INTERNAL MARKET FOR INCLUSIVE AND ASSISTIVE ICT
ATIS4ALL
Sebastiaan van der PeijlMadrid, 14 March 2011
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Contents
Aims and objectivesScopeApproachEU policy contextMain findings of the studyConclusionsRecommendations
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Aims and objectives
Main research question:“What are the main barriers and opportunities today in the European Internal Market for Assistive
ICT, and what could be gained in terms of economic and social impacts derived from addressing barriers and embracing opportunities in the market for Assistive ICT?”
Tasks:– Gather representative evidence on the market for Assistive ICT products and services in
Europe, including market mechanisms.– Analyse barriers and opportunities in relation to social and economic impact associated
with the use of Assistive ICT, including the impact for users, the Assistive ICT industry and the administrations.
– Propose recommendations for improvement, building on the advice of experts and relevant stakeholders.
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Scope
9 Member States: ES, DE, DK, FR, IT, LV, NL, SE, UKAssistive ICT:
External Assistive ICT
Independent Living
Work
Education & Training
ICTAccessible
ICT
Embedded Assistive ICT
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Approach
Extensive desk researchMS and EU level interviewsCase StudiesScenarios
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EU policy contextUN convention: signed and ratified by the EU, signed by all MS (ratified by 16), protocol signed by 22 MS (ratified by 14)
European Disability Strategy (2010-2020): equal rights, dignity, treatment, independence, full participation
– Accessibility: improving the availability and choice of assistive technologies, public procurement
– Participation: e.g. use of sign language, Braille, accessible websites and copyrighted works, etc.
– Employment, education, independent living, health: focus on sound working conditions, personal-assistance schemes, legal and organisational barriers, inclusive education, non-discriminatory health services and facilities, disability part of curricula of health professionals
– MS cooperation: information exchange and policy coordination (High Level Group on Disability)
– Awareness raising and data collection
European Accessibility Act in 2012?– To substantially improve the proper functioning of the internal market for accessible
products and services
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EU policy context
Digital Agenda– Enhancing digital literacy, skills and inclusion– Inclusive digital services, web accessibility, ambient assisted living
e-Inclusion: e-Accessibility– Ensure that people with disabilities and elderly people can access ICTs
on an equal basis with others
e-Accessibility and Assistive Technology (AT):– Design for All: universal design, adaptive design,
interfacing/interoperability with AT– Public procurement & Mandate 376
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Provision of assistive ICT in the EU The market for assistive ICT
No recent and consistent data on people with a disability on the EU level (only 2002 LFS Eurostat)No quality data on take-up of ICT by people with a disability (some MS-data)No quality data on take-up of assistive ICT (some studies (MEAC, AEGIS))Little data on public expenditure on Assistive ICT (some data in e.g. NL GIPdatabank)No consistent data on the assistive ICT supply (only national databases)
Romania
Italy
Slova
kia
Lithuan
iaMalt
aSp
ain
Greece
Irelan
d
German
y
Hungary
Luxe
mbourg
Cypru
s
Austria
EU 25
Norway
EU 15
Belgium
Slove
nia
Denmark
Portuga
l
Swed
en
Czech Rep
ublic
Estonia
France
Netherl
ands
United Kingd
om
Finlan
d0.05.0
10.015.020.025.030.035.0
Disability prevalence rates across countries
Source: EUROSTAT
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Provision of assistive ICT in the EU The market for assistive ICT (public) service
provider
Manufacturers / distributors
People with a disability
Disability organisations
(e.g. associations, charities, NGOs,
etc)
Source: Robotiker–Tecnalia, 2009
Different actors involvedGov support schemes implemented by (public) service providers: Service Deliver Models (SDM)SDMs play an important role in the value chain: financing and procurement.
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Provision of assistive ICT in the EU Service Delivery Models
Different types of SDM:– Medical / social model:
• Service providers act as intermediaries• People with a disability are generally not the final
decision makers
– Consumer oriented model:• Service providers act as advisor and funding provider• People with a disability, or a representative, are the
final decision makers
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The most prevailing type of SDM is the medical/social modelFreedom of choice: often none (limited to lists), but more freedom of choice schemes are being implemented (e.g. DE, DK, NL, SE)SDMs have an important influence, they are the main buyers on the market
Provision of assistive ICT in the EU Service Delivery Models
Education Work Home/independent living
Denmark M/S Mixed: M/S, C Mixed: M/S, CFrance M/S Mixed: M/S, C Mixed: M/S, CGermany Mixed: M/S, C Mixed: M/S, C Mixed: M/S, CItaly M/S M/S M/SLatvia M/S, limited * M/S, limited * M/S, limited*The Netherlands
M/S M/S Mixed: M/S, C
Spain M/S M/S M/S or noneSweden Mixed: M/S, C M/S Mixed: M/S, CUnited Kingdom
M/S M/S M/S
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Provision of assistive ICT in the EUA complex reality…
Government support differs widely across MS and life environments, even regions:
– different beneficiary types, different actors involved, differences in prescription or reimbursement processes, different types of procurement, different governance models (more or less decentralised), different levels of coverage (ranging from full reimbursement models to none, depending on the country/region), differences in eligible products...
Overlaps between the different systems across the life environments can result in unclear responsibilitiesDisabled people face a complex environmentAssistive ICT companies similarly face a complex environment
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Provision of assistive ICT in the EUA complex reality…The market structure for Assistive ICT can be characterised by ‘supply push’: companies compete to get in the SDM system, lower attention to end-users
Some key dimensions emerged and were addressed through case studies
People with a disability
Manufacturers / Distributors
of Assistive ICT
Service Delivery Models
Supply push
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Provision of assistive ICT in the EUImportant trends / opportunities
In the work environment, support schemes are usually well defined, supported by the focus on reasonable accommodationFreedom of choice schemes are on the rise, either with a reimbursement or personal budget scheme (e.g. DE, DK, NL, SE)Function vs. Form debate: functional descriptions of products eligible for funding (e.g. NL, SE)Many organisations are active in the MS to provide information and advice to people with a disabilitySingle points of access are hardly established, with exceptions in e.g. DE, FR
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Provision of assistive ICT in the EUMain findings
Different levels of coverage
Different actors in the
life environments
Localised MarketsLong supply chains
Limited cross border trading within the Internal
Market
Non-transparent pricing, can lead to high prices and
price differences
De facto restrictions on market entry Small production volumes
High investment for market entry
In some cases: high margins
Different types of support
Supply: Company perspective
Demand: End-user perspective
High efforts to get access to funding and the right
solutions
Limited choice
Lack of information / independent advice
Need to work through local distributors or local
presence
Difficulties with overlap in different life environments
Service Delivery Models
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Case studies
Main findings from the case studies2 Case studies on
freedom of choice (DE, SE)
2 Case studies on info provision(ES, UK)
1 Case study on internet and mobile uptake
1 Case study on pricing of assistive ICT
1 Case study on product and cross-border activity
Freedom of choice turns people with a disability into decision makers and stimulates the market.
Information is key to a successful implementation of a freedom of choice scheme. Information will increasingly be provided by manufacturers themselves, government will also have a role to play.
Stark differences across Europe. High market potential for assistive ICT
Price differences occur within the internal market, due to complex supply chains and other factors
Most EU assistive ICT companies do not operate cross border and are highly specialised, targeting niche segments of the market
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Case Studies (1/7)
Freedom of choice in Sweden (Fritt Val)– User empowerment:
• Better informed, better choices• Function vs. form
– Stimulating the market: • Closer relations with the customer• Bundling: services and extra features• Price reduction
– At no additional cost
Potential for: more user focus, better information provision, more competition.
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Case Studies (2/7)
Freedom of choice in Germany (Persönliches Budget)– Public agencies:
• Fear of loosing control over: the system, the quality, type of fundable devices
• Higher administrative costs• Non-standardised admin procedure and faulty
individual target agreements
– Stimulating the market: new user group expected to emerge, more competition and innovation
Transition issues, but expected to grow
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Case Studies (3/7)
Information provision by local charities in the UK– The need for: ‘good information’, close customer relationships,
services close to the user (e.g. assessment, training)– Local charities:
• Information provision, awareness, try out ATs, conferences, exhibitions
• Geographically close to users, no registration required• Support informed decision making: both for occupational therapists
and end-users• Provide ‘second-tier’ assessment and training to meet specific needs• Established networks with: suppliers, agencies, technology
networks, education& training inst. / employers, end-users
Filling the gap: enabling blind people, market facilitation
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Case Studies (4/7)
Information provision by RETADIS in Spain– Try out assistive ICT:
• 26 centers throughout Spain with computers and assistive ICT + 50 private home-users
• RETADIS social network: contact with peers, forums, newsletters
• Training by occupation therapists and for education and work
Bringing together stakeholders, manufacturers, end-users, occupational therapists for better information and hands-on experience
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Case Studies (5/7)
Product pricing of Assistive ICT– CNSA, AT price-monitoring agency
• Issues: complexity of use, prices differences, difficulties for new entrants, knowledge of professionals
• Recommendations: information sharing between beneficiaries and distributors, showrooms and regional centers, include training in public funding
– Non-transparency is a big issue
Opportunities for improvement– Need for product reviews– Separation of services from product pricing– e-Commerce provides transparency– towards a more Consumer Oriented Model
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Case Studies (6/7)
Assistive ICT supply– Based on 8 National Databases (810 Assistive ICT companies)– Available information is inconsistent across databases– The analysis adds insight, but the market remains opaque
Fragmentation: narrow markets, mostly SMEsNumber of ISO subcategories per company (total sample)Average ISO groups per company 1.523
Companies with 8 ISO groups 3
Companies with 7 ISO groups 3
Companies with 6 ISO groups 13
Companies with 5 ISO groups 10
Companies with 4 ISO groups 22
Companies with 3 ISO groups 47
Companies with 2 ISO groups 120
Companies with 1 ISO group 592
Total number of companies in sample 810Total Number of assistive ICT companies in the overall sample per ISO 22 subcategory(multiple presence of companies possible)
ISO 22.03
ISO 22.06
ISO 22.09
ISO 22.12
ISO 22.15
ISO 22.18
ISO 22.21
ISO 22.24
ISO 22.27
ISO 22.30
ISO 22.33
ISO 22.36
ISO 22.39
126 16 9 65 12 57 155 252 67 79 28 371 135
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Case Studies (6/7)
Origin of foreign companies per countryCountries of origin of foreign companies
Database
DE DK ES FR IT NL SE UK US Others Foreign companies
DE - 1 2 1 2 2 4 8 27 11 58DK N/A - N/A N/A N/A N/A N/A N/A N/A N/A N/AES 1 0 - 1 0 0 0 1 1 1 5FR 10 2 1 - 2 4 4 12 30 26 91IT 10 1 3 7 - 5 6 15 42 19 103NL N/A N/A N/A N/A N/A - N/A N/A N/A N/A N/ASE N/A N/A N/A N/A N/A N/A - N/A N/A N/A N/AUK N/A N/A N/A N/A N/A N/A N/A - N/A N/A N/A
Little cross border presence:International presence of assistive ICT companies in the sample (8 countries)Average presence of companies (number of countries in sample)
1.162
Companies with presence in 5 countries 2
Companies with presence in 4 countries 8
Companies with presence in 3 countries 26
Companies with presence in 2 countries 48
Companies with presence in 1 countries 726
Total number of companies in sample 810
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Case Study (7/7)
Estimating demand for Assistive ICT– Lack of data on both the PWD population and the
take-up of Assistive ICT
Assessment of internet and mobile phone uptake: 1. Estimation of PWD population2. Estimation of internet uptake3. Estimation of assistive ICT uptake
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Case Study (7/7)
Methodology: estimating internet uptake for PWDs
0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.90
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
f(x) = 0.0534130706013989 exp( 2.99839594437232 x )R² = 0.972246698921777
Exp.function fitting
PWDExponential (PWD)
General population
PWD
popu
latio
n
Austria
Belgium
Bulgaria
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Ireland
Italy
Latvia
Lithuania
Luxembourg
Malta
Netherlands
Poland
Portugal
Romania
Slovakia
SloveniaSpain
Sweden
United Kingdom
y = 0.0534e2.9984x
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1
Fitted
value
s for
PWDs
uptak
e
General population uptake
exp fitted values
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Case Study (7/7)
Methodology: internet uptake rates for PWDs
00.10.20.30.40.50.60.70.80.9
Au
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De
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Esto
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Fin
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EU-2
7
internet uptake rate forPWDs in the EU (2009)
0.00
0.10
0.20
0.30
0.40
0.50
0.60
Au
stri
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Be
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Bu
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Cyp
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Cze
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De
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Esto
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Fin
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Fran
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Ge
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Gre
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Hu
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Ire
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Ital
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Latv
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Lith
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Luxe
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Mal
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Ne
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Po
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Ro
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Slo
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Slo
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Spai
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Swe
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Un
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ingd
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EU-2
7
Internet use age group 65-74 (2009)
uptake 65-74
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Case Study (7/7)
Methodology: assistive ICT uptake rates for PWDs
0
500000
1000000
1500000
2000000
2500000
3000000
Austr
iaBe
lgium
Bulga
riaCy
prus
Czec
h Rep
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Denm
ark
Esto
niaFin
land
Fran
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Hung
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Latvi
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Polan
dPo
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mania
Slova
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Swed
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ited K
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PWDs using assistive ICTs to access the internet
assistive ict use pwds 15-64
assistive ict use pwds 65+
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Case Study (7/7)
Methodology: assistive ICT uptake rates for PWDsMain results:– Estimation of more than 29 million disabled people
using internet in the EU in 2009• 21 million aged 15-64, • 8 million aged above 65
– Estimation of 9.86 million EU citizens already using assistive ICT to access the internet in the EU
– Large existing disparities in uptake, especially for old people
– Internet uptake is increasing fast
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Scenarios
Conceptual framework Freedom of choice
Awareness and information
Level of competition in the assistive ICT market
Competitive pricing
Demand:informed and empowered consumers
Supply: competitive supply of assistive ICT
Supplypush
Demandpull
Supp
ly
Demand
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Demand: informed & empowered usersFreedom of choice & information, awareness
Freedom of choice, drivers– User empowerment– Role of SDM– Functional description of needs– Mainstreaming– e-Commerce
Awareness and information, drivers:– Digital literacy– Close relationship with consumers– Multi-stakeholder approach– Independent information / advice– Training
Freedom of choice
Awareness and information
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Supply: competitive supply of A-ICTLevel of competition & pricing
Competition, drivers:– Transparency– Competition IN the market not FOR the market– Barriers within the market– e-Commerce
Pricing, drivers:– Transparency– Supply chain– Comparing– Knowing what you pay for
Level of competition in the assistive ICT market
Competitive pricing
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Demand and supplyDemand pull and supply push growth
Demand: informed and empowered consumers
Supply: competitive supply of assistive ICT
Supply push
Demand pull
Freedom of choice
Awareness and information
Level of competition in the assistive ICT market
Competitive pricing
Demand
Sup
ply
Scenario 4:Large scaledemand pull
Scenario 1: supply push
Scenario 2: supply push with increased awareness
Scenario 3: small scale demand pull
Scenario 4: large scale demand pull
Freedom of choiceLimited increase Limited increase High Fully available
Information & awareness Limited increase Increased High Fully aware
CompetitionIncrease,
Reduced marginsIncrease Increased High
Competitive pricing Minor changes Increased Increased High
Scenario 1Scenario 2Scenario 3Scenario 4
Demand: informed and empowered consumers
Supply: competitive supply of assistive ICT
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Toward a consumer oriented market
User empowerment, more transparent market, closer customer relations, more cross-border trade, changing the role of SDMs
People with a disability
Manufacturers / Distributors
of Assistive ICT
Service Delivery Models
Demand pull
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Forecasting exerciseImpact on the market
Based on internet uptake:
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Forecasting exercise Impact on the market
Impact on internet uptake
2010 2012 2014 2016
Austria 561,325 853,393 1,124,505 1,338,905Belgium 1,086,415 1,564,422 1,963,778 2,269,527Bulgaria 230,744 449,159 731,082 1,007,122Cyprus 24,904 49,783 79,102 107,503Czech Republic 742,025 1,198,437 1,665,558 2,047,361Denmark 869,481 1,070,888 1,208,964 1,267,217Estonia 134,847 198,362 256,355 301,029Finland 1,066,818 1,359,316 1,591,930 1,726,066France 6,375,984 9,427,246 12,378,853 14,836,371Germany 6,838,776 9,610,234 11,755,177 13,241,029Greece 212,728 415,706 717,307 1,058,091Hungary 397,629 672,632 984,222 1,260,813Ireland 223,826 370,360 514,965 637,203Italy 1,149,297 2,518,188 4,208,465 5,883,910Latvia 136,433 218,188 296,378 360,048Lithuania 94,242 173,014 256,638 332,397Luxembourg 51,304 64,742 75,050 80,810Malta 16,160 27,925 40,385 50,859Netherlands 3,399,454 4,018,832 4,367,321 4,478,640Poland 1,847,128 3,167,317 4,588,220 5,836,980Portugal 452,116 877,234 1,388,599 1,868,047Romania 211,264 496,229 908,198 1,380,916Slovakia 239,376 356,324 474,583 577,287Slovenia 133,338 218,181 305,834 379,787Spain 1,593,669 2,892,120 4,283,536 5,528,850Sweden 1,620,299 1,940,472 2,130,547 2,201,595United Kingdom 11,251,668 14,441,832 16,753,777 18,017,768European Union (27 countries) 35,867,061 57,509,219 76,765,969 91,506,917
2010 2012 2014 20160
10,000,00020,000,00030,000,00040,000,00050,000,00060,000,00070,000,00080,000,00090,000,000
100,000,000
EU 27, estimated internet uptake by PWDs
European Union (27 coun-tries)
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Forecasting exerciseImpact on the market
Impact on assistive ICT usage
2010 2012 2014 2016
Austria 190,851 290,154 382,332 455,228Belgium 369,381 531,903 667,684 771,639Bulgaria 78,453 152,714 248,568 342,421Cyprus 8,468 16,926 26,895 36,551Czech Republic 252,289 407,468 566,290 696,103Denmark 295,624 364,102 411,048 430,854Estonia 45,848 67,443 87,161 102,350Finland 362,718 462,167 541,256 586,863France 2,167,835 3,205,264 4,208,810 5,044,366Germany 2,325,184 3,267,480 3,996,760 4,501,950Greece 72,328 141,340 243,884 359,751Hungary 135,194 228,695 334,635 428,676Ireland 76,101 125,922 175,088 216,649Italy 390,761 856,184 1,430,878 2,000,529Latvia 46,387 74,184 100,768 122,416Lithuania 32,042 58,825 87,257 113,015Luxembourg 17,443 22,012 25,517 27,475Malta 5,494 9,495 13,731 17,292Netherlands 1,155,814 1,366,403 1,484,889 1,522,738Poland 628,023 1,076,888 1,559,995 1,984,573Portugal 153,719 298,260 472,124 635,136Romania 71,830 168,718 308,787 469,512Slovakia 81,388 121,150 161,358 196,278Slovenia 45,335 74,182 103,983 129,128Spain 541,847 983,321 1,456,402 1,879,809Sweden 550,902 659,761 724,386 748,542United Kingdom 3,825,567 4,910,223 5,696,284 6,126,041European Union (27 countries) 12,194,801 19,553,134 26,100,429 31,112,352
2010 2012 2014 20160
5,000,000
10,000,000
15,000,000
20,000,000
25,000,000
30,000,000
35,000,000
EU 27, estimated assistive ICT use
European Union (27 coun-tries)
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Forecasting exerciseImpact on the market
Estimates are based on assumptions and are projected in accordance with the S-curve of the NetherlandsActual internet take-up developments depend on many exogenous factors, such as general development of internet connections (infrastructure), digital literacy, etc.Yet, this analysis shows the expected direction, although country specifics should be taken into accountThis also shows that currently there is a large unexploited market potential
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Conclusions The impact of the role of government
Public procurement: – Can reduce cost (e.g. volume contracts) – But leads to competition FOR the market not IN the
market: i.e. market distortion– Result: a heterogeneous EU Market (mainly local markets),
limited economies of scale for producers, limits incentives for R&D and investment
Information provision:– Training of professionals in the SDM is essential– End-user should be aware and well informed
Funding:– Uneven across MS, as well as prices paid by the SDM
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ConclusionsFunction vs Form
Away from ‘positive lists’ of eligible products…– Keeping positive lists up-to-date is cumbersome or
simply not happening (e.g. IT)– It can take a lot of time for new products to become
‘eligible’
…towards a function based approach (with possibly a ‘negative list’)– A function based approach opens up opportunities
for new products, innovation– A function based approach enables choice and user
empowerment
- 40 -
ConclusionsTowards a Consumer Oriented Model
Empower people with a disability: decision makersEncourage interaction between companies and end-users: closer customer relationships, more information aimed at people with a disability (direct marketing, try-out sessions)Scope for reduced prices (e.g. SE)Mentality change: SDM becomes principally advisor and funding providerSingle access points, across life environments
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ConclusionsDemand
Information provision: essential for professionals and end-users, the internet offers important opportunities (e-Commerce, product reviews, etc)Empowerment: more focus on desirable products (less stigma)Training: also essential for both end-users and professionalsMaintenance, upgrades: clear rules are needed
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ConclusionsSupply
Market fragmentation: mostly local markets, small companiesLack of transparencyDistributors are essential today for local market accessLong supply chains: high pricesFocus on SDM reduces consumer orientationMore consumer orientation opens possibilities for: – easier market access– more competition– lower prices– potentially better after sales services– e-Commerce– more information aimed at the end-user– increased economies of scale and incentives to invest and conduct R&D– mainstreaming: accessible mainstream solutions become attractive
alternatives, incentives for Design for All
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ConclusionsData availability
There is a general lack of statistics– People with a disability: wide divergence due to different applied
definitions across MS, lack of cross-country comparable data– Use of ICT and assistive ICT: only ad-hoc national measurements– Supply of assistive ICT: definition of assistive ICT: ISO 9999 Cat 2? EU
NACE has no classification for A-ICT, resulting in lack of data
Demand SupplyDemographics -> uptake
Prevalence of disability Work, Education, Independent Living:
nr of PWD (un)emplyment rate, supported employment
nr of PWD in mainstream/special education, educational attainmentnr. of PWD living independently
Uptake of Information and Communication Technology by PWD(only available in some countries)Uptake of Assistive ICT by PWDExpenditure (public and private)-not available at the granular level of assistive ICT
Market information -> market structure
Nr of companiesMarket share (e.g. sales / turneover)Pricing and profitabilityLevel of competitionDistribution channels
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Recommendations
Shaping a more competitive and better functioning market for assistive ICTImprove the availability of data:– common and consistent definition and measurement of people
with a disability and their use of ICT and assistive devices– need for granular data on MS expenditure– need for an extensive survey at an EU level– a common taxonomy of assistive ICT
Fine-tune the role of government: – consumer oriented, empower the end-user, freedom of choice– provision of independent information and advice– a common functional list for Europe– establish single access points
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