Cognitive Accessibility in eHealth – Introducing Participatory Research through Design
Time: Fri 2025-06-13 14.00
Location: Kollegiesalen, Brinellvägen 6 (Tillgänglighetsanpassad entré), Stockholm
Video link: https://kth-se.zoom.us/j/68571101309
Language: English
Subject area: Human-computer Interaction
Doctoral student: Marika Jonsson , Medieteknik och interaktionsdesign, MID
Opponent: PhD, Senior Research Fellow Sarah Lewthwaite, University of Southampton
Supervisor: Professor Jan Gulliksen, Medieteknik och interaktionsdesign, MID; Docent Catharina Gustavsson, Center for Clinical Research Dalarna; PhD Stefan Johansson, Medieteknik och interaktionsdesign, MID; Med Dr Lars Lindsköld, Västra Götalandsregionen
QC 20250513
Abstract
The digitalisation of healthcare often comes with promises of solving future expected increasing demands on healthcare and ensuring equitable health service distribution. However, this promise is not yet realised in Sweden’s present eHealth services. Meanwhile, Swedish public healthcare is moving towards person-centred care, where the person’s resources, experiences, and needs are considered. The primary motive of this thesis is to contribute to knowledge on how to design eHealth services that support cognitive accessibility for increased equity. The work in this thesis is based on the idea that accessibility is important, and that people affected by problems in eHealth should be part of the design of accessible eHealth services. The research started by looking into previous research on accessibility in eHealth services and then focused on Sweden’s local context. There are regulations on accessibility in eHealth services the European Union (EU). Therefore, we investigated how Swedish public healthcare complies with this regulation. The scope was then narrowed to cognitive accessibility, an area not sufficiently covered by the EU regulations and current guidelines. Together with people with lived experiences of cognitive impairments, we explored participatory design methods for cognitive accessibility and how to make an impact in real-life settings. We used two cases for the research: the personal eHealth services on the Swedish national healthcare website 1177.se; and a symptom checker and triage tool, called 1177 direkt, presented as a conversational agent. For the first case, we co-designed a prototype for enhanced cognitive accessibility and used it as a dialogue tool to make an impact on the development of the existing eHealth services. For the second case, we evaluated 1177 direkt and conducted co-design activities for suggestions on enhanced cognitive accessibility with a collaborative approach with representatives from the product owner. In this case, the product owners are both the company that develops and markets the product, and Inera, which procures the product so that public healthcare providers can select it from Inera’s range of services and products. This thesis ii concludes that eHealth services that are experienced as inaccessible will most likely remain inaccessible if we continue developing eHealth services as before. Considering the insights from people with lived experience of cognitive impairment in participatory approaches when designing eHealth services can contribute to eHealth services that support person-centred care.