Hitting a moving target: digital transformation and welfare technology in Swedish municipal eldercare

Figures & data

Table 1. Examples of welfare technologies and services.

Digital locks	Caregivers can open doors to different homes with their mobile phones to save time retrieving keys if the visit schedule changes
GPS alarms	Caregivers can determine the location of a care receiver
Virtual doctor visits	Patients can get medical opinions via video links from the comfort of their home
Safety bracelets	Patients can use bracelets with sensors that analyse movement patterns and can warn carers if there is an increased risk for falls
Shower robots	Disabled people can shower on their own and control soap and shampoo with keystrokes
Mobile access	Caregivers can access patient records through smartphones so they do not have to carry documentation or bring paper lists
Digital signing	Caregivers can sign for medications and drugs on their smartphones
Incontinence detection sensor technology	Patients can have a sensor in their incontinence pads that detects daily urine patterns as well as when the incontinence protection needs to be changed
Artificial intelligence coupled with sensors	Smart home sensors analysed by AI can learn an individual’s movement patterns and alert personnel or relatives in case of deviations

Table 2. Responsible welfare technology framework; modified from Stahl and Coeckelbergh [86].

	Purpose (Addresses why the product/service should be implemented at all)	Process (The activities involved in the preparation and implementation of a product/service)	People	Product Welfare technology/digital service
Prediction/anticipation (Risk analysis)	Why should this welfare technology be used and implemented? What are the benefits and the risks?	How should this welfare technology be implemented?	Who should be involved in the decision-making process? Who should be involved in the implementation?	Usability: Is the welfare technology solution useful, effective, efficient and satisfactory? Social acceptance: Is the welfare technology solution socially desirable? Budget: Is the welfare technology solution affordable?
Reflection (Contemplation of objectives for and implications of the welfare technology and its implementation)	What are the consequences of using this welfare technology? What are the consequences of the implementation?	What processes are used for decision-making? What processes are used for the implementation?	Who is affected by the welfare technology? Who is affected by the implementation?	What might be the potential usage? What do we not know about, e.g., risks and consequences? How can we ensure social desirability?
Inclusion (Initiate debates and engagement with a broad audience)	Are the purpose and risks acceptable?	How do we engage a wide group of stakeholders?	Who matters? Who prioritizes? For whom is the implementation of the specific welfare technology done?	What are the viewpoints of a wide group of stakeholders?
Responsiveness (Influence the course of actions, codes of conduct and implementation process)	How do we verify the success of the technology for end-users? How do we measure success? What kind of benchmarking or metrics are relevant? What kind of impact would we like to achieve? If it is not successful, what do we do? How do we verify that the implementation is successful? How do we measure the progress of the implementation process? What kind of benchmarking or metrics are relevant? If the implementation is not successful, what do we do?	How can the implementation structure become flexible? What training is required? What infrastructure is required?	What training is required? What infrastructure is required?	How can we modify and adapt the product to ensure usability among a wide group of end-users? How can we modify and adapt the product to ensure social desirability among a wide group of end-users? How do we achieve sustainable modification and adoption of the product?

Stahl BC, Coeckelbergh M. Ethics of healthcare robotics: towards responsible research and innovation. Robot Auton Syst. 2016;86:152–161.

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