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Challenges in digital health system innovation: Actor analysis of Personal Emergency Response System (PERS) usage in morning shift nursing home
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Health Informatics and Logistics.ORCID iD: 0000-0003-1312-6123
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems.ORCID iD: 0000-0003-2069-0507
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems.ORCID iD: 0000-0003-0563-3635
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Health Informatics and Logistics.ORCID iD: 0000-0003-1126-3781
(English)Manuscript (preprint) (Other academic)
Abstract [en]

The increasing global aging population has highlighted the need for qualified elderly care services. The shortage of care services presents challenges in meeting these increasing demands. The Personal Emergency Response System (PERS), a telehealth technology, is seen as a solution to improve care quality by simplifying care tasks. However, the complexity of PERS adoption and care workers' concerns about using the technology in care work are rarely addressed. This study applies the Actor Network Analysis, Action, Factor and Goal (AFG) model to understand careworkers' behaviors regarding PERS in nursing homes, focusing on operational and perceptual levels. Our findings reveal that PERS use involves two key areas: software interaction with residents and colleagues, and hardware implementation. Three operational disparities were identified, and the care workers' perceptions during the adoption process were discussed. The AFG model helps identify gaps in PERS use, providing a clearer context for caregivers' experiences. This research offers valuable insights for aging care scholars and practitioners, helping them better understand the challenges care workers facing with innovative technologies. Additionally, it provides PERS providers with a broader view of caregivers' and elderly residents' needs. By recognizing operational and perceptual barriers, this study can support a smoother integration of PERS into nursing home care.

Keywords [en]
Aging care, Actor analysis, Complex system, Digital healthcare, Technology innovation solution implementation disparities
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:kth:diva-369229OAI: oai:DiVA.org:kth-369229DiVA, id: diva2:1993596
Note

QC 20250901

Available from: 2025-08-31 Created: 2025-08-31 Last updated: 2025-09-01Bibliographically approved
In thesis
1. Multi-actor influence in achieving sustainable complex innovation systems: Case studies in transportation, automotive and aging care industries
Open this publication in new window or tab >>Multi-actor influence in achieving sustainable complex innovation systems: Case studies in transportation, automotive and aging care industries
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis investigates the application of the Action, Factor and Goal (AFG) actor analysis method in complex technology innovation systems across three distinct domains: transportation, heavy automotive automation, and aging care. The research addresses the critical need to understand multi-actor influences in the early adoption stages of technological innovations. This challenge has become increasingly significant as innovation processes become more global and multifaceted. The study employs a mixed-method approach, combining qualitative data collection through interviews, observations, and document analysis with the structured AFG framework. This method comprehensively examines innovation adoption's technical, institutional, and social dimensions across the selected domains.

By leveraging AFG analysis, the study investigates multi-actor influences, uncovering how diverse behaviors, perspectives, and organizational priorities impact technological integration. In the transportation domain, AFG analysis reveals challenges in the electric road system (ERS) and mobility-as-a-service (MaaS) solutions. In the production domain, the study examines Human-Robot Collaboration (HRC) in heavy vehicle manufacturing, highlighting safety, ergonomics, and productivity considerations across regulatory and operational levels. In the aging care sector, AFG analysis addresses the adoption of Personal Emergency Response Systems (PERS) in an aging care home, capturing the interplay of caregiver practices, resident safety, and ethical concerns related to technology deployment.

Key findings reveal that the AFG method effectively captures multi-actor challenges by providing a structured analysis of system characteristics and actor concerns, visualizing stakeholder perceptions, and identifying potential conflicts and synergies.

The research contributes to innovation management and multi-actor analysis literature by demonstrating the AFG method’s adaptability and effectiveness in analyzing complex, multi-actor innovation systems. It also provides practical insights for project managers and policymakers on developing targeted communication plans, creating collaborative platforms, and tailoring adoption strategies to address specific actor needs and motivations.

Limitations of the AFG method implementation, including potential observer bias, qualitative nature, and static representation of dynamic systems, are acknowledged and addressed through proposed methodological refinements. Future research directions are suggested to enhance the method’s empirical validation and quantitative precision.  

This thesis advances our understanding of multi-actor influences in technology innovation systems and offers a robust analytical tool for understanding the complexities of innovation adoption across diverse industrial sectors.

Abstract [sv]

Avhandlingen undersöker tillämpningen av aktörsanalysmetoden Action, Factor and Goal (AFG) i komplexa innovationssystem inom tre specifika områden: transport, automation inom den tunga fordonsindustrin och äldreomsorg. Forskningen inriktas på det kritiska behovet av att förstå hur inflytandet från flera aktörer sker i tidiga genomförandestadier av tekniska innovationer. Denna utmaning har blivit allt viktigare i takt med att innovationsprocesser blir mer globala och mångfacetterade. I kasusstudierna används en varierad metod, som kombinerar kvalitativ datainsamling genom intervjuer, observationer och dokumentanalys med det strukturerade AFGramverket. Denna metod undersöker på ett omfattande sätt tekniska, institutionella och sociala dimensioner av innovationsadoptionen i de utvalda områdena.

Genom att använda AFG-analys undersöker studien inflytandet från flera aktörer, och klargör hur olika beteenden, perspektiv och organisatoriska prioriteringar påverkar teknisk integration. Inom transportområdet visar AFG-analys utmaningar i Elektrifierade Vägar (ERS) och Mobility-as-a-Service (MaaS)-lösningar. Inom produktionsområdet undersöker studien Människa-Robot Samarbete (HRC) inom tunga fordonsindustri, belyser säkerhet, ergonomi och produktivitetsöverväganden på regulatoriska och operativa nivåer. Inom vårdsektorn för äldre tar AFG-analysen upp införandet av Personal Emergency Response Systems (PERS) i äldreboenden, och fångar samspelet mellan vårdgivares praxis, boendesäkerhet och etiska problem i förhållande till teknik.

Avgörande upptäckter visar att AFG-metoden effektivt fångar utmaningar med flera aktörer genom att tillhandahålla en strukturerad analys av systemets egenskaper och aktörsproblem, visualisera intressenternas uppfattningar och identifiera potentiella konflikter och synergier.  

Forskningen bidrar till innovationsledning och litteratur som inriktas på fleraktörsanalys genom att demonstrera AFG-metodens anpassningsförmåga och effektivitet i att analysera komplexa multiaktörskomplexa innovationssystem. Det ger också praktiska insikter för projektledare och beslutsfattare om att utveckla riktade kommunikationsplaner, skapa samarbetsplattformar och skräddarsy adoptionsstrategier för att möta specifika aktörers behov och motiv.

Begränsningar för införande av AFG-metoden, inklusive potentiell partiskhet, kvalitativ karaktär och statisk representation av dynamiska system, erkänns och åtgärdas genom föreslagna metodiska förbättringar. Framtida forskningsriktningar föreslås för att förbättra metodens empiriska validering och kvantitativa precision.

Den här avhandlingen främjar förståelsen av multiaktörsdynamik i tekniska innovationssystem och erbjuder ett robust analytiskt verktyg för att navigera i komplexiteten av innovationsinföranden i olika industrisektorer. 

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2025. p. 111
Series
TRITA-CBH-FOU ; 2025:23
Keywords
Actor analysis; Social technical systems; Complex systems; Electric road systems; Mobility as a Service; Automotive industry; Aging care systems; Human robot cooperation; perceptions; system analysis.
National Category
Engineering and Technology
Research subject
Technology and Health
Identifiers
urn:nbn:se:kth:diva-369210 (URN)978-91-8106-362-2 (ISBN)
Public defence
2025-09-18, Zoom: https://kth-se.zoom.us/j/65328718619, T2, Hälsovägen 11C, Huddinge, 09:00 (English)
Opponent
Supervisors
Note

QC 20250829

Available from: 2025-08-29 Created: 2025-08-29 Last updated: 2025-12-16Bibliographically approved

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Wang, QiuchenChang, FangyuanÖstlund, BrittMeijer, Sebastiaan

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