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Determining Value in Welfare-Technology: The Need for a Multi-Perspective Framework

Background: Stakeholders in health and social care are implementing digital solutions to facilitate person-centred care for citizens. One problem is choosing which digital solution to implement. Ordinary cost-benefit analysis implicates the measurable parts of the value, leaving the immeasurable without any trace in an analysis. Results: We used design thinking to design a framework that implicates what to add as valuable factors on individual, organisational, and governmental levels. The design is based on empirical material from workshops and literature reviews on systems thinking, quality management, and value factors. The valuable factors at an individual level could include independence, autonomy, and empowerment, and the factors at the organisational level accessibility, competence, and independence. On a central level, the factors are related to person-centred care and its value proposals, such as autonomy and independence. Conclusions: While conducting a cost-benefit analysis, focusing on a standard definition of the value concept is essential. The designed framework needs to be dynamic due to the broad range of welfare technology. The created rubrics cube model, including strategic, organisational-operational and individual levels, should be used by decision-making groups as a flexible foundation. Forthcoming research will test this framework, including the proposed scale for measurement and focusing on welfare technology for older citizens.

Value, Measurements, Person-Centred Care, Welfare Technology, Immeasurable

Karin Brodén, Kristen Snyder, Helle Soerensen, Magnus Zingmark. (2023). Determining Value in Welfare-Technology: The Need for a Multi-Perspective Framework. International Journal of Health Economics and Policy, 8(4), 76-88.

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Al Muammar AM, Ahmed Z, Aldahmash A. Paradigm Shift in Healthcare through Technology and Patient-Centeredness. Int Arch Public Health Community Med. 2018; 2: 015.
2. WHO. World Health Organization guideline: recommendations on digital interventions for health system strengthening: World Health Organization; 2019.
3. Paparella G. Person-centred care in Europe: a cross-country comparison of health system performance, strategies and structures. 2016.
4. Epstein RM, Street RL. The values and value of patient-centered care. Annals Family Med; 2011. p. 100-3.
5. Nergårdh A, Andersson L, Eriksson J, Lundberg M, Nordström K, Lindevall M. God och nära vård–En primärvårdsreform. Stockholm, Sweden: Socialdepartementet [Google Scholar]. 2018.
6. Ahlin K, Snyder K, editors. Person-centred Health Care Resting on Digitization and Systematic Processes: A position paper. GLOBAL HEALTH 2021 The Tenth International Conference on Global Health Challenges, Barcelona, October 3-7, 2021; 2021: International Academy, Research and Industry Association (IARIA).
7. Ahlin K. Benefits of Digital Technical Information: Mid Sweden University; 2020.
8. Ward J, Daniel E. Benefits Management: How to Increase the Business Value of Your IT Projects (2nd Edition). Somerset, NJ, USA: John Wiley & Sons; 2012.
9. Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes: Oxford university press; 2015.
10. Ellström E, Ellström P-E. Two modes of learning-oriented leadership: a study of first-line managers. Journal of Workplace Learning. 2018.
11. Plattner H, Meinel C, Leifer L. Design thinking: understand–improve–apply: Springer Science & Business Media; 2010.
12. Bertalanffy Lv. General system theory: Foundations, development, applications: G. Braziller; 1968.
13. Capra F. Ecology and community. Center for Ecoliteracy. 1994: 1-11.
14. Hwang J, Christensen CM. Disruptive innovation in health care delivery: a framework for business-model innovation. Health affairs. 2008; 27 (5): 1329-35.
15. Malm H, Pikkarainen M, Hyrkäs E. Impact of coupled open innovation on company business models: A case study of demand-driven co-creation. Journal of Innovation Management. 2020; 8 (3): 75-108.
16. Hellberg S, Johansson P. eHealth strategies and platforms–The issue of health equity in Sweden. Health Policy and Technology. 2017; 6 (1): 26-32.
17. Ahlin K, Zingmark M, Persson Slumpi T, editors. A transition towards digital home visits in social care and home health care during the corona pandemic. GLOBAL HEALTH 2021, The Tenth International Conference on Global Health Challenges, Barcelona, Spain,[DIGITAL], October 03-07, 2021; 2021.
18. Ahmad A, Ahlin K, Mozelius P, editors. The Technology-Enhanced Requirements for the Three-Fold Stroke Rehabilitation to Support Independent Living. Information and Communication Technologies for Ageing Well and e-Health: 5th International Conference, ICT4AWE 2019, Heraklion, Crete, Greece, May 2–4, 2019, Revised Selected Papers 5; 2020: Springer;
19. Fadhil A. Beyond patient monitoring: Conversational agents role in telemedicine & healthcare support for home-living elderly individuals. arXiv preprint arXiv: 180306000. 2018.
20. Susło R, Paplicki M, Dopierała K, Drobnik J. Fostering digital literacy in the elderly as a means to secure their health needs and human rights in the reality of the twenty-first century. Family Medicine & Primary Care Review. 2018 (3): 271-5.
21. Hermann M. Digital Competencies and Attitudes Towards Adherence Solutions Among Elderly Patients Treated with Novel Anticoagulants: A Qualitative Study. Journal of Medical Internet Research. 2020; 22 (1): 1-13.
22. Elg M, Gremyr I, Halldorsson Á, Wallo A. Service action research: review and guidelines. Journal of Services Marketing. 2020.
23. Parviainen P, Tihinen M, Kääriäinen J, Teppola S. Tackling the digitalization challenge: how to benefit from digitalization in practice. International journal of information systems and project management. 2017; 5 (1): 63-77.
24. Olson, Olson. Distance matters. Human–computer interaction. 2000; 15 (2-3): 139-78.
25. Star SL, Griesemer JR. Institutional ecology, translations' and boundary objects: Amateurs and professionals in Berkeley's Museum of Vertebrate Zoology, 1907-39. Social studies of science. 1989; 19 (3): 387-420.
26. Snyder K, Ingelsson P, Bäckström I. Enhancing the study of Lean transformation through organizational culture analysis. International Journal of Quality and Service Sciences. 2016.
27. Ahlin K, editor Measuring the immeasurable? The intangible benefits of digital information. 52nd Hawaii International Conference on System Science; 2019; Grand Wailea, Mahui.
28. Ahlin K, editor Design and test of a measurement method for the benefits of technical information. IRIS/SCIS Conference 2018, Denmark, 5-8 August 2018; 2018.
29. Herman KM, Hopman WM, Craig CL. Sex differences in the association of youth body mass index to adult health-related quality of life: the physical activity longitudinal study. Canadian Journal of Public Health. 2011; 102 (1): 42-6.
30. Jenkinson C, Layte R. Development and testing of the UK SF-12. Journal of health services research & policy. 1997; 2 (1): 14-8.
31. Månsdotter A, Ekman B, Meili KW, Feldman I, Hagberg L, Hurtig A-K, et al. Towards capability-adjusted life years in public health and social welfare: Results from a Swedish survey on ranking capabilities. PloS one. 2020; 15 (12): e0242699. doi:
32. Lindholm L, Rosén M, Emmelin M. How many lives is equity worth? A proposal for equity adjusted years of life saved. Journal of Epidemiology & Community Health. 1998; 52 (12): 808-11.
33. Carlson JJ, Brouwer ED, Kim E, Wright P, McQueen RB. Alternative approaches to quality-adjusted life-year estimation within standard cost-effectiveness models: Literature review, feasibility assessment, and impact evaluation. Value in Health. 2020; 23 (12): 1523-33.
34. Carmi E, Oestreicher-Singer G, Libai B, Yassin O. Assessing value in product networks. International Conference on Information Systems; Orlando Florida 2011.
35. Evans GE, Riha JR. Assessing DSS effectiveness using evaluation research methods. Information & Management. 1989; 16 (4): 197-206. doi:
36. Womack JP, Jones DT. Lean thinking: Banish Waste and Create Wealth in your Corporation.. 2nd ed. London: Simon & Schuster; 2003.
37. Müller SD, Skau S. Success Factors Influencing Implementa-­tion of E-­government at Different Stages of Maturity: A Literature Review International Journal of Electronic Governance. 2014; 7 (2): 136-70. doi: 10.1504/ijeg.2015.069495.
38. Carnwath JD, Brown AS. Understanding the value and impacts of cultural experiences. Manchester, United Kingdom: Arts Council England. 2014.
39. Brown AS, Novak-Leonard JL. Measuring the intrinsic impacts of arts attendance. Cultural Trends. 2013; 22 (3-4): 223-33.
40. Holden J. Cultural value and the crisis of legitimacy. Demos London; 2006.
41. Bannister F. When Paradigms shift: IT evaluation in a brave new world. The Electronic Journal of Information Systems Evaluation. 2005; Vol. 8 (Iss. 1): 21-30.
42. Brynjolfsson E. The Productivity Paradox of Information Technology. Communications of the ACM. 1993; 36 (12): 67-77.
43. Chircu AM, Kauffman RJ, editors. Limits to Value in Electronic Commerce-Related IT Investments. 33rd Hawaii International Conference on System Sciences; 2000; Hawaii.
44. Akkerman SF, Bakker A. Boundary Crossing and Boundary Objects. Review of Eductational research. 2011; 81 (132).
45. Meynhardt T, Chandler JD, Strathoff P. Systemic principles of value co-creation: Synergetics of value and service ecosystems. Journal of Business Research. 2016; 69 (8): 2981-9.
46. Deming W, Feigenbaum A. Total quality management: origins and evaluation of the term. Harvard Business Review. 1986; 34 (6): 93-101.
47. Snyder KM, Eriksson H, Raharjo H. The management index: simplifying business excellence for management teams? International Journal of Quality and Service Sciences. 2020.
48. Leavy B. Collaborative innovation as the new imperative–design thinking, value co-creation and the power of “pull”. Strategy & Leadership. 2012.
49. Galvagno M, Dalli D. Theory of value co-creation: a systematic literature review. Managing service quality. 2014.
50. Nero J, Svensson J. Autonomi: En begreppsanalys. University of Borås/School of Health Sciences; 2011.
51. Corbett J. The quality of life in the ‘Independence’curriculum. Disability, Handicap & Society. 1989; 4 (2): 145-63.
52. Dworkin G. The theory and practice of autonomy: Cambridge University Press; 1988.
53. Socialstyrelsen. E-hälsa och välfärdsteknik i kommunerna 2020. 2020.
54. Erikson R, Blanck A. Får vi det bättre? Om mått på livskvalitet. SOU; 2015.
55. Danielsson A, Lovisa V. Spelar det någon roll hur självständig andra tycker att du är, om du inte känner dig självständig?: Upplevd självständighet hos äldre i behov av stöd i vardagen, utformandet av ett självskattningsformulär. 2021.
56. Gustafsson S, Sandsjö L. Evaluation of an interactive showroom to increase general knowledge about welfare technology and its potential in municipal care settings. Scandinavian Journal of Occupational Therapy. 2020; 27 (8): 591-600.
57. Soldatos J, Kyriazakos S, Ziafati P, Mihovska A. Securing IoT applications with smart objects: framework and a socially assistive robots case study. Wireless Personal Communications. 2021; 117 (1): 261-80.
58. Zander V, Johansson-Pajala R-M, Gustafsson C. Methods to evaluate perspectives of safety, independence, activity, and participation in older persons using welfare technology. A systematic review. Disability and Rehabilitation: Assistive Technology. 2020; 15 (4): 373-93.
59. Stokke R, Melby L, Isaksen J, Obstfelder A, Andreassen H. A qualitative study of what care workers do to provide patient safety at home through telecare. BMC Health Services Research. 2021; 21 (1): 1-10.
60. Frennert S. Lost in digitalization? Municipality employment of welfare technologies. Disability and Rehabilitation: Assistive Technology. 2019; 14 (6): 635-42. doi: 10.1080/17483107.2018.1496362.
61. Wass S, Safari MC. Photovoice—Towards Engaging and Empowering People with Intellectual Disabilities in Innovation. Life. 2020; 10 (11): 272.
62. Lindberg J, Carlsson E. Digitala vårdlandskap–kritiska reflektioner om e-hälsa i glesbygden. Socialmedicinsk tidskrift. 2018; 95 (1): 62-9.
63. Siren A, Knudsen SG. Older adults and emerging digital service delivery: A mixed methods study on information and communications technology use, skills, and attitudes. Journal of aging & social policy. 2017; 29 (1): 35-50.