279 General discussion 9 TAKE HOME MESSAGES | THEME 2 (Continued) • Multidisciplinary collaborations between medical researchers and designers requires both parties to invest time and effort to learn each other’s language, the healthcare context in which the research is performed, and the value of design and its process. • The governance and protocols of medical ethical committees are not favourable for participatory design research projects as these are based on a linear approach, require pre-specification of study procedures and documents, and consider people solely as participants that can be harmed by research activities. THEME 3 –IMPORTANCE OF CREATING VALUE FOR ALL STAKEHOLDERS FOR SUSTAINABLE IMPLEMENTATION The importance of involving other stakeholders, such as various healthcare professionals, in eHealth design is also becoming more evident (26). Especially considering the fact that current healthcare problems often involve complex and interconnected challenges, known as “wicked problems,” which are characterised by stakeholders having additional needs or conflicting needs compared to end users. Stakeholder involvement ensures that the intervention aligns with the existing work processes and thinking of those who will interact with the technology or health service, or in another way will experience impact of the intervention on themselves or their work. For example, nurses should incorporate the Hospital Hero animals (chapter 4) in their interaction with children to create an immersive safari experience. Additionally, involving developers, such as those working on smart asthma inhaler programs, is necessary to align with their business strategy (chapter 2). To facilitate effective stakeholder involvement, the first step is to identify all relevant stakeholders. Tools like stakeholder identification and analysis and stakeholder mapping (27) help identify all individuals affected by a given technology, their responsibilities, interdependencies and what is at stake for whom (28). Second, the needs of stakeholders should be identified. This can be achieved by involving them directly in the participatory design activities such as experience journey mapping sessions (chapter 4) or through separate meetings to discuss insights, align thoughts and plan subsequent steps collaboratively (chapter 2). Strategies like prototyping can be employed to communicate early ideas and identify areas of agreement and disagreement. Besides identification and prioritisation of all stakeholders’ needs, early stakeholder involvement is important for implementation. Stakeholders play an important and often influential role in the decision-making process, particularly in the context of purchasing decisions (29). Moreover, when stakeholders perceive that their input has been heard and incorporated into the design, they are more likely to support the innovation and advocate for its adoption (30, 31). As such, late or no stakeholder involvement has been found to form a barrier for the uptake and implementation of digital health interventions (31, 32). Throughout our research, we strived to involve
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