Health care 2050 glossary – a Schaltzeit reference on the future of health care, accompanying the 25th DKVF, September 23–25, 2026, Uniklinik Köln
It is meant as a tool, not a textbook: the definitions are deliberately short and are intended to create a shared language, for example for our workshop at the DKVF. You can find our position on health care in 2050 in the article “Health care 2050: Who shapes what is still the future today?”.
Each term is assigned to one of nine topic areas:
DigitizationCare structuresReform & financingGovernanceMedicinePrevention & public healthEthics & participationWell-beingLongevity
A
Additional contribution (Zusatzbeitrag) – An insurer-specific surcharge on top of the general contribution rate. Reform & financing
Advanced Practice Nurse (APN) – Academically qualified nurses with expanded authority. Care structures
AI Act – EU rules for AI systems; medical AI is usually classified as high-risk and must also comply with medical device law. Digitization
AI-assisted diagnostics – AI helps analyze images or lab values. Digitization
Algorithmic Bias – Systematic distortions in training data that make AI results worse for certain groups. Digitization
Ambient AI / AI documentation – AI automatically drafts doctors’ letters and consultation notes. Digitization
Antimicrobial resistance (AMR) – Pathogens against which antibiotics no longer work – one of the major public health threats looking ahead to 2050. Medicine
B
Behavioral and structural prevention – Targeting the individual (behavior) or the environment, prices and rules (conditions) – the latter has a broader effect. Prevention & public health
Biohacking / body hacking – Deliberate interventions in your own body – from supplements and cold training to implants. Longevity
Biological age / epigenetic clock – Measuring the state of aging based on biomarkers instead of date of birth. Longevity
Brain-computer interface (BCI) / neurotechnology – Direct connection between brain and computer – in medicine, for example, to control prostheses in cases of paralysis. Medicine
Burnout – State of exhaustion caused by chronic work stress – particularly widespread in the health professions. Well-being
C
Calorie restriction / fasting – Reduced energy intake as an approach to extending healthy years of life. Longevity
Care regions – Planning areas defined by need and accessibility, sometimes across state borders. Governance
Cell and gene therapies (ATMP) / CRISPR – Mostly one-off, very expensive therapies that alter cells or genetic material – for example with the CRISPR gene scissors. Medicine
Citizens’ insurance (Bürgerversicherung) – Proposed model of a single insurance for all citizens that takes all types of income into account. Governance
Contribution stability – Political goal of keeping health insurance contributions from rising any further. Reform & financing
Cross-sectoral care – Closer integration of medical practices, hospitals and nursing care. Care structures
Cryonics / cryosleep – Freezing bodies in the hope of later revival – scientifically unproven. Longevity
D
Data protection vs. data use – Weighing the protection of sensitive health data against its benefits for research and care. Ethics & participation
Data silos – Separate IT worlds between which findings don’t flow. Digitization
De-implementation – The orderly phasing out of services whose benefit has not been proven. Governance
DiGA (digital health applications) – “Apps on prescription” reimbursed by health insurers. Digitization
Digital Detox – Deliberately going without digital devices in order to recover. Well-being
Digital Health / E-Health – Umbrella term for digital applications in medicine and health care. Digitization
Digital twin – Virtual model of a patient or organ for simulating therapies. Digitization
DiPA (digital nursing care applications) – Reimbursable apps for people in need of care – the long-term care insurance counterpart to DiGA. Digitization
Disease management programs (DMP) – Structured treatment programs for the chronically ill, for example with diabetes or coronary heart disease. Governance
E
E-prescription – Digital prescription instead of a paper one. Digitization
Emergency care reform – Reorganization of emergency care with integrated emergency centers. Reform & financing
ePA (electronic patient record) – Central digital record for findings and medications. Digitization
Euthanasia / assisted suicide – Assistance in dying – ethically and legally controversial, and in Germany still without new legislation to this day. Ethics & participation
Evidence-based medicine and guidelines – Decisions based on the best available evidence, bundled into treatment guidelines. Governance
F
FHIR interfaces – Standard for exchanging health data between IT systems. Digitization
Flourishing – A state of comprehensive well-being that goes beyond mere health. Well-being
Full long-term care insurance (Pflegevollversicherung) – A model in which long-term care insurance covers all care costs and out-of-pocket costs are eliminated. Reform & financing
G
G-BA and benefit assessment – The Federal Joint Committee (Gemeinsamer Bundesausschuss) decides on the statutory health insurance benefits catalog; the benchmark is proven added benefit. Reform & financing
Gender Health Gap – Systematic differences in diagnosis, therapy and research to the detriment of women. Prevention & public health
Gender medicine – Taking sex and gender differences into account in diagnosis and therapy. Medicine
Generative AI / large language models – Language models that generate text – the basis for ambient AI, chatbots and documentation assistance. Digitization
Genome sequencing / DNA tests – Reading the genome for diagnostics and risk profiles – increasingly also as a commercial test without medical supervision. Medicine
GLP-1 drugs / weight-loss injections – Active ingredients such as semaglutide with great social and financial significance. Medicine
Gut health / microbiome – The composition of gut bacteria and its influence on the immune system, metabolism and mental health. Medicine
H
Happiness research – Scientific study of life satisfaction, for example in the World Happiness Report. Well-being
Health conventions (Gesundheitskonvente) – Proposed regional bodies with representatives of citizens, health care providers, the public health service (ÖGD) and payers. Governance
Health data use / EHDS – Use of health data for research – nationally via the GDNG and the Research Data Center, EU-wide in the European Health Data Space. Digitization
Health Finance Commission (Finanzkommission Gesundheit) – Expert panel for cost-cutting proposals in statutory health insurance (GKV). Reform & financing
Health ID – Digital proof of identity for insured people to access the ePA, e-prescriptions and other services. Digitization
Health Impact Assessment – Advance assessment of the health impacts of policy projects outside the health sector. Prevention & public health
Health inequality – Systematic differences in life expectancy and burden of disease depending on social status. Ethics & participation
Health insurer mergers – Consolidation into fewer, larger insurers – the hope is administrative savings, the fear is less competition. Reform & financing
Health kiosks / community health nurses – Low-threshold points of contact, often in disadvantaged neighborhoods. Care structures
Health literacy – The ability to understand and use health information. Prevention & public health
Health Technology Assessment (HTA) – Systematic evaluation of the benefits, costs and consequences of a health technology before reimbursement. Governance
Healthspan – The number of healthy years of life rather than mere lifespan. Longevity
Heat protection – Protection plans against the health effects of heat waves. Prevention & public health
Hospital at Home – Hospital treatment in your own home. Care structures
Human Enhancement – Umbrella term for interventions intended to enhance abilities beyond the healthy norm. Longevity
Hybrid DRG – Uniform reimbursement for procedures, regardless of whether they are outpatient or inpatient. Reform & financing
I
Informal care / family caregiving – Most care takes place unpaid within families – making it the quietest pillar of the system. Care structures
Integrated emergency centers (INZ) – Joint points of contact of hospitals and the on-call medical service for emergencies. Governance
Integrative medicine – Conventional medicine combined with complementary methods. Medicine
International recruitment of skilled workers – Recruiting health care staff from abroad. Care structures
Interoperability – The ability of different IT systems to exchange data. Digitization
Interregional benchmarking – Transparent comparison of structures, processes and outcomes between regions. Governance
L
Learning health system – A system that continuously analyzes care data and feeds the results directly back into practice. Governance
Levels of care – Assigning conditions to facilities according to complexity, case numbers and equipment. Governance
Loneliness as a health risk – Loneliness as a public health issue. Prevention & public health
Long Covid / ME-CFS – Long-lasting exhaustion and secondary illnesses after infections, with care that has so far been patchy. Medicine
Longevity – Extending healthy years of life through lifestyle, biomarker tracking and medical interventions. Longevity
Looksmaxing – Optimizing your own appearance as far as possible; controversial because of risky practices. Longevity
M
Mandate to ensure care (Sicherstellungsauftrag) – The statutory duty of the Associations of Statutory Health Insurance Physicians to guarantee nationwide outpatient care. Care structures
-maxxing trends – Umbrella term for optimization trends such as sleepmaxxing or looksmaxing. Longevity
Medical tourism – Treatment abroad – for cost reasons, because of waiting times or for services not offered at home. Care structures
Mental Health – Mental health as a care field of its own – from prevention and psychotherapy to waiting times for children and adolescents. Prevention & public health
Microdosing – Taking tiny amounts of psychoactive substances to boost mood or performance. Longevity
Mindfulness – Conscious, non-judgmental awareness of the present moment. Well-being
Minimum volumes and quality indicators – Thresholds and metrics that restrict elective procedures to sufficiently experienced hospitals. Governance
Morbi-RSA (morbidity-based risk structure compensation) – Financial equalization between health insurers based on the burden of disease of their insured. Reform & financing
mRNA technology – A platform that instructs the body’s cells to produce active substances themselves – beyond vaccines, also in cancer therapy. Medicine
Multimorbidity – Several chronic diseases at the same time – the norm in old age, not the exception. Medicine
MVZ / investor-owned MVZ – Medical care centers (Medizinische Versorgungszentren) with employed physicians; politically controversial when owned by capital investors. Care structures
N
National health care goals – Politically set, measurable goals for health care, supplemented by resilience goals for crisis situations. Governance
Needs-based planning (Bedarfsplanung) – Set of rules that determines how many physician practice licenses and hospital capacities a region receives. Care structures
Neuroenhancement / nootropics – Substances and methods for improving concentration and memory. Longevity
Neurofeedback / brainwave tracking – Measuring brain activity via EEG in order to deliberately influence concentration, relaxation or sleep. Longevity
Nursing Competence Act (Pflegekompetenzgesetz) – More independent authority for registered nurses. Care structures
O
ÖGD (public health service) – Local health offices and state authorities – responsible for infection control, prevention and health reporting. Prevention & public health
One Health / Health in All Policies – Health as a cross-cutting issue across government departments, animal and environmental health. Prevention & public health
Opt-out – The ePA is created automatically for everyone; anyone who doesn’t want it has to actively object. Digitization
Out-of-pocket costs – Costs that insured people pay themselves – most noticeably the rising out-of-pocket costs in nursing homes. Reform & financing
Overuse, underuse and misuse of care – Too much, too little or the wrong thing – the classic trio of misaligned incentives. Governance
P
Palliative care – Care aimed at quality of life and symptom control rather than cure. Medicine
Patient autonomy – The right to decide about your own treatment – even against medical advice. Ethics & participation
Patient Empowerment – Enabling patients to make informed, self-determined decisions about their treatment. Ethics & participation
Patient navigation – Deliberately guiding patients to the appropriate level of care. Care structures
Pay-for-Performance (P4P) – Portions of reimbursement tied to achieved quality or outcome indicators. Governance
Personalized medicine / precision medicine – Therapy tailored to genes, biomarkers and lifestyle. Medicine
Pflexit / exodus from nursing – Qualified nurses leaving the profession because of workload, pay and working hours. Care structures
Pharmacy reform – Restructuring pharmacy services, including with a view to rural pharmacies. Reform & financing
Physician Assistant – Academically trained physician assistants who take on delegated medical tasks under a physician’s responsibility. Care structures
Planetary Health / Green Hospital – Climate protection and sustainability in health care. Prevention & public health
Polypharmacy and deprescribing – Long-term use of many medications – and the targeted discontinuation of unnecessary drugs. Medicine
Positive psychology – Research on strengths, meaning and life satisfaction. Well-being
Prevention paradox – Prevention usually only pays off in the long term, while the consequential damage of inaction is hardly ever accounted for. Governance
Preventive medicine – Medical action that prevents diseases or detects them early instead of treating them later. Medicine
Primary care centers (PVZ) – Team practices in which family doctors, nurses and therapy professions provide care under one roof. Care structures
Primary care physician system / primary care – The family doctor as the first point of contact who refers patients onward. Care structures
PROMs and PREMs – Patient-reported outcome measures (PROM) and patient-reported experience measures (PREM). Prevention & public health
Psychedelic-assisted therapy – Use of substances such as psilocybin or ketamine for depression and PTSD, currently in clinical trials. Medicine
Q
Quintuple Aim – A set of goals comprising patient experience, population health, cost efficiency, health equity and staff well-being. Prevention & public health
R
Reducing bureaucracy – Cutting documentation requirements in medical practices and nursing care. Reform & financing
Regional budget – A budget for a care region based on morbidity-related need. Governance
Regionalization and centralization – Two opposing governance logics: organizing care close to where people live, or concentrating it in specialized centers. Governance
Remote Patient Monitoring – Monitoring vital signs at home via connected devices. Digitization
Resilience – Psychological resilience to stress. Well-being
S
Salutogenesis – A change of perspective: what keeps people healthy, rather than what makes them sick? Well-being
Self-governance – Governance of statutory health insurance by insurers, physicians and hospitals rather than directly by the state. Reform & financing
Self-tracking / Quantified Self – Measuring your own sleep, pulse, steps, etc. Longevity
Senolytics – Active substances intended to remove aging cells – so far mostly experimental. Longevity
Service groups (Leistungsgruppen) – Core element of the hospital reform: hospitals may only provide defined services if they have proven equipment and staffing. Reform & financing
Shared Decision Making – Treatment decisions made jointly by clinicians and patients, based on evidence and personal preferences. Ethics & participation
Shift to outpatient care (Ambulantisierung) – Moving treatments from the hospital into the outpatient sector. Care structures
Shortage of skilled workers and physicians – Structural lack of staff in nursing, primary care and the therapy professions, aggravated by the age structure of the workforce. Care structures
Skill mix / delegation – Distributing tasks across different professional groups. Care structures
Sleepmaxxing – Deliberately optimizing sleep quality and duration. Longevity
Social determinants of health – Income, education, housing and work shape health more strongly than medical care itself. Prevention & public health
Social guarantee (Sozialgarantie) – Political pledge to cap total social security contributions at around 40 percent. Reform & financing
Social Prescribing – Doctors “prescribe” social activities such as clubs or courses. Prevention & public health
Standby funding (Vorhaltevergütung) – New reimbursement component of the hospital reform: hospitals are paid for the service groups they keep available, not just for case numbers. Reform & financing
Structural Commission on Long-Term Care (Strukturkommission Pflege) – Newly announced body for a fundamental reform of long-term care. Reform & financing
T
Telematics infrastructure (TI) – Closed network connecting practices, hospitals, pharmacies and health insurers – the technical foundation for the ePA and e-prescriptions. Digitization
Telemedicine / video consultation – Medical treatment at a distance. Digitization
Telenursing – Nursing advice and support via video or sensors, for example for wound monitoring. Care structures
Trust in institutions – A prerequisite for data use, vaccination campaigns and patient navigation to be accepted. Ethics & participation
Two-tier medicine – The accusation that privately and statutorily insured patients receive different care, for example in waiting times and appointments. Ethics & participation
V
Vaccine hesitancy / infodemic – Reluctance to get vaccinated and the flood of contradictory health information that amplifies it. Prevention & public health
Value-based Healthcare – Reimbursement based on treatment outcomes rather than volume. Reform & financing
W
Wearables / Smart Rings – Smartwatches, rings, trackers and sensors that continuously measure pulse, sleep and activity. Digitization
Well-being / Wellness – Holistic physical, mental and social well-being. Well-being
Wellbeing Economy – An economic model with well-being rather than GDP growth as its goal. Well-being
Women’s Health / FemTech – Medicine and digital services for long under-researched topics such as the menstrual cycle, endometriosis and menopause. Medicine
Workplace health management (BGM) – Health promotion by employers. Prevention & public health
Are we missing any trends or topics in this collection? Then feel free to write to us: zukunft@schaltzeit.com – we’ll take your suggestions with us to the workshop in Cologne.
Further reading:
