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© Johanna Fick
[Translate to English:]
Institute of

LV Rural Studies


Digitalisation of basic services in rural areas

© Rido -

Digitalisation of basic services in rural areas. Opportunities and challenges in the field of medical care  

Digital technologies can contribute to improve basic service provision, even in sparsely populated and peripheral regions. At the same time, there are obstacles to the creation of new types of digitally-based solutions, such as a lack of broadband connections, human resources or technical knowledge. With a focus on the field of medical care, the project will analyse which actors, processes and structures have a significant influence on the digitisation of basic services in rural areas at the local, regional and supraregional level and how innovative solutions can be supported.

Background and Objective

As a current megatrend, digitalisation is changing almost all areas of society and thus also basic service provision. New solutions are often first developed and tested in large cities ("smart cities"). In contrast, many needs for action and potential for improvement, including in the field of medical care, are especially distinct in sparsely populated and peripherally located rural regions. Here long distances and thin public transport networks make it difficult for people to visit surgeries and hospitals. Doctors have to travel long distances for home visits and emergencies, and specialists and clinics in smaller towns and villages can hardly work economically due to limited demand. In view of this, digital solutions may help to overcome physical distances without wasting time, save travel costs and serve smaller locations. For doctors, telemedicine opens up possibilities to care for patients from a distance, to intervene quickly in emergency situations and to cooperate with specialists from more distant regions. 

However, a specific focus on rural areas is not only relevant with regard to the opportunities, but also with regard to the challenges of digitalisation in medical care and other fields of basic service provision. Debates on territorial peripheralization problematise the resource bottlenecks of structurally weak rural regions, including financial, personnel and infrastructural (e.g., broadband) aspects, impeding effective digital basic service solutions.

Nevertheless, research on digital basic services has so far been largely urban. The few rural studies concentrate strongly on the meso level of selected projects. With our analyses on medical care, we broaden this perspective and focus on the micro-level of the IT professionals, doctors and patients acting on site, their access to resources and their helpful network contacts. In reconstructing the latter, the supra-regional macro-level and the key institutions acting there (e.g., association of statutory health insurance physicians, health insurance funds and health ministries) are also taken into account. With this multi-level analysis, we pursue the goal of working out the opportunities and challenges of digital solutions for medical care and other basic services.

Target Group

Science; BMEL; designers and providers of rural basic services


Literature research; document analyses; expert interviews; analysis of social, economic and spatial structural data; qualitative interviews with providers and users of digital solutions; ego-centred network analyses with key persons.

Our Research Questions

  • What digital solutions for medical care already exist in rural regions and what practical experience has been gained?
  • What contribution can digital solutions make to securing and improving medical care in rural regions?
  • What resources do regional actors need to develop, implement and disseminate effective and efficient digital solutions?
  • What is the importance of supra-regional key institutions (e.g., ministries of health, associations of statutory health insurance physicians, health insurance funds) in these processes?
  • How do patients living in rural areas accept digital solutions for medical care?
  • To what extent do the different social, economic and spatial contextual conditions of rural regions affect the realisation of digital solutions for medical care?


6.2022 - 5.2026

More Information

Project status: ongoing

Publications to the project

  1. 0

    Mettenberger T (2024) Telemedizin in der ländlichen Gesundheitsversorgung - Potenziale und Hürden aus Expert:innensicht. Z'GuG 47(2):180-198, DOI:10.5771/2701-4193-2024-2-180

  2. 1

    Mettenberger T (2024) Vielfältige ländliche Räume in Deutschland : Implikationen für die Erbringung und Nutzung von Daseinsvorsorgeangeboten. In: Hammer V (ed) Demokratie lernen : Ländliche Räume und Volkshochschulen. 1. Auflage. Weinheim: Beltz Juventa, pp 197-209, DOI:10.3262/978-3-7799-7472-7

  3. 2

    Mettenberger T, Küpper P (2021) Innovative Versorgungslösungen in ländlichen Regionen: Ergebnisse der Begleitforschung zum Modellvorhaben Land(auf)Schwung im Handlungsfeld "Daseinsvorsorge". Braunschweig: Johann Heinrich von Thünen-Institut, 258 p, Thünen Rep 90, Band 1, DOI:10.3220/REP1634815865000

  4. 3

    Küpper P, Brensing J, Bergholz C, Mettenberger T, Pollermann K, Tuitjer G (2021) Ländliche Regionen entwickeln: Erkenntnisse der Begleitforschung zum Modellvorhaben Land(auf)Schwung für die Praxis. Braunschweig: Thünen-Institut für Ländliche Räume, 127 p

  5. 4

    Mettenberger T, Zscherneck J, Küpper P (2021) Wenn Neues aufs Land kommt. Entwicklung, Umsetzung und Verbreitung innovativer Lösungen zur digitalen Daseinsvorsorge. Raumforsch Raumordn Spat Res Plann 79(6):543-556, DOI:10.14512/rur.90

  6. 5

    Küpper P, Mettenberger T (2020) Regionale Anpassungsstrategien der Daseinsvorsorge für schrumpfende ländliche Räume. Europa Regional 26(3):22-39

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