Digital Health Testbeds in Sweden: An exploratory study

Abstract

Objective This study explored the Swedish digital health testbeds through the lens of complexity science. Methods The purposive sampling was used to identify 38 digital health testbed organizations to conduct interviews in written or audio-conferencing. The interview responses were aggregated and analyzed using thematic analysis. The themes were mainly generated through complexity theory and the principles of complex adaptive systems. Results Fifteen testbed organizations responded, comprising 13 written responses and two audio-conferencing. Five main theoretical themes were generated: agents and diversity, connections and communication, adaptation and learning, perturbations, and path dependence. Agents and diversity depicted different types of testbeds, stakeholders and innovation, and the primary function and purpose of the testbeds. Various factors enhancing connections and communications among multiple stakeholders were identified, such as the quality of e-health solutions and the 2030 Agenda for Sustainable Development. Some adaptation and learning factors, such as internal reorganization, sharing and creating learning opportunities, and additional funding, guaranteed the sustainability of testbeds. Perturbations were characterized by two factors: non-linear interactions – lack of commitment and transparency in stakeholders' engagement, and uncertainty about testbed definitions and concepts. Path dependence highlighted the importance of history, such as previous positive and negative experiences. Conclusion This study provided insights into testbeds' organization, their functions, how various aspects were challenged, and how they adapted to overcome and improve the system issues. Identifying the stakeholders and relevant factors, commissioning an evaluation, backing up with a contingency plan, securing adequate funding, and disseminating the findings can improve the testbeds' design and implementation.

Operational disruption in healthcare associated with software functionality issue due to software security patching: a case report

“…Notwithstanding these limitations, the findings and the devised strategies can be considered as alerts to enlighten healthcare digitalization in Sweden to adopt the culture of digital safety and effectiveness. This also implies that the lessons learned from this case report can be useful and pertinent to adopt elsewhere for overall healthcare quality improvement and patient safety ( 7 , 17 , 32 ).…”

“…A robust mechanism of system resilience and high-reliability organizations must address system flaws or software-related issues, including software patches, in a timely manner ( 31 ). Ensuring a robust mechanism means that similar types of errors are not repeated in the future, which will further guarantee that preventive and corrective interventions are applied at a system level ( 32 ). Therefore, such a system-wide approach and reliable systems can quickly identify and fix the issues related to HIT systems, minimize the stress and dissatisfaction of healthcare professionals, and thus improve healthcare quality ( 33 ).…”

Characterizing patient details-related challenges from health information technology-related incident reports from Swedish healthcare

“…The studies we conducted previously followed a general set of preventive and corrective strategies to improve the healthcare quality and patient safety associated with HIT systems. The strategies recommended are based on the overall challenges encountered by particular HIT systems or types of HIT incidents ( 5 , 28 , 46 ). However, the hallmark of a socio-technical complex system is much more complicated than it seems to be.…”

Current challenges of healthcare co-creation and testbeds

“…While testbeds are a stage for the co-creation and renewal of the healthcare sector, they are also a service. This can be a challenge in Scandinavia, especially in Finland, where most healthcare testbed services are offered by public sector organizations, such as higher education institutes and public health service providers [7,8]. For organizations like these, offering co-creation services, or any kind of services with a price tag and value proposition, is often a path less travelled.…”