Background: Recently the European Union, through its Horizon 2020 fund has awarded numerous research projects tasked with the development of cloud-based health technology solutions. A number of these projects have a specific focus on ambient assisted living (AAL) technologies; solutions that offer a unique opportunity to improve the quality of life of persons with mild cognitive impairments. The diffusion of these solutions across a European wide cloud infrastructure presents a novel opportunity to reduce economic pressures currently experienced by European health systems. However, no route to market framework currently exists for a European wide healthcare delivery system. Objectives: The goal of the paper is to conduct the review and develop the literature around technology assessment for AAL technologies and route to market frameworks. Methods/Approach: We highlight the role of Total Cost of Ownership (TCO) when conducting a technology assessment by reviewing existent literature. Results: We discuss three TCO models that can support the assessment of AAL technologies. Conclusions: There is a gap in the analysis of TCO models in the context of AAL technologies particularly in public and private sector collaborations. TCO process should be developed into a key award criterion when conducting AAL technology assessment and procurements, thus aiding long term strategic decision making.

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