Cocreation to Facilitate Communication and Collaboration Between Multidisciplinary Stakeholders in eHealth Research and Development: Case Study of the CARRIER (Coronary Artery Disease: Risk Estimations and Interventions for Prevention and Early Detection) Consortium.

BACKGROUND: Collaboration with diverse stakeholders in eHealth research is fundamental yet complex. Stakeholders from various disciplines do not "speak the same language" and have different levels of power and interest, resulting in contrasting objectives, priorities, and expectations. An approach to constructive communication and collaboration is necessary to overcome this complex dynamic. Cocreation, known in the field of eHealth most often to involve end users, may also be suitable for facilitating stakeholder engagement and alignment. OBJECTIVE: This paper provides insights into the application of cocreation, specifically in the early phases of research that focus on involving and aligning relevant stakeholders from different academic and professional backgrounds. METHODS: The case for this study was a group discussion with members of a multidisciplinary consortium that works on developing a personalized eHealth intervention for atherosclerotic cardiovascular disease. Using stakeholder mapping, health and medicine experts, big data scientists, software developers, and an innovation manager (N=8) were invited to participate. The discussion was based on a user scenario and structured according to the Six Thinking Hats of de Bono, representing 6 different types of thinking. The discussion was recorded, transcribed verbatim, and analyzed thematically with the use of ATLAS.ti software. RESULTS: First, informative and intuitive thinking served the preparatory purpose of familiarization with the project details and other participants. Second, positive and critical thinking constituted the body of the discussion and resulted in an in-depth conversation. Third, creative and organizational thinking were action oriented and focused on solutions and planning to safeguard future progress. The participants repeatedly reflected on various intervention-related themes, ranging from intervention content to technical functionalities and from legal requirements to implementation in practice. Moreover, project-related matters were discussed, including stakeholder management and time and budget constraints. CONCLUSIONS: This paper demonstrates how cocreation can be of value for multidisciplinary stakeholder engagement and alignment. Based on stakeholder mapping (with whom to discuss), a dream user scenario (what to discuss), and the Six Thinking Hats of de Bono (how to discuss), the participants shared information, discussed differences, searched for solutions, and moved toward a collective approach regarding intervention development. The lessons learned may further improve the understanding of how cocreation can contribute to multidisciplinary collaboration.

Predicting the place of out-of-hours care--a market simulation based on discrete choice analysis.

BACKGROUND: Increasing cost pressure and changing patients' needs in the healthcare sector have led to new delivery models for primary care. Researchers and practitioners need to establish innovative methods to obtain insights into patients' preferences and effectiveness of healthcare services. AIM: This study reveals the crucial decision criteria of patients in choosing out-of-hours services and provides a projection of a future market share of the newly established central out-of-hours service, called General Practitioner Cooperative. DESIGN: A computer-aided discrete choice experiment. METHOD: Respondents were 350 patients in a European city who decided for a service when confronted with a medical emergency in an out-of-hours case; two scenarios called 'adult' and 'child', describing the persons requiring medical assistance, were used to increase generalizability. RESULTS: The two most important attributes were 'explanation by the doctor' and 'waiting time' while the others - 'availability of technical equipment', 'ease of access', 'type of consultation' and 'payment method' - were of less importance. The market share projections predict that the new General Practitioner Cooperative will capture about one third of the market ('adult': 39.1%, 'child': 31.3%), ahead of the emergency department, the second most preferred service ('adult': 32.7%, 'child': 30.7%). CONCLUSIONS: This study quantifies the adoption of a new medical service. As a result, it extends current research approaches on eliciting and matching patient's needs and assists policy makers in establishing adequate service capacities.