 || 17 
 FP7 is about the same compared to the national rules of participation || 25 || 22 
 FP7 is more complex compared to the national rules of participation || 47 || 54 
Table 7 - Complexity of the use of the
Framework Programme 7 compared to the national rules of participation[31]
The Interim Evaluation has also confirmed
the user friendliness of the AAL JP compared to other funding schemes[32].
6.           Comparison
of Options 
6.1.        Comparison
by the costs and benefits
The first criterion against which the
options could be compared are the costs and benefits of the AAL JP. The costs
are varying according to the levels of co-financing between the EC and the
other two sources, which are AAL Member states and the programme participants.
The first scenario pictures the programme being financed by all three sources.
As the continued and improved AAL JP 2 options count on their financing, the
yearly leveraged funds from the AAL Member states would amount to € 33 million
€, compared to zero under the termination option. The continued and improved AAL
JP2 options assume 35 % of financing by AAL Member States, 25 % by the EC and
40% by project participants. This means that the EC can leverage a total amount
of € 91 million by investing its € 23 million. In the scenario of the termination
option, the AAL Member States would not contribute to the AAL JP2 at all, and
the participants contribution would be governed by H2020 rules. If this would
be based on FP7 rules, with a participant's maximum contribution of 25%, the
leverage would not be € 91 but € 31 million, given the same amount of EC
investment of € 23 million. 
   || Option 1 - AAL JP2 identical to AAL JP1 Option 3 - AAL JP2, as reinforced and improved AAL JP1 || Option 2 - No AAL JP2 
   || 2014-2020 || yearly || 2014-2020 || yearly 
 AAL MS (Mio. €) || 228 || 33 || 0 ||  0 
 EC (Mio. €) || 161 || 23 || 175 || 23 
 Private (Mio. €) || 249 || 36 || 58 || 8 
 Total funding || 637 || 91 || 233 || 31 
Table 8: Level of co-financing
As the AAL JP is a research programme the benefits
are not measurable as they depend on the projects outcomes and their take-up.
However the emerging evidence suggests that the ICT solutions could contribute
to the containment of these age-related health and long-term care costs and
thus improve the long-term outlook for the sustainability of public finances.
Evidence from the Scottish Telecare Development Programme suggests that
implementation of telecare results in the reduction of admissions to care homes
and hospitals, and in earlier discharges from the hospital. Potential annual
cost savings as a result of avoiding hospitalisation of the elderly because of
the implementation of telecare could be substantial. The AAL JP supports
projects where ICT based solutions serve for prevention and management of
chronic conditions as well as home care of the elderly. For example the Health
@ Home AAL project focuses on the chronic disease management cost reduction by
the use of personal health systems. Those can help save in lives and resources
by focusing on prevention and prediction rather than on costly medical
interventions after symptoms and disease have developed. The project explores
the possibilities of cost reductions by enabling remote self-management of
chronic disease and improving the care systems. Many other AAL JP projects
(further examples can be found in the Annex II) deliver similar findings in the
area of ICT and ageing. As presented in the section 2.1. the potential number
of users of telecare and telehealth systems in the EU ranges between 24 to 59
million by 2060, which would have its cost saving effect on the public finances
depending on the deployment. 
6.2.        Comparison
by mix of the project participants. 
The Interim evaluation
highlighted positively the high proportion of the SME participation. Both the continued
and improved option would retain the current level of their participation,
which is 50%. Furthermore it pointed out the underrepresentation of user
organisations in the Programme. The improved option suggests more than tripling
the involvement of users or their respective organisations. As the AAL projects
have usually at least five partners, at least one of them can be assumed to come
from the user side, thus targeting 20%. Lastly the Interim Evaluation pointed
out that projects are too research driven. Under the improved option involvement
of research bodies would be lowered.
 Option || Option 1 - AAL JP2 identical to AAL JP1 || Option 2 - No AAL JP2 || Option 3 - AAL JP2, as reinforced and improved AAL JP1 
 Large enterprises || 10% || 10% || 10% 
 SMEs || 52% || 25% || 50% 
 User and other organisations || 11% || 6% || 20% 
 Research organisations || 14% || 35% || 10% 
 Universities and other || 13% || 24% || 10% 
Table 9: The mix of the project participants
6.3.        Comparison
by the distance to the market of the project results 
Under Option 1 (AAL JP2
identical to AAL JP1) the distance to the market would be further reduced
because of continuation of the AAL JP process would help achieve the critical
mass of applied research and development needed to create a more mature market
for products and services for ageing well.
Under Option 2
(termination) no coordinated and funded applied research at European level
would take place. This would leave a gap in the innovation chain between
upstream (more fundamental H2020) research and downstream (pilot)activities
(such as CIPs). This would create a greater distance to market for products and
services for ageing well. 
Under Option 3 (AAL
JP2, as reinforced and improved AAL JP1) the distance to market would be
reduced the most, as the alignment with the EIP on Active and Healthy Ageing
would lend focus to the AAL JP projects, which moreover could benefit from the
deployment on topics like prevention, medication adherence and integrated care
by the Action Groups.
6.4.        Comparison
by the impact on the EIP AHA
The Option 3 would
present better alignment to the EIP AHA as it would cover its all three themes
compared to Options 1 covering just one theme and Option 2 not covering any
theme. 
6.5.        Overall
comparison of the options
The overall comparison below illustrates whether
the Options achieve the proposal objectives, and if they comply with the overarching
objectives of EU 2020, H2020 and EIP.
 Options || Option 1 - AAL JP2 identical to AAL JP1 || Option 2 - No AAL JP2 || Option 3 - AAL JP2, as reinforced and improved AAL JP1 
 Economic impacts ||   ||   ||   
 Public authorities || + || - || ++ 
 Innovation and research || + || - || + 
 Competitiveness, trade and investment flows || + || - || + 
 Functioning of the internal market and the competition || + || - || ++ 
 Consumers and households || + || - || ++ 
 Social impacts ||   ||   ||   
 Employment and labour markets || + || - || + 
 Public health and safety || + || - || ++ 
 Governance, participation, good administration, access to justice, media and ethics || + || - || + 
 Environmental impacts ||   ||   ||   
 Transport and the use of energy || + || + || + 
 Summary || + || - || + / ++ 
Table 10: Overall comparison of the
options
6.6.        Preferred
option
Option 3 is the preferred option. 
7.           Monitoring and Evaluation 
7.1.        Monitoring
The AAL JP2
would be monitored by the AALA continuous basis and by the EC on annual basis.
The indicators would be used to check if implementation is on track and the
extent to which the AAL JP is achieving its objectives. Most of the data for
the indicators are already available by extracting it from the AALA evaluation
and project monitoring system, to which the national contact point feed in the
information. The remaining data will be provided by Market observatory, which will
be set up by the AALA to follow-up more closely the exploitation of the project
results and compare them with other on-going activities. Additionally, the EIP
monitoring system will be used for the purposes of AAL JP monitoring. It will
address among other some areas which are relevant to the Programme. Firstly, it
will gather the evidence, reference examples create repository for age-friendly
innovation in order to establish a shared basis of sound, robust data and
reliable methodologies, to enable exchange and dissemination of tested and
proven practices, as well as to help in replication and scaling up of
successful cases. Secondly, the EIP monitoring system will set up an
marketplace to facilitate cooperation among various stakeholders in order to
link up interested stakeholders to create partnerships implementing innovative
solutions; facilitate innovation and knowledge transfer by networking between
individuals and organisations, in the EU and internationally. The monitoring
results would be reported to the EC and the General Assembly of the AAL JP. 
Indicators (in
bold) have been grouped by their repose to the objectives (objective codes are
corresponding to the Section 3):
Indicators
related to the general objectives:
GO1: Percentage
of projects lead by the industrial partner and Percentage of funds being spent
by the SMEs in the projects (also applicable to OO2)– The target is to
maintain the current level. Percentage of projects for which intellectual
property has been secured and Percentage of projects for which financing beyond
the funding from the AAL JP is secured for going to the market - The target
is to either maintain or increase the current level. Number of Member States
able to fund all types of participants (also applicable to OO3) – The
target it to achieve that at least 10 Member States would be able to fund all
types of participants. The data would be gathered by the AALA.
GO2: Amount
of evidence on cost saving measures due to the use of ICT for aging – The
target is to consolidate the evidence through the use of EIP monitoring system.

GO3: Total amount of co-financing by the
project participants and the Member States contributing to R&D spending and
realisation of the European Research Area in the field of ICT for ageing
and Total amount of SME's funding in the projects and Number of
participants in annual AAL JP Forum. The target is to either maintain or
increase the current levels. The data would be gathered by the AALA. 
GO4 and OO5: Contribution of AAL JP2
projects to implementation of Strategic Implementation plan of EIP-AHA  –
The target is to give the possibility to cover three themes of EIP-AHA.
Indicators
related to the specific objectives:
SO1: Percentage
of funds being spent by user organisations and service providers in the
projects (also applicable to OO3) – Target will be increase the percentage
and will be monitored by AALA. Increase in sustainability of care systems by
enhancing the availability of ICT based products and services for active and
healthy ageing – The target is to consolidate the evidence through the use
of EIP monitoring system.
SO2: Number
of participants in the AAL JP and Number of participants in annual AAL JP Forum
(also applicable to OO3) –– Target will be achieve slight increase. Percentage
of funds being spent by user organisations and service providers in the
projects – Target will be increase the percentage. Percentage of funds being
spent by the SMEs in the projects – Target will be to maintain the current
level. The data would be gathered by the AALA.
SO3: Percentage of participant's funding
in the projects (also applicable to OO4)  - The target is to either
maintain or increase the current level. The data would be gathered by the AALA.
Indicators
related to the operational objectives:
0O1: Time
between the approval of the evaluations ranking and the project contract
signature (time to contract) and Time between the receipt of the request
of the payment form the project and the payment realisation (time to pay).
The target is that all Member States' maximum time span is lower than average
of all plus 10 %.  
0O2: Percentage
of projects resulting in new products, systems and services in the market -
The current projects are scheduled  to deliver to the market earliest by 2015,
therefore the target would be to reach a least 25% of all running projects by
2020. The data would be gathered by the Market observatory of the AALA. 
0O4: Number of participating Member
States - The target it to achieve an increase from the current number of
Member States of 23. The information would be gathered by the EC. Percentage
of Member States' funding in the projects - The target it to achieve the
same level or increase. The data would be gathered by the AALA.
7.2.        Evaluation
A mid-term evaluation
will be carried out after 3 years with independent experts as it was done from
the AAL JP1 in 2010. This means that an assessment of the AAL JP2 will take
place in 2017 in order to evaluate the quality and efficiency of the implementation,
including scientific, management and financial integration of the AAL Joint
Programme. Particular attention will be paid to the possible continuation of
projects downstream after funding has ended, to the trans-European dimension of
the products and services, to the inclusion of end-users and service providers
in different stages of the projects as well as to the alignment of the scope of
the Programme to that of the EIP AHA. In its proposal for Horizon 2020, the
Commission has identified a number of criteria for assessing potential
initiatives under Article 185.
8.           Annexes
8.1.        Annex
I: Table of figures
Figure 1- AAL JP governance and operational structure. 4
Figure 2 - Representation of different stakeholders in
the consultation on the EIP-AHA.. 6
Figure 3 - Significance of the barriers to the innovation
in the area ICT and ageing according to the stakeholders (percentage) 7
Figure 4 - Representation of different stakeholders in
the interviews of the Interim evaluation of the AAL JP  8
Figure 5 - Number of submissions to Public online
consultation on the AAL JP by country. 9
Figure 6 - Penetration of social alarms among people over
65 years old in %.. 12
Figure 7 - Potential take-up of home telehealth solutions
for the years 2010 to 2060 in millions of users. 13
8.2.        Annex
II: List of current national public sources for the co-financing of the AAL JP calls
in 2012
   || AAL Member State || Source of the funding 
 1 || Austria || BMVIT – Austrian Federal Ministry for Transport, Innovation and Technology. 
 2 || Belgium || IWT – Agency for Innovation by Science and Technology,. Flemish funding programme "O&O Bedrijfsprojecten". 
 3 || Switzerland || Federal Office for Professional Education and Technology. 
 4 || Cyprus || Research Promotion Foundation. 
 5 || Germany || Federal Ministry for Education and Research. 
 6 || Denmark || Danish Agency for Science, Technology and Innovation. 
 7 || Greece || Currently not participating in the calls. 
 8 || Spain || Ministry of Science and Innovation/ ISCIII – Instituto de Salud Carlos III. "Strategic Action for Health Research within the R+TF+I National Plan 2008-2011" and Ministry of Industry, Tourism and Trade. 
 9 || Finland || Tekes – Finnish Funding Agency for Technology and Innovation. 
 10 || France || ANR – French Research Agency and CNSA – French National Fund of Solidarity for Autonomy. 
 11 || Hungary || The National Office for Research and Technology 
 12 || Ireland || Enterprise Ireland. 
 13 || Israel || Ministry of Industry, Trade and Labour. "Encouragement of Industrial Research & Development law 57744-1984". 
 14 || Italy || MIUR - Ministero dell'Istruzione, dell'Università e della Ricerca. FAR (Fondo Agevolazione alla Ricerca). 
 15 || Luxemburg || Luxinnovation – Agènce Nationale pour la Promotion de l'Innovation e de la Recherche. Fond National de la Recherche. INTER/AAL Programme. 
 16 || The Netherlands || Ministry of Health, Welfare and Sport. 
 17 || Norway || The Research Council of Norway. IT Funk. 
 18 || Poland || National Centre for Research and Development. 
 19 || Portugal || UMIC - State Organization Knowledge Society Agency. 
 20 || Romany || Ministry of Education, Research, Youth and Sport. programme "Partnership". 
 21 || Slovenia || Ministry of Higher Education, Science and Technology. 
 22 || Sweden || VINNOVA – Governmental Agency for Innovation Systems. 
 23 || United Kingdom || Technology Strategy Board. programme "Assisted Living Innovation Platform". 
8.3.        Annex
III: Examples of AAL projects and their business plans
SOFTCARE
Many elderly have a 'classic' alarm button
they have to push themselves. With ICT more than that can be done. SOFTCARE project
develops a system that alarms them or their carers (professionals or family) if
something bad happens like for example falling asleep in bath. Even better, it
also warns them on long-term trends that could indicate future problems
(proneness to falls). These issues could be identified early enough to reduce admissions
to care homes and hospitals. The SOFTCARE business plan
estimated revenues for 2013 to 2018. Three devices are required: a wrist worn
device, a static node and a main node. Users will pay for directly or
indirectly for the devices, installation, call and data centre, testing, market
research, sales and marketing. This would require an initial investment of €
4.5 million and € 4 to 8 million operational costs per year. If the project
develops as planned, in 2018 there will be 100 000 users, with a projected
revenues of € 66 million. 
HOMEdotOLD
Older people
living by themselves run the risk of becoming lonely and isolated. The
HOMEdotOLD project helps them stay in touch with the world around them and have
a social life, even if they are not able to easily go out of the house. The can
share a 'remote dinner' with distant friends, or exchange photos with relatives.
They can keep their calendar and receive personalised news. All on their own
trusted TV, via existing services and protocols (e.g. Picasa, Skype, RSS
feeds). This increases marketability for a family context where other family
members already make use of these popular services. For the business plan of
HOMEdotOLD it is assumed that the user pays a standard fee to the NET TV
service provider (either cable company or ISP) for a HOMEdotOLD social service
bundle. It is estimated that in 2017 there will be total revenue of €1.427.000.
ExCITE
Older people need care, but carers can't always be there
due to substantial costs. The ExCITE project allows an experience close to the
real thing. A remotely controlled robot with videoconferencing system allows
caregivers to virtually visit older people, move about and look around in their
house, and talk with them. The project has deployed currently 25 Giraff robots
in 6 countries (Sweden, Denmark, Norway, Germany, Italy, and Spain) and will soon deploy 15 more. In 2012, the robot producer Giraff Technologies AB estimated in its
five-year financial forecast revenue of 7.5 million SEK with 119 units sold in
the European AAL market alone. By 2015 the revenue is projected to be 378.1
million SEK with 5,123 units sold. 
IS-ACTIVE
The IS-ACTIVE
system helps people with chronic diseases (like COPD) lead an active life. Via
a sensor network it monitors their physical activity and condition and gives
practical feedback, to inspire them to manage their own health and life. The
IS-ACTIVE system consists of an activity sensor node, a mobile application on
smart phone and a web-based application. Initially it will be sold to the
health care institutions treating people with chronic disorders for which an
active life style is relevant. The project is targeting the fast growing a
market of COPD, with 44 million patients in Europe, 24 million in USA and 56 million in Asia. 
[1]     Article
21 of Commission Regulation (EC, Euratom) No 2342/2002 laying down detailed
rules for the implementation of Council Regulation (EC, Euratom) No 1605/2002
on the Financial Regulation applicable to the general budget of the European
Communities (OJ 2002/L 357/1).
[2]               See http://www.aal-europe.eu

[3][3] http://www.a2e2.eu/5 
[4]               As of October 2012 the AAL JP consisted
of 19 EU Member States: Austria, Belgium, Cyprus, Denmark, Finland, France,
Germany, Hungary, Ireland, Italy, Luxembourg, the Netherlands, Poland,
Portugal, Romania, Slovenia, Spain, Sweden and the United Kingdom and 3
associated countries: Israel, Norway and Switzerland. Greece is currently not taking part in the calls for proposals. 
[5]               Decision no 742/2008/EC of the European
Parliament and the Council of 9th July 2008
[6] See http://ec.europa.eu/health/ageing/consultations/ageing_cons_01_en.htm,
for the full report, the list of respondents and the questionnaire.
[7] See http://ec.europa.eu/information_society/activities/einclusion/docs/aal/interim_evaluation_report.pdf

[8]               Conclusions of the Competitiveness Council of 30 May
2012
[9]               http://www.tekes.fi/fi/gateway/PTARGS_0_201_403_994_2095_43/http%3B/tekes-ali1%3B7087/publishedcontent/publish/fi_content/news/aal/aal_mid_term_evaluation_net_effect_final.pdf

[10] Source: Finnish Involvement in the Ambient Assisted Living Joint
Programme: Mid-Term Evaluation, 2010
[11]             Source,
p 56 of The 2012 Ageing Report; Economic and budgetary projections for the 27
EU Member States (2010-2060) [European Economy 2|2012 (provisional version).]
Http://ec.europa.eu/economy_finance/publications/european_economy/2012/pdf/ee-2012-2_en.pdf

[12]             European Commission’s preliminary
own estimates based on EUROSTAT and OECD data
[13]             COM(2009) 545, 17 Sept 2009
[14]             The
2012 Ageing Report; Economic and budgetary projections for the 27 EU Member
States (2010-2060) [European Economy 2|2012 (provisional version).]
Http://ec.europa.eu/economy_finance/publications/european_economy/2012/pdf/ee-2012-2_en.pdf
[15]             Empirica and WRC (2005): Various Studies on Policy
Implications of Demographic Changes in National and Community Policies. LOT 7: The Demographic Change – Impacts of New Technologies and Information Society, Final
Report
[16] Quotations on respectively page 27 and 32.
[17] See http://auseaccess.cis.utas.edu.au/
for publications, outcomes, final conference and summary.
[18] See http://futurage.group.shef.ac.uk/resources.html.
[19] FP7 report, Spring 2010, European Commission, DG-Research
[20]Average SME participation in the whole FP7 ICT
programme is 14.4% (FP7 report, Spring 2010, European Commission, DG-Research).
[21] The data shown for both programmes are for submitted proposals. As
the data for ranked proposals (i.e. those eligible for funding) are not
presented as they are very similar. 
[22]             COM(2010)2020, 3 March 2010
[23]             COM(2010)1161, 6 Oct 2010
[24]             COM(2008) 468, towards Joint Programming in research
[25] E! 5287 DIYA project Digital Inclusion Youth & Ageing. It
concerns a 'Platform for digital inclusion of Europe’s ageing population with a
Mobile Social Software turnkey solution and platform designed to reduce social
isolation, improve quality of life, and provide services with user-friendly
tools in a context of digital equality.' 
[26] Empirica and WRC, ICT & Ageing European Study on Users, Markets
and Technologies; January, 2010
[27] Haynes RB. Interventions for helping patients to follow
prescriptions for medications. Cochrane Database of Systematic Reviews, 2001,
Issue 1. Cited in the report Adherence to long term therapies: evidence for
action, WHO, 2003 
[28] Windle, K., Wagland, R., Forder, J., D’Amico, F., Janssen D and
Wistow, G. (2009) National evaluation of partnerships for older people
projects: final report Personal Social Services Research Unit, University of Kent, Canterbury. 
[29] Hebert, R., Brayne, C., and Spiegelhalter, D. Incidence of
Functional Decline and Improvement in a Community-Dwelling, Very Elderly
Population. Am.J Epidemiol. 5-15- 1997;145(10):935-44. 
[30] F. Luppi, F. Franco, B. Beghe, L. M. Fabbri (2008): 'Treatment of
chronic obstructive pulmonary disease and its comorbidities', ProcAm Thorac Vol
5, states that conditions such as chronic heart failure and COPD often develop
together with one or more co-morbid conditions. More than half of all older
people have at least 3 chronic medical conditions and a significant proportion
has 5 or more; and these are often unrecognised and untreated.
[31] European Commission DG Research and Innovation, Assessing the
Effectiveness of Simplification Measures under FP7, pg. 75
[32] Interim Evaluation of the Ambient Assisted Living Joint Programme,
Meglena Kuneva, Jeremy Millard, 09/2010, pg. 38