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In many developed countries, the number of older adults is increasing. Many of them suffer from loneliness, causing mental and physical health challenges. Technological innovations offer the potential to address such challenges. However, a mismatch of user-needs and intervention design often leads to technology abandonment. Therefore, we propose a multi-stakeholder scenario-based co-design approach to design a desirable technological solution for and with older adults. To develop in-depth, relatable scenarios, we extended the methodology with dilemma-driven design and the NADI (Needs and Aspirations for Design and Innovation) model. The approach was tested in a case study involving 80 older adults and 20 geriatric experts and industry partners using an iterative design method with four phases. We found that implementing such approach allows older adults to overcome taboos and to express themselves freely. Due to the transdisciplinary collaboration, it has led to increased empathy and unexpected ideas based on the needs and wishes of older adults. The incorporation of dilemma-driven design and the NADI model offered clarity in translating the gathered information into effective scenarios. In conclusion, the implementation of a multi-stakeholder scenario-based co-design approach offers the potential to design suitable solutions for older adults suffering from complex societal challenges.

To enable patients with rheumatoid arthritis (RA) and their healthcare professionals to choose the optimal treatment, it is crucial to accurately assess the current state of inflammatory activity. The objectives of this study were to (1) investigate the perspective of RA patients on their insight into the current status of their disease, and to (2) investigate the patients’ perspective on the possible added value of a monitoring device based on optical spectral transmission—called the HandScan—that measures the location and severity of joint inflammation. A survey was distributed online among patients with RA in the Netherlands. Four-hundred and eight patients with RA completed the survey. Of these, 298 (73%) felt they have sufficient insight into their current disease status. Most respondents perceived either a large (n = 242; 59%) or small (n = 148; 36%) added value of the HandScan in their monitoring process, mostly because the device provides additional knowledge on the presence of inflammation. This perceived added value was higher for respondents experienced with the device (n = 46; p = .04). Respondents preferred monitoring with the device on every (n = 192; 47%) or most (n = 171; 42%) visits to the outpatient clinic, or even more often than on every visit (n = 17; 4%). Monitoring RA using an optical spectral transmission device is seen by patients as a possibly valuable addition to the monitoring process of inflammatory activity during visits to an outpatient clinic. Their main reason was that the device can increase insight into their current disease status. More insight may support patients in discussing treatment options with their rheumatologist.

Doelstelling Leefstijlaanpassingen zijn essentieel voor patiënten met diabetes type 2 (DT2) en eHealth interventies kunnen hier effectief in ondersteunen. Echter, deze interventies zijn vaak niet toegankelijk voor DT2-patiënten met beperkte gezondheidsvaardigheden. Deze patiënten hebben moeite om informatie over leefstijl te begrijpen en beoordelen. Veel eHealth interventies zijn niet afgestemd op de behoeften van deze doelgroep. Om mensen met DT2 en beperkte gezondheidsvaardigheden beter te kunnen begeleiden is in dit onderzoek een device ontwikkeld en geëvalueerd dat als aanvulling op een eHealth interventie gebruikt kan worden. Methode Het Creative Technology Design Process diende als leidraad voor het ontwerpproces waarbij gebruik werd gemaakt van divergerende en convergerende ontwikkelfasen op basis van expert opinies en literatuur. Het prototype werd geëvalueerd op begrijpelijkheid en gebruiksvriendelijkheid onder mensen met beperkte gezondheidsvaardigheden en een zorgprofessional met kennis van de doelgroep door middel van think-aloud sessies. Resultaten Het device is een “box” uitgerust met speakers en vier lades waarin kaarten liggen met uitdagingen op het gebied van beweging en voeding, informatie over een gezonde leefstijl en quizvragen. Iedere kaart bevat een illustratie en een korte tekst met het doel van de kaart. De kaart kan op een platform op het device worden gelegd waardoor een karakter met DT2 aanvullende auditieve informatie geeft. Tevens kan iedere kaart gescand worden met de mobiele telefoon waardoor een animatie met instructies, informatie of quizvragen over leefstijl getoond wordt waarin het karakter met DT2 terugkomt. De zorgprofessional was zeer positief door het interactieve karakter van het device. De doelgroep was enthousiast over het concept, vonden het device er aantrekkelijk uitzien en makkelijk in gebruik. Een belangrijk verbeterpunt is het instellen van herinneringen voor het pakken van een nieuwe kaart. Conclusie In het device zijn verschillende essentiële elementen voor informatieoverdracht aan mensen met beperkte gezondheidsvaardigheden gecombineerd. Naar aanleiding van de evaluatiestudie zal het prototype verder worden ontwikkeld.

Additional file 1: Supplementary material I. Routing for the focus groups.

Additional file 2: Supplementary material II. Quotations supporting findings, as referenced within the text.

A healthcare organization in the Netherlands, in collaboration with their research partners and a Virtual Reality (VR) company, have been developing an innovative product for rehabilitation care, the VReye!. This prototype product aims to close the gap between the clinic and the real world, by allowing children with developmental coordination disorder (DCD) to learn how to ride a bicycle in a safe VR environment. The objective of our study was to create a Business Model for this VR product. First, a structured literature review was performed (Wolfswinkel, 2013). Next, 14 interviews were conducted with different stakeholders. The data was analysed with the method of Miles and Hubermann (2014). For the business modeling we used the STOF model (Service, Technology, Organization Finance) (Haaker et al, 2013). The literature study showed that the eye tracking function of the VReye! would be of additional value in the rehabilitation of children with DCD. In addition, the organization and financial aspects of VR in healthcare were insufficiently reported. Based on the interview results, we propose an early-stage business model. In this model, the most viable option for the VReye! is to first apply for a research funding to cover the development stage towards a medical product. For the latter, a possible suitable model would be centered around health insurance companies, in which the VReye! is offered as a service to healthcare organizations. Business modelling for VR in healthcare is still underdeveloped. We proposed a possible business model of a specific case: the VReye! The STOF model was found effective in this case. More research is needed to investigate its suitability in daily clinical context.

Implementing information and communications technology (ICT) at scale requires evaluation processes to capture the impact on users as well as the infrastructure into which it is being introduced. For older adults living with cognitive impairment this requires evaluation that can accommodate different levels of cognitive impairment, alongside input from family and formal caregivers, plus stakeholder organisations. The European Horizon 2020 project INdependent LIving support Functions for the Elderly (IN LIFE) set out to integrate 17 technologies into a single digital platform for older people living with cognitive impairment plus their families, care providers and stakeholders. The IN LIFE evaluation took place across six national pilot sites to examine a number of variables including impact on the users, user acceptance of the individual services and the overall platform, plus the economic case for the IN LIFE platform. The results confirmed the interest and need among older adults, family caregivers, formal caregivers and stakeholders, for information and communications technology (ICT). Relative to the baseline, quality of life improved and cognition stabilized, however, there was an overall reluctance to pay for the platform. The findings provide insights into existing barriers and challenges for adoption of ICT for older people living with cognitive impairment.

Additional file 1. Measurement items.