The healthcare and life sciences sectors are currently undergoing a transition towards becoming digitized. Mobile health (mHealth), a subset of digital health, offers many potential benefits to healthcare. Despite that, it has been reported that the majority of mHealth initiatives do not evolve beyond the pilot stage. A core reason seems to be the lack of user-centered value propositions in mHealth projects. Here, we evaluate if the use of the principles of design thinking (DT) can endorse the creation process of user-centered value propositions. For that, several scoping meetings with experts on topics of relevance were carried out, which helped define the scope, the methodology, and formulate the research question in the optimal direction. Interviews with the founders of four startups that operate in the mHealth industry constituted the basis of the findings, with the product or service development process as the central aspect. A framework for DT was employed to analyze the cases, which proposes five themes that should be considered throughout the process: User Focus, Problem Framing, Experimentation, Visualization and Diversity. Our research shows that the use of DT principles can help achieve more valuable outcomes (e.g. more user-centered value propositions), be more efficient and collaborate better. Nevertheless, more knowledge about DT is needed among entrepreneurs, as well as a more uniform consideration of the five themes of DT.

Politikwissenschaftliche Studien der vergangenen Jahre stellen fest, dass das deutsche und österreichische Gesundheitswesen eher reformresistent sind. Anhand der Einführung der elektronischen Kartensysteme im deutschen und österreichischen Gesundheitswesen zeigt diese Dissertation, dass gesundheitspolitische Reformschritte möglich sind. Durch ein vergleichendes Forschungsdesign werden anhand der zwei relativ ähnlich strukturierten Staaten Deutschland und Österreich mit dennoch relevanten Unterschieden im Politikfeld Gesundheit Theorien aus der vergleichenden Policy-Forschung und der Staatstätigkeitsforschung auf ihre Erklärungskraft hin untersucht. Durch eine qualitative Inhaltsanalyse nach Mayring und die Auswertung von Experteninterviews werden die Bestimmungsfaktoren für den gesundheitspolitischen Wandel analysiert. Auf Grund der Abweichung dieser Dissertation (Reformmöglichkeit) von bisherigen empirischen Ergebnissen (Reformresistenz) aus dem Bereich der Gesundheitspolitologie, leistet die in dieser Arbeit vorgenommene Erklärung von politischem Wandel einen Beitrag zur politikwissenschaftlichen Forschung. Die Dissertation zeigt, dass eine Kombination von Theoriemodulen aus der vergleichenden Staatstätigkeitsforschung und der Policy-Forschung die Einführung der elektronischen Kartensysteme im deutschen und österreichischen Gesundheitswesen sinnvoll erklären kann. Die Arbeit stellt dar, dass der politische Wandel vor allem bis zur Phase der Implementation im Politikzyklus in beiden Staaten zügig möglich war. Geänderte Machtverhältnisse, die Verteilung von Machtressourcen zwischen den Interessengruppen im Politikfeld, vormals getroffene politische Entscheidungen und selbstverstärkende Mechanismen, das Engagement "neuer" Akteure im Subsystem, sowie gebundene Rationalitäten der politischen Entscheider sind die maßgeblichen Gründe, welche die Einführung des elektronischen Kartensystems im deutschen und im österreichischen Gesundheitswesen veranlassten.

The complex process of patient placement within a hospital is a big challenge. The main focus in the process is how to coordinate clinics to make sure that the patients get the best possible care. The rise of digital health has led to a greater use of technologies to facilitate the activities within the hospitals’ processes. This study has been focusing on how Internet of Things can be used in the patient placement process. Respondents to participate in the interviews were chosen with help from a coordinator based on their experience within the study area of interest. Observations were done in meetings where the staff discussed patient placements. From a perspective of problem based coordination, a thematic analysis was done on the collected data and from the themes that were created a solution was presented. The object of this study is to map the process of patient placement and to present an analytic approach on how to facilitate the patient placement process with the use of Internet of Things. Our proposed approach will contribute to a greater understanding of the patient placement process and how Internet of Things can be used within it.

This dissertation explores how people address problems of real human concern in situations of complexity, ambiguity, uniqueness, conflicting values and rapid change. Such circumstances stretch formal and idealistic rules and procedures to the breaking point. And yet, people in a variety of fields work through such difficulties in a pragmatic manner, at times finding ways to assert their humanity. Sensemaking and human- centred design are related activities through which many people approach such work. Through cases in digital innovation, global health care delivery and an unlikely voyage of the Amazon River, this portfolio shows that they are relevant to a wide range of settings. Rather than isolating the components or key variables of such work and taking their measure, this research advances a more holistic view of sensemaking and designing as sociomaterial practices. My research is grounded in performing the phenomenon of study, offering insights from complex practice rather than a spectator’s study of it. This ethnographic approach has yielded theoretical contributions related to designing for the emergence of practices, embodied sensemaking, a more substantive notion of what it means to be ‘human’ centred and more pragmatic ways of investigating sociomaterial practices. By discussing sensemaking and human-centred design as antidotes to failures of imagination in global health and development, this dissertation suggests a distinctive perspective on why these topics matter for the health of poor and marginalized people around the world.

This paper aims to investigate women’s experience of digital technology as a contraceptive. Research on the female body has not always been a natural part of human– computer interaction (HCI) research but is beginning to be seen through various aids in menstruation, pregnancy and likewise (Balaam, 2017). In 2017, a mobile application was approved as a contraceptive in Sweden and by that, digital technology took a step into the industry of contraceptives (Suni, 2017). The product is made by the company Natural Cycles, which therefore has become the natural focus of this paper. This study was created to find out how women experience the first fully technological contraceptive, focusing on trust through interfaces and experience design. To answer the purpose of the study, a questionnaire was created and a focus group interview was held, where one of the participants was asked to write a diary for one week to document her feelings and thoughts about her use of Natural Cycles.The results from the survey showed that about half of the respondents trust Natural Cycles and may be interested in trying the product. The other half says that they do not trust the products safety. The results from involved a simple interface and good marketing with a lot of information about statistics. The answers also showed that those who didn’t trust digital technology as contraceptives lacked truthful information about studies and use. / Denna uppsats ämnar att undersöka kvinnors upplevelse av digital teknik som preventivmedel. Forskning kring kvinnokroppen har inte alltid varit en naturlig del av människa–datorinteraktion (MDI), men börjar synas genom olika hjälpmedelsapplikationer vid menstruation, graviditeter och dylikt (Balaam, 2017). År 2017 blev en mobilapplikation godkänd som preventivmedel i Sverige och då tog också den digitala tekniken ett steg in i preventivmedelsbranschen (Suni, 2017). Produkten ges ut av företaget Natural Cycles, vilket också har blivit det naturliga fokuset för denna uppsats. Denna studie skapades för att ta redapå hur kvinnorna upplever det första helt digital tekniska preventivmedlet, med fokus på tillit genom gränssnitt och upplevelsedesign. För att besvara studiens syfte skapades en enkät och en fokusgruppsintervju, där en av deltagarna dessutom ombads skriva en loggbok under en vecka för att dokumentera känslor och tankar kring sitt användande av Natural Cycles.Resultatet från enkäten visade på att ungefär hälften av de svarande känner tillit till Natural Cycles och kan tänka sig att testa produkten. Den andra halvan anger att de inte tror på produktens säkerhet. Ett sammanlagt resultat från fokusgruppen, enkäten och loggboken visade på att en viktig del för tilliten är ett enkelt gränssnitt och en god marknadsföring med mycket information kring statistik. Resultatet visade också på att de som inte kände förtroende för digital teknik som preventivmedel saknade sanningsenlig information kring studier och användande.

Cardiovascular diseases and diabetes are increasing worldwide due to unhealthy lifestyle habits. Behavior change support systems (BCSS) are a new means of promoting a sustainable lifestyle change. These systems are more effective when behavior change theories are applied. The aim of this thesis to integrate well-known behavior change theories into a conceptual model of behavior change progress to form the basis for the BCSS. The research question of this thesis is: what parameters of behavior change should be included in a conceptual model of behavior change progress? The model was created by integrating concepts and their relationships from existing behavior change theories. Next, the model was the validated by experts in behavior change. The outcome is a conceptual framework that can be function as a tool for understanding causal relationship between behavior change concepts, for presenting feedback, and building automated assessments. Furthermore, the model extends already existing knowledge networks.

Bakgrund Kranskärlssjukdom är ett av världens stora hälsoproblem där både insjuknandet och dödligheten är hög.Det finns god evidens för att träningsbaserad hjärtrehabilitering minskar mortaliteten och behovet avsjukhusvård. Trots detta är det i Sverige endast 20% av patienterna som deltar i träning inomcenterbaserad hjärtrehabilitering. En vanlig orsak till lågt deltagande är långa avstånd. Träning förmedladvia E-hälsa har potential att kunna öka tillgängligheten till hjärtrehabilitering. Innan implementeringbehöver effekten utvärderas. Syfte Syftet är att genom en systematisk litteraturöversikt jämföra effekten av träningsbaseradhjärtrehabilitering i klink med träningsbaserad hjärtrehabilitering på distans med hjälp av digital teknik. Metod Den systematiska litteraturöversikten utfördes genom artikelsökningar från databaserna PubMed ochCinahl. Söksträngarna formulerades enligt PICO-modellen. Därefter granskades artiklarna och bedömdesför bias enligt SBU:s formulär ”Bedömning av randomiserade studier”. Resultat Tretton artiklar uppfyllde inklusionskriterierna. De former av E-hälsa som användes varmobilapplikationer, websidor, telefonkontakt, SMS, mail och videomöten. Syreupptagningsförmåga mätt iVo2 peak eller Vo2 max var likvärdig eller bättre i interventionsgrupperna (E-hälsa) jämfört medkontrollgrupperna (sedvanlig vård). Följsamhet till träningen rapporterades vara bättre iinterventionsgruppen än kontrollgruppen och den självskattade livskvalitén som lika god iinterventionsgrupperna jämfört med kontrollgrupperna. Konklusion Resultaten tyder på att träningsbaserad hjärtrehabilitering förmedlad via E-hälsa kan vara lika effektivsom centerbaserad hjärtrehabilitering. Att använda E-hälsa som ett kompletterande hjälpmedel skullekunna göra träning inom hjärtrehabilitering mer lättillgänglig och öka både deltagande och följsamhet.

The purpose of this study is to produce new knowledge concerning the perceived user’s value generated using machine learning technologies that activate data network effects factors that create value through various business model themes. The data network effects theory represents a set of factors that increase the user’s perceived value for a platform that uses artificial intelligence capabilities. The study followed an abductive research approach where initially found facts were matched against the data network effects theory to be put in context and understood. The study’s data was gathered through semi-structured interviews with experts who were active within the research area and chosen based on their practical experience and their role in the digitization of the healthcare sector. The results show that three out of six factors were fully realized contributing to value creation while two of the factors showed to be partially realized in order to contribute to value creation and that is justified by the exclusion of users' perspectives in the scope of the research. Lastly, only one factor has limited contribution to the value creation due to the heavy regulations limiting its realization in the health sector. It is concluded that data network effects moderators contributed differently in the activation of various business model themes for value creation in a general manner where further studies should apply the theory in the assessment of one specific AI health offering to take full advantage of the theory potential. The theoretical implications showed that the data network factors may not necessarily be equally activated to contribute to value creation which was not initially highlighted by the theory. Additionally, the practical implications of the study’s results may help managers in their decision-making process on which factors to be activated for which business model theme.

Migraine is ranked as the third most widespread disease in the world by Global burden of Disease and study 2010. To reduce pressure on health care and also help patientsunderstand their condition, mobile health applications have become increasingly popularand accessible. These applications help by providing disease information, to documentsymptoms and analyze attack patterns. However, there is both a lack of patient centeredperspective and scientific based knowledge behind the design of these applications. Therefore, the aim of this study is to explore what might affect the patients’ motivationto use a mobile application to explore their condition. This by looking into how these applications can be designed so that patients’ find them helpful and easy to use. This wasdone by doing a qualitative interview study with ten patients with severe migraine andanalyzing the transcribed data through a reflexive thematic analysis. The thematic analysis resulted in three overarching themes personal motivations of exploring migraine, healthcare related motivations of exploring migraine, and technical support for motivation of exploringmigraine. Each overarching theme contained themes and sub-themes that are backed up byquotes in the data from the interviews. Also a proposal on how to visualize the threeoverarching themes in relation to each other is presented.In conclusion, designing applications that help with acceptance of condition, adaptivecontent and functionality, and deciding on a specific target patient group, are central findings of this study. Directives from health care was found to be the largest motivationaldrive in this study and could further be explored to work better with migraine applications.

Background: Laboratory results are of central importance for clinical decision making. The time span between availability and review of results by clinicians is crucial to patient care. Clinical decision support systems (CDSS) are computational tools that can identify critical values automatically and help decrease treatment delay. Objective: With this work, we aimed to implement and evaluate a CDSS that supports health care professionals and improves patient safety. In addition to our experiences, we also describe its main components in a general manner to make it applicable to a wide range of medical institutions and to empower colleagues to implement a similar system in their facilities. Methods: Technical requirements must be taken into account before implementing a CDSS that performs laboratory diagnostics (labCDSS). These can be planned within the functional components of a reactive software agent, a computational framework for such a CDSS. Results: We present AMPEL (Analysis and Reporting System for the Improvement of Patient Safety through Real-Time Integration of Laboratory Findings), a labCDSS that notifies health care professionals if a life-threatening medical condition is detected. We developed and implemented AMPEL at a university hospital and regional hospitals in Germany (University of Leipzig Medical Center and the Muldental Clinics in Grimma and Wurzen). It currently runs 5 different algorithms in parallel: hypokalemia, hypercalcemia, hyponatremia, hyperlactatemia, and acute kidney injury. Conclusions: AMPEL enables continuous surveillance of patients. The system is constantly being evaluated and extended and has the capacity for many more algorithms. We hope to encourage colleagues from other institutions to design and implement similar CDSS using the theory, specifications, and experiences described in this work.