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1. Introduction Ehealth solutions are in great need in the community of elderly in general, as patients or home carers, however a design approach that delivers this is illusive. In this research we present the experiences from a set of design processes targeting elderly’s needs of support or home care, based on a co-design approach. The purpose is to present guiding principles for how to work with elderly in a co-design process, to be used as basis for future set up of co-design processes. 2. Theory and Methods Co-design stresses the equal cooperation between end-users, professionals, technical personnel and other key groups. It moves beyond more traditional participative design approach, with user involved in design, to a process were decision making, leadership are shared with end-users. Empirical material consists of 3 case studies, including field notes, recordings of design sessions, and experience of the design process leaders, gathered by design leaders/action researchers. The material is analysed using current co-design theory and best practice on how to structure co-design processes. 3. Results Case studies included co-design groups: 1) 10-15 persons designing self-care system for heart failure, 2) 5-10 persons designing home carers educations system and 3) 5-10 persons designing fall prevention systems. In the meetings, both professionals and technical experts were present. The design processes consisted of about 5 to 10 meetings during 6 to 12 months. A number of patterns were observed. Central themes include: 1) motivation: to contribute to, improve, complain about, or influence the development of the health care system, 2) to be social: interact with peers and experts, and meet people, 3) technology interests: both due to personal knowledge or lack of knowledge about technology, and to be informed, use technologies 4) being heard and recognized as an individual, with a focus on personal health situation, 5) the possibility to contribute in decision making, and giving back something to the community. 4. Discussion The co-design approach makes many of these driving forces possible, enabling elderly to be active and interested in designing. The social context is also important, but seems not to be an important part of current theory of co-design. Co-design needs to prepare for processes of learning and socialising with fellow elderly and professionals and experts, and to enable knowledge development for all parties. 5. Conclusions Co-design process need to take into account a number of key factors and dimensions for the elderly as co-designers, including motivation, social interaction, technology ability, the elderly as a person and the ability of the elderly to be a part of decision making. 6. Lessons learned Working with elderly as end-user representative demands a co-design process adapted to their needs, restrictions, interests and values. 7. Limitations The study is based on a set of single cases, and thus only limited generalisation is possible. 8. Suggestions for future research Systematic follow up on effectiveness of co-design, when it comes to both resources spent on development and the usefulness of the resulting system, is very limited.

Let the games begin : serious games in prevention and rehabilitation to improve outcomes in patients with cardiovascular disease

This paper presents a framework for the development of flexible eHealth solutions based on a platform logic and a set of processes for cooperative development. The framework consists of both a specification detailing the activities of the development process and a technical platform integrating sensors, IoT integration data management and end-user interfaces as well as business and user processes.

The paper presents the process of developing a digital platform, especially the databases that support the possibilities to handle big data in the e-health sector for purposes of fall prevention with the objective to achieve independent living at home. It focuses on the system development process, i.e. requirements elicitation, engineering, as well as highlights consequently the explicit aspects, challenges and matters encountered in the development process of the FRONT-VL project, specifically for the database development phase. In addition, the importance of considering existent standards during the development process are highlighted. Hence, it aims to provide best practices for the development process. Thus, the authors go through the requirements elicitation process to understand the data and technologies needed to attain ICT objectives of the project.

Experiences in a successful implementation of an IS-development model for co-design in a quadruple helix project. 1. Introduction Information systems (IS) research of the last twenty years has shown a phenomenon of unused research results, for instance IS-development models that do not reach practice. In some cases it may be relied upon that it takes considerable long time to transfer the new innovation from academy to practice. The reason for that could be that there is a lack of relevance for practice. In a quadruple helix project where academy and practice are cooperating to develop IS relevant for practice, a new model for IS-development has been formed. It is a co-design model to bridge the gap between all stakeholders. It motivates end-user involvement at an early stage to catch needs of the IS. The co-design model must therefore be transferred to all the stakeholders of the quadruple helix project and the purpose in this research is to obtain deeper understanding of the model transfer process. 2. Methods Qualitative interview study of stakeholders in the quadruple helix project, thus practitioners (healthcare workers, system developers, end-users) and academics (researchers). 3. Results The co-design model is transferred to practice when used by practice. For that it must be understood by all stakeholders. There are many ways to understand the model and to communicate the learnings from using it. Issues remain to get the model transferred completely. Researchers are also exposed to difficulties by having to balance the theoretical model against the practical process of co-design. 4. Discussions The transfer of the co-design model has been successful as the model have been used in a setting intended for it. Technology/knowledge transfer theories are considered, but still issues in order to succeed transferring the model remains. The knowledge bearers must be included early and all the way through the model transfer, and the diversity of the stakeholders and their professions must be carefully considered. For instance, end-users and technicians in several cases have disparate affiliations in social systems, and thus not a common ground for communicating the transfer issues. Another issue is that the transfer is slowed down if representing stakeholder is not the decision maker. 5. Conclusions The stakeholders are early adopters of the co-design model and they are all affected by explained and perceived attributes, decisions, time, communication channels and the nature of their social systems. It is motivated to consider the complexity surrounding the co-design model. 6. Lessons learned There is a need to perform the stakeholder interviews in different ways to recognise information that is capturing for instance conflicts, values, time frames and ways of working among the various stakeholders. 7. Limitations The credibility of the research can be questioned by the lack of prolonged engagement, thus enough time is not spent in becoming oriented with the evidence of the implementation. 8. Suggestions for future research A longitudinal research as well as research on model transfer in other quadruple helix projects can give the research width and depth.

1.Introduction The Internet of Things(IoT) plays a vital role on medicine today; studies show that, 40% of IoT-related technologies will be assigned to the health domain in 2020. This new ICT reshape the possibilities to accomplish integrated care, among all stakeholders. The aim is to demonstrate the level of new ICT-integration and models for integrating the personal health, quality of life and self-care into conventional health care processes. 2.Method The study is based on a case study of an codesign process with a group of 6 elderly and 5-7 different health care professionals and 6 technical developers/researchers. During five focus group meetings the group discussed the need for support of new ICT solutions and care processes when focusing on designing new processes for preventing fall accidents. The study is based on integrated care theories and models. 3.Results and discussion The necessary technical requirements will be shifting in different stages of a natural ageing process, the older person can go from being totally independent to more and more dependent on effective health care services. Three different personas were developed by the group, and all these stages need different types of integration of IoT and use of big data analytics. * Active Alice, the main ICT-challenge is to support the elderly to stay in this stage for as long as possible, using IoT for inspiring them to take actions for health promotion, preventing accidents and upholding a good quality of life. The gathered data can also be viewed by health care professionals on regular care and follow up meetings. * Vital Hubert, the older adult is still living independently at home but faces a number of health issues, including chronic conditions. It is essential to uphold and rehabilitate the elderly to stay as independent as possible and get the best possible care at the time it is needed. By using innovative technologies to share clinical- and health-related information among the different experts, the service will with less efforts, than today, produce an individualised and integrated horizontal care to prevent more severe conditions. * Life fighter Lee, the older person is dependent on care and in this stage and the use the IoT-technology will be as a tool to plan and coordinate a seamless care around the patient – going with the help of innovative technologies from a plan-based-care to a need-based-care that are integrated both horizontal (experts) and vertical (primary, secondary etc.). 4.Conclusions New ICT sloutions like IoT and big data analytics will be important to get an effective vertical and horisontal integrated care that focuses on the patients empowerment. 5. Lessons learned Using the co-design approach for defining new models for integrated care are beneficial and takes all stakeholders into account. 6. Limitations and future studies The health and wellbeing sectors are very diverse across Europe and the world, where each person has their own specific needs, preferences and interests when it comes to using ICTs for living independently at home. Thus, there is a need to study it further.

The Internet of Things plays a vital role in today’s medicine. Adding to this the demographic changes will further set a significant challenge. Innovative techniques for supporting health systems and independent life for the aging population is therefore essential, not at least in relation to fall prevention and technology for promoting a good life throughout the lifespan.Further, participation from patients is a goal for healthcare worldwide. In line with this challenge of integrated care the patient itself will be the most important resource for promotion of health, why Co Design is needed as a method for innovation in healthcare sector. It is important for the users ‘experiences and insights to contribution in improvements but not at least because it has been shown that increased involvement with the user in care reduces the number of hospital visits. However, there are several challenges when participation and engagement are to be created together with users, as users are different in terms of health, personal needs, characteristics and behaviors why more knowledge is needed on how to integrate users to achieve the highest level of participation and commitment in a deeper and broader way, not least to develop and improve the conditions for health and a good life for future demands.The aim was to examine innovative ways of learning, commitment and to communicate, as in Co Design, in order to support an independent, healty life for seniors related to fall prevention. We conducted the Co Design model by using a Quadraple Helix including senior citizens, technicians, researchers and professionals in healthcare sector.From a fall perspective the QH-consortium found challenges in the fact that a person might go from being totally independent of health one day into dependency on health care services the other day. In order to meet this change of transformation to better meet the challenges in the process, the QH created three different personas using the Co Design model to more easily meet the challenges;1. Active Alice, a woman that still have a very active and social life and have little risk for falling. In this stage the need is to be aware of the risk and her own risk behaviors to be able to actively prevent the first severe fall accident.2. Vital Hubert, a man that may have developed one chronical illness like diabetes or heart failure in the early phase and still manage to stay active and live independent at home.3. Lifefighter Lee, hir (he/she) still living at home but manage that by help with daily life activities from spouse and relatives and care personals that visit hir regularly.Considering the mentioned aspects, using the current solutions can be hard for older persons to carry out independently. Meanwhile, facing the constant change in technologies is a challenge for companies when adjusting themselves to the new needs and requirements of the customers. Sustainability is a key challenge.

Life expectancy is increasing and physical activity has been shown to be an effective to improve outcomes for patients with chronic conditions. However, there are a lot of barriers that make elderl ...

The rapid development of the possibilities of obtaining ubiquitous use of IT brings the digitalization of all processes, services and products to society at large. This development provides the opportunity of creating novel business models, reaching new market segments with novel products at cheaper/better and more targeted price levels. In this paper, we demonstrate the wide range of possibilities that are emerging with digitalization of a business environment in the e-health field, deriving from a process of digitalized business modelling. We discuss this approach by presenting a case of e-health in the form of an IoT solution for creating a safer home environment, and how it can be offered in different ways to its end users. The use of creative business modelling can thus be demonstrated to make emerging internet technologies available to broader segments of society. The ways that value networks interact and distribute incomes and costs create new methods of providing new services to new people, thus driving the digital transformation of society forward. The paper concludes with a set of principles for approaching creative business planning in a digitalized business reality with an e-health focus.

This paper deals with the planning of eHealth systems in the area of chronic care from a patient-centered perspective. The specific area is heart failure (HF) and systems that support patients’ possibilities to be active learners during the care processes and facilitate learning as a process of life style changes. Becoming better at self-care implies changes in lifestyle and the creation of a new identity. A better understanding of this process is intended to create a base for developing appropriate information systems or information technology (IS/IT) support for learning processes. The objective of this paper is the development of a better understanding of the challenges of self-care within chronic illnesses with special focus on HF. As a result, we present a set of issues that could guide the choice and design of ICT-based support systems.

Self-care is important for heart failure patients. However, what are the views of patients on their situation when it comes to realizing self-care? The aim of the paper is to investigate the self-care needs of HF patients, by understanding the issues they embrace in their self-care processes. In this paper we make a review of 17 interviews and make a classification of what the needs are for possible information technology support systems. Based on the analysis of these interviews, we identify the diversity of needs in support of activities related to different background conditions and the dynamics of change of learning and changes in the heart failure condition. The contribution of the paper is a framework for understanding the diversity of needs and the specific situations of this group of patients.

This article aims to develop an empirically grounded understanding of how newcomers learn to do their work and the role information systems play in this learning. Actor network theory views technol ...

This paper presents a novel way of thinking about how information systems are used in organisations. Traditionally, computerised information systems are viewed as objects. In contrast, by viewing the in-formation system as an actor, the understanding of the structuration process increases. The user, being influenced by the ERP (Enterprise Resource Planning) system and giving it an actor role, thereby also confers agency on the ERP system; through its very use it influences actions and thus also the structure. Based on a case study of ERP use in an ABB company over a decade, five different roles played by the ERP systems were identified. The ERP systems acted as Bureaucrat, Manipulator, Administrative assistant, Consultant or were dismissed (Dismissed) in the sense that intended users chose to avoid using them. These terms are defined in the full text. The purpose of this approach here is not to "animate" the information systems, to give them life or a mind of their own, but rather to make explicit the socially constructed roles conferred on them by users and others who are affected by them. On this basis, it is possible to suggest how the roles can help us open up new areas of exploration concerning the fruitful use of IT.

In this paper the nature of user involvement in a co-design process will be explored. The outlines of a research project aiming at developing support systems for self-care inpatients suffering from chronic heart failure will be presented. The project is planned to perform a co-design effort where users (patients and healthcare professionals) will be given the opportunity to influence the development of support systems. We will discuss a number of possibilities and challenges that lie in the design of this kind of project and also some findings from its early stages. This report presents the experiences of users’ input, which are discussed in the context of previous research on benefits of user contributions in systems development. Conference on ENTERprise Information Systems / International Conference on Project MANagement / Conference on Health and Social Care Information Systems and Technologies, CENTERIS / ProjMAN / HCist 2015 October 7-9, 2015

Heart failure seems inevitable as we grow older; even younger people succumb to its cruel onset. Finding solutions has kept medical researchers continually chasing ways to limit its effects. Yet much can be done in a proactive sense for patients with heart conditions that can be used to support patients in becoming reflective, empowered and active self-carers themselves. We investigated individual patient-centered case-studies, to understand how to best encourage people to become confident self-carers. We propose that a successful evaluation framework should consider the need for individual extensibility of effective human-computer interactive (HCI) healthcare solutions to design and build a proof-of-concept eLearning system that innovates quality eHealth education for self-care heart failure prevention.

The paper deals with the planning of eHealth systems in the area of chronic care from a patient-centred perspective. The particular area is heart failure (HF) and systems that support patients’ possibilities to be active learners during the care processes. A better understanding of this process is hoped to create a basis for the development of appropriate information systems or information technology (IS/IT) support of learning processes. The objective of this paper is the development of a better understanding of the challenges of chronic illness with special focus on HF. The results are presented as a planning framework that guides the choice and design of ICT-based support systems.

Ten years ago, technology (including IT) was viewed with suspicion by many in Sweden. Today the general sentiment is one of a strong belief in the power inherent in IT — IT will transform society and be a prerequisite for economic survival of enterprises and individuals. Less then a year ago, small IT companies were expected to expand and stand for the largest growth. Almi Foretagspartner, a state-owned organisation that supports new business ventures, found that: “It is still only the IT companies which interest the venture capitalists” (Kuylenstierna, 2000).