Exploring the future of digital health services for older adults in Iran using the GBN scenario planning method

Background Population aging is one of the most important demographic transitions of the twenty-first century and is creating new demands for health and social welfare systems. In Iran, rapid population aging, expanding digital transformation, and persistent inequities in access to care have made the future of Digital Health Services (DHS) for older adults increasingly uncertain. This study aimed to explore plausible future pathways for the development of DHS for older adults in Iran using the scenario planning approach by Global Business Network (GBN) method. Methods This exploratory qualitative futures study was conducted in three phases using the GBN scenario planning method. In the first phase, five Focus Group Discussions (FGDs) were held to identify factors influencing the future of DHS for older adults in Iran. These factors were organized according to the STEEP (Social, Technological, Economic, Environmental, and Political) framework into social, technological, environmental, economic, and political dimensions. In the second phase, an expert panel scored the identified factors according to importance and uncertainty. In the third phase, a scenario-building workshop was conducted to develop future scenarios based on the key scenario-driving axes, where the intersecting axes formed the basis of a two-dimensional scenario framework generating four distinct future scenarios for the 2035 horizon. Results A total of 70 variables influencing the future of older adult care were initially identified, of which 20 key variables remained after consolidation and expert evaluation. The findings identified Governance and Political–Economic (G-PE) support, together with the Technological Advancement and Innovations (TAI), as the two principal drivers shaping future scenarios of older adult care in Iran. Based on these drivers, four plausible scenarios were developed. Conclusions The future of older adult care in Iran will depend not only on TAI but also on the strength of G-PE integration. The scenarios showed that technology can either improve care quality and accessibility or intensify inequality and system fragmentation, depending on institutional capacity and regulatory effectiveness. The study highlights the need for a national integrated roadmap to align governance, digital platforms, and health and social care policies toward resilient, equitable, and human-centered older adult care systems.