Patients in hospital can be prone to sudden, life-threatening changes in their cardiovascular state. Haemodynamic parameters such as blood pressure, pulse transit time (PTT) and perfusion can be monitored in clinical situations to identify these changes as early as possible. Continuous blood pressure is usually monitored using a catheter placed into a major artery, but this is invasive and involves risk to the patient. In the last decade, the field of non-contact vital sign monitoring has emerged, with growing evidence that the remote photoplethysmogram (rPPG) signal can be used to estimate vital signs using video cameras. If the analysis of the rPPG signal can be expanded to include the estimation of haemodynamic parameters, it could result in methods for the continuous, non-contact monitoring of a subject's haemodynamic state. In a physiology study, a series of video recordings were made of 43 healthy volunteers. The subjects sat in a purpose-built chamber, and the composition of the air was carefully adjusted to cause the subjects to experience large, controlled changes in blood oxygen levels. To validate the video camera algorithms, reference data were also collected. Along with the volunteer study, a clinical study was performed to acquire data in a challenging clinical environment. Data were collected from patients on haemodialysis in the Renal Unit, a population likely to experience sudden changes in haemodynamics. The reference data from the Renal Unit study were analysed to determine the extent to which PTT and mean arterial pressure (MAP) are related. The correlation coefficients and linear fits were found on a global and a per-subject basis. In addition, the video recordings from the Physiology study were processed to derive rPPG signals, and these signals were analysed to obtain estimates for PTT. Local rPPG signals were also derived for different regions of interest, and the waveforms were analysed using a novel application of the technique of signal averaging to produce spatial maps of perfusion and blood flow. The correlation between conventionally measured PTT and MAP was found to be weaker in the haemodialysis population than has been shown elsewhere in the literature, except for a sub-set of patients. The results of the video analysis showed that PTT could be estimated robustly and consistently, although direct validation of these estimates was not possible because of the different method used to calculate the reference PTT. For most subjects, the spatial mapping methods produced robust maps that were consistent over time. These results suggest that it is possible to detect changes in haemodynamics using a video camera, and that this could have applications in healthcare, providing that challenges such as subject movement and clinical validation can be overcome.

Today, new technologies are introduced to the market every day, and constantly changing our way of living. Especially in the healthcare sector, the change process is approaching a point where doctors can benefit from the use of, for example, connected portable reading devices instead of paper-based medical record systems. The information and communication technology is promoting the evolution of a new pathway of care delivery, a paradigm shift that alters the fundamental relationship between a doctor and its patient. The concept is defined as telehealth and formulates the provision of care at a distance and provides the possibility to treat patients in their home environment instead of at the hospital. This master’s thesis has been performed on the request of Cenvigo AB, a company active in the implementation of new IT-solutions into the healthcare and eldercare. Cenvigo AB are the owners of the Parkinson’s Digital Assessment (PANDA) application. The application has been developed through research at Dalarna University and Uppsala University Hospital.  This project will initiate the launch of PANDA and also create a model for implementation of innovative IT-solutions into the healthcare systems. The model is founded in a theoretical framework and shaped with interviews related to the implementation of technology with a focus on telehealth applications. Interviews has been performed with healthcare professionals, technology developers and users to acquire a complete picture and opinions regarding the introduction of innovation in healthcare today. From the acquired information, a model is formulated as a stepwise and chronological linear process were identified key activities are included to promote a successful implementation process. The model is connected to the practice through the implementation of PANDA. In the process of implementing PANDA into the Swedish healthcare system, a collaboration with the innovation centre at Uppsala University Hospital as a healthcare organization stakeholder, has been initiated. The model consists of five phases; Assessment, Dissemination, Adoption, Implementation and Continuation. The phases are seen as transitional steps in the innovation process, critical barriers to overcome towards a successfully implementation in a mainstream routine setting. Each phase includes a number of activities and to achieve progression in each phase, these activities must be performed in order to advance to the next phase. In the case of PANDA, the process of progression has passed assessment and are currently involved in activities related to the dissemination phase. The purpose of the model is to be used both for existing and future applications in the segment of medicine technology sector. The structure of the model is designed to promote a co-design or a common value principle of development and practice regarding an innovation. By connecting actors from both technology and healthcare in close relationships the actual needs of healthcare professionals could more effectively be identified and developed into a solution, a result from the amplification of a two-way engagement. The outmost aim is to serve as a catalysing factor, complementing the implementation models of healthcare in Sweden today. Through this study, a need for facilitating the implementation process of new technology into the healthcare systems has been identified. This model offers the necessary input that many technology companies lack. The recommendation to Cenvigo AB is to continue to develop the model during the last step in the process of launching PANDA, and parallel use this model as a business model mainly for technology start-ups and larger foreign companies that has not yet established pathways into the Swedish healthcare system. / <p>TVE 14 036</p>

In recent years, healthcare has been shifting toward a people-centred vision. Within the intersection connecting service design and healthcare innovation, co-design communication tools are increasingly being used to bring the voice of patients and their families into healthcare co-creation activities. Existing documented use of such tools primarily focuses on empathy and how designers derive inspiration from participants’ materials, while little draws on the actual design process and how design attributes can effectively support patients and their families in generating and expressing their dreams. From this perspective, this thesis first analyses existing tools that aim to elicit participants’ self-expression and evoke their future-oriented thinking, which strategies for designing a tool that supports individuals in expressing their dreams are identified with a particular focus on materiality and visuality. Taking a research through design approach, this thesis enters into the extremely challenging rare disease context to design a toolkit to help family caregivers of people with ALS identify and convey their dreams for life after diagnosis. Through observations of participants’ interaction during the prototyping process, this study further demonstrates that considering both the vulnerability and intelligence of patients (families) in the design of tangible toolkits effectively breaks participants’ habitual perceptions and brings them to an imaginative space towards the future. In doing so, co-design tools commonly used in service design can be better adapted to the healthcare context. Additionally, the thesis provides family caregivers’ questions, insights, and ideas about ALS healthcare services, thereby informing the future ALS healthcare innovation.

European Union (EU) healthcare systems are under financial and pandemic related pressure and will face further challenges not only due to a lack of medical workers and an ageing population. Technical innovation is seen as one of the ways to diffuse this ticking time bomb. Where innovation initiatives on corporate and governmental levels have in part failed, startups have the chance to be a grass-roots source for healthcare innovation in the future. This thesis explores the landscape of EU-based high performing healthcare startups. I try to answer the question: What types of EU-based healthcare startups are successful?In this thesis academic literature is examined for appropriate information on EU healthcare and healthcare innovation. Additionally, Crunchbase was utilized to identify one hundred high performing healthcare startups. Based on available academic literature I propose a new categorisation framework for healthcare innovation and use this framework to analyse the sample of one hundred high performing EU-based healthcare startups. The Crunchbase rank and funding amount were additionally used to quantitively analyse the sample.The results indicate that successful innovators in healthcare software mainly target consumers potentially due to lower entry barriers. Additionally, I find data supporting previous notions that pharmaceuticals use startups to outsource R&amp;D activities. This coincides with relatively vast amounts of funding for some of these startups. Software innovations targeting medical care providers also see relatively high funding amounts potentially due to higher entry barriers. This research provides a better understanding of the landscape of high performing healthcare startups in the EU. Researchers and practitioners may use the new healthcare innovation categorization framework when analysing healthcare startups. Additionally, this work provides helpful insights on the stakeholders in healthcare, the state of healthcare innovation in the EU, and the landscape of innovative healthcare startups especially regarding funding.

Information Systems (IS) innovations in healthcare sector are seen as panacea to control burgeoning demand on healthcare resources and lack of streamlining in care delivery. Two particular manifestations of such innovations are telehealth and electronic records in its two forms: the electronic medical records and the electronic health records. Deployment efforts concerning both of these IS-innovations have encountered a rough terrain and have been slow. Problems are also faced while evaluating the effectiveness of innovations on health and care delivery outcomes through strategies such as randomised controlled trials- particularly in case of telehealth. By taking these issues into account, this research investigates the issues that affect IS innovation deployment and its evaluation. The strategy adopted in this research was informed by recursive philosophy and theoretical perspectives within IS that strived to expound this recursive relationship. It involved conducting two longitudinal case studies that are qualitative in nature. The first study involved telehealth deployment and its evaluation in the UK, while the second case study involved the deployment of electronic medical/health records in the US. Data was collected through focus group discussions, interviews and online discussion threads; and was analysed thematically. The results of this research indicate that there are nine issues that arise and affect the deployment and evaluation of IS innovation in healthcare; and these are design, efficiency and effectiveness, optimality and equity, legitimacy, acceptance, demand and efficacy, expertise, new interaction patterns, and trust. These issues are attributes of relationships between the IS innovation, context of healthcare and the user. The significance of these attributes varies during the deployment and evaluation process, and due to iterative nature of IS innovation. This research further indicates that all the attributes have either direct or indirect impact on work practices of the user.

Orientador: Prof. Dr. Anderson Orzari Ribeiro / Dissertação (mestrado) - Universidade Federal do ABC, Programa de Pós-Graduação em Engenharia e Gestão da Inovação, 2017. / Inovações tecnológicas no setor da saúde são observadas em novos produtos, serviços e processos utilizados para diagnosticar, monitorar, prevenir e indicar o tratamento mais adequado aos pacientes. Neste setor, a vasta gama de doenças conhecidas representa um enorme desafio para a elaboração de novos diagnósticos e tratamentos, ainda mais quando se considera redução dos custos e o prolongamento da vida ativa dos cidadãos. O presente estudo, cuja amostra é uma empresa de medicina diagnóstica reconhecida por suas práticas de gestão de inovação, pretende analisar o processo de implantação de inovações da empresa e questiona como uma ferramenta de engenharia pode ser complementar a gestão de inovação, apoiando a integração necessária entre as diversas unidades de negócio envolvidas no lançamento de uma inovação. Para responder a essa pergunta, faz-se uso de uma abordagem de engenharia de sistemas, mais especificamente, a aplicação do método de engenharia de sistemas no modelo de ciclo de vida do sistema. Os resultados demonstraram que a ferramenta traz uma visão instrutiva do processo de design e desenvolvimento de um conceito inovador de serviço, produto ou processo, podendo ser complementar à gestão de inovação. Sugere-se que a metodologia aplicada possa ser projetada para outras empresas, e também ser utilizada para desenvolvimento de um software de suporte à gestão de inovação. / Innovations in healthcare are present in new products, services and processes used to diagnose, monitor, prevent and indicate the most appropriate treatment to the patients. The known diseases represent a huge challenge to elaborate new diagnosis procedures and treatments, considering especially lengthening people¿s life and cost reduction. This present study, which uses a medical diagnostic company recognized for innovation as a sample, intends to analyse the process to implement innovations the company. The question it aims to understand is if a system engineering method can be used to complement innovation management, in order to understand the steps it take until innovation launch and also to have a better integration between different businesses units involved in innovation launch processes. To answer this question, a system engineer approach is used as methodology, more specifically, the system engineering life cycle model. Results shows that the methodology provides an instructive view of innovations design and development processes, which may be complementary to innovation management. The results also suggest that the methodology can be used in other companies, and can be applied to design a software to support innovation management.

Innovation in healthcare is a central way of coping with the changes affecting the healthcare system through the megatrends of demographic change, digitalization as well as the opportunities in the life-sciences sector and the “-omics” subjects. Due to the multiple facets of the topic, research on innovation in healthcare is diverse and draws insights from systems theory, management theory, human resources, innovation and change management. While the literature on innovation in healthcare has grown steadily in the last 20 years and publications on pharmaceutical and medical device innovation, health technology assessment strategies, or digital innovations have increased significantly, other areas such as sectoral health innovation systems, the creation and implementation of innovation in hospitals still remain fairly uncharted. Applying established concepts such as systems of innovation theory, mass customization theory or management of employee involvement in innovation activities to the healthcare sector provides new insights into a field that is often considered a “blackbox”. This thesis adds to the topic in three essays, each focusing on a different aspect and depth level ranging from a macro perspective on healthcare innovation on a global scale to a meso level perspective on the implementation of personalized medicine in one country and putting a micro lens on innovation activities of hospital staff. The aim of this thesis is to provide an overview for researchers, policy makers and healthcare stakeholders about current developments, propose tools for measuring innovation and allow for benchmarking the current status quo in healthcare in order to foster new and innovative developments.

Overcrowded emergency departments (EDs) are a critical problem in healthcare, and emerging technology presents new solutions to this problem. One solution is ambulatory in-home services, like Mobile Integrated Health (MIH) programs, offering care to patients inside of their homes using telehealth technology. For an ambulatory in-home service to cross the chasm and be accepted by a larger population, two aspects have to be investigated and developed for an earlystage implementation: 1) The product offering, and 2) stakeholder attraction. A case of a newly developed MIH program has been studied with the purpose to understand what aspects should be prioritized in the development of an ambulatory in-home service, such as the MIH program. Firstly, the product offering should have a niche approach using early triaging, to ensure that its selling promise gets fulfilled. Secondly, the generic product should consist of basic services that can be expanded after the service has proven trialability. However, the potential of the product should be researched and presented to the management with a realistic selling promise commitment. Lastly, the complexity, mostly associated with administrative tasks, should be minimized. To further increase the adoption rate, knowledge exchange with other programs should be utilized. Moreover, the study shows evidence that both patients and providers have a high satisfaction associated with ambulatory in-home services, and that they have a relative advantage in comparison to an ED visit. The diffusion will mostly be through word-of-mouth, making the product offering even more important. To achieve maximum diffusion the patients and providers have to know that the service is available to other individuals in their social system. During the early stages of adoption, external influence will also play an important role in creating awareness. Moreover, loyalty and continuous use of the service have to be promoted. / Överbelastade akutmottagningar är ett kritiskt problem i sjukvård, och utvecklingen av ny teknikger en lösning till detta problem. En lösning är akuta hemtjänster, liksom "Mobile Integrated Health" (MIH) program, som erbjuder vård till patienter inuti deras hem genom att använda "telehealth" teknologi. För att en akut hemservice ska korsa spridningsklyftan och bli accepterad av en större befolkning måste två aspekter undersökta och utvecklade i ett tidigt stadie: 1) produkterbjudande och 2) intressentattraktion. I denna studie har ett nyutvecklat MIH program studerats med avsikten att förstå vilka aspekter som ska prioriteras under utvecklingen av en akut hemtjänst, liksom MIH programmet. För det första så måste produkterbjudandet ha en nischad strategi, som använder sig av tidig triage för att säkerhetsställa att säljlöftet genomförs. För det andra så ska den generiska produkten bestå av bastjänster, vilka kan expanderas efter att provbarhet har bevisats. Dock så ska den potentiella produkten undersökas och presenteras för ledningen med ett realistiskt säljlöfte. Slutligen så ska komplexiteten, som är mestadels kopplad till administrativa uppgifter, minimeras. För ytterligare ökning av spridningsfrekvensen så ska kunskapsutbyten med andra program utnyttjas. Fortsatt, så visar studien på att både patienter och vårdgivare har en hög belåtenhet kopplat till akuta hemtjänster, och att de har en relativ fördel i jämförelse med besök på akutmottagningar. Spridningen sker mestadels genom "word-of-mouth" vilket gör produkterbjudandet ännu viktigare. För att nå maximal spridning måste patienter och vårdgivare veta att tjänsten är tillgänglig för andra individer i deras sociala system. Under den tidiga adoptionsfasen, är extern influens också viktigt för att sprida medvetenhet. Även lojalitet och fortsatt användning av tjänsten måste framhävas.

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Healthcare is a complex system under great pressure for meeting the patients’ needs. Implementing technology at inpatient wards might possibly support healthcare professionals and improve quality of care. However, these technologies might come with issues and the system might not be used as intended. This master thesis project investigates how healthcare professionals communicate at an inpatient ward and how this might be affected by implementing a Mobile Healthcare Solution (MHS). Further, it sought to question why healthcare professions might, or might not, use the MHS as a support of their daily work and what some reasons for this might be. Research methods were of qualitative approach. Field studies were performed at an inpatient ward and further, two healthcare professionals were interviewed. Grounded Theory (GT) was chosen as a method to process the data and obtain understanding for communication at the inpatient ward. The results showed that healthcare professionals communicate verbally, written and by reading, using different tools. The most prominent ways of communication were verbally, where it was common to report or discuss about a patient. The means for communication did not get drastically affected by implementing the MHS and reasons for this were of social, technical and organizational types. Some reasons for not using the MHS were habits and due to healthcare professionals perceiving the MHS as more time consuming than manual handling. However, a specific investigation of whether this might affect the usage of the MHS is yet needed