The work aims to understand the personalized health needs of the lonely elderly under the home scenario mode in the first and second tier cities, including seven dimensions:health management, health education, health monitoring, health assessment, health archives, health insurance and health assistance, and analyze users' attitude and willingness to accept smart health industry. Through literature analysis and sample volume research, the original needs of the lonely elderly for health products or services in the home environment were sorted out, and the Kano model was established by means of field interview and feedback evaluation. The original needs were verified and the preliminary screening needs were determined according to the classification of necessary needs, expected needs and charming needs to intuitively reflect the need degree of the target user for each function, and then the needs were resorted out according to the need level and satisfaction coefficient to obtain the necessary, expected and charming needs. The future smart home health needs of the lonely elderly are developing towards family and service. Daily life care, spiritual comfort, chronic disease prevention, information visualization and emotional communication have become the key needs to be optimized and the need importance established through Kano model analysis can provide effective reference for prioritization of relevant design elements.