Digital Health and Wireless Solutions

This paper aims to understand the value-added services that the future 6G-enabled metaverse can and will bring to hospitals. This is important since most studies on 6G and the metaverse are heavily driven by technological solutions. Adopting a qualitative research approach, this paper collects experts’ opinions on the usage scenarios of the 6G-enabled metaverse in hospitals. Six use cases within hospital contexts have been identified from open-ended interviews. The analysis of each case reveals that 6G, as a general-purpose technology, offers the necessary capabilities to support the development of the metaverse in hospitals. The metaverse-enabled services are expected to design future smart hospitals and improve work processes and resource allocation in hospitals, while also promoting preventive healthcare and training and enhancing the quality of care in emergency, treatment, and rehabilitation. Consequently, the development of both metaverse and 6G will progress in tandem, hand in hand, offering local services in hospitals. From a value perspective, this paper contributes to the development of the 6G and metaverse in the hospital vertical by understanding the needs, capabilities, and key values of the future 6G-enabled hospital metaverse.

Dementia is a series of neurodegenerative disorders that affect 1 in 4 people over the age of 80 and can greatly reduce the quality of life of those afflicted. Alzheimer’s disease (AD) is the most common variation, accounting for roughly 60% of cases. The current financial cost of these diseases is an estimated $1.3 trillion per year. While treatments are available to help patients maintain their mental function and slow disease progression, many of those with AD are asymptomatic in the early stages, resulting in late diagnosis. The addition of the routine testing needed for an effective level of early diagnosis would put a costly burden on both patients and healthcare systems. This research proposes a novel framework for the modelling of dementia, designed for deployment in edge hardware. This work extracts a wide variety of thoroughly researched Electroencephalogram (EEG) features, and through extensive feature selection, model testing, tuning, and edge optimization, we propose two novel Long Short-Term Memory (LSTM) neural networks. The first, uses 4 EEG sensors and can classify AD and Frontotemporal Dementia from cognitively normal (CN) subjects. The second, requires 3 EEG sensors and can classify AD from CN subjects. This is achieved with optimisation that reduces the model size by 83×, latency by 3.7×, and performs with an accuracy of 98%. Comparative analysis with existing research shows this performance exceeds current less portable techniques. The deployment of this model in edge hardware could aid in routine testing, providing earlier diagnosis of dementia, reducing the strain on healthcare systems, and increasing the quality of life for those afflicted with the disease.

6G will fulfill the requirements of future digital healthcare systems through emerging decentralized computing and secure communications technologies. Digital healthcare solutions employ numerous low-power and resource-constrained connected things, such as the Internet of Medical Things (IoMT). However, the current digital healthcare solutions will face two major challenges. First, the proposed solutions are based on the traditional IoT-Cloud model that will experience latency and reliability challenges to meet the expectations and requirements of digital healthcare, while potentially inflicting heavy network load. Second, the existing digital healthcare solutions will face security challenges due to the inherent limitations of IoMT caused by the lack of resources for proper security in those devices. Therefore, in this research, we present a decentralized adaptive security architecture for the successful deployment of digital healthcare. The proposed architecture leverages the edge-cloud continuum to meet the performance, efficiency, and reliability requirements. It can adapt the security solution at run-time to meet the limited capacity of IoMT devices without compromising the security of critical data. Finally, the research outlines comprehensive methodologies for validating the proposed security architecture.

The confluence of the Internet of Things (IoT) within the healthcare sector, called Internet of Medical Things (IoMT), has ushered in a transformative approach to real-time patient monitoring. Traditional methods that typically involve the direct transmission of medical sensor data to the cloud, falter under the constraints of medical IoT devices. In response, Multi-access Edge Computing (MEC), as defined by the European Telecommunications Standards Institute (ETSI), brings forth an innovative solution by relocating computing resources closer to the origin of data. However, MEC alone does not fully address the exigencies of constrained medical IoTs in the realm of real-time monitoring. Our architecture advances the computing continuum by seamlessly integrating local edge computing for direct data capture, MEC for nuanced data processing, and cloud computing for the comprehensive synthesis and presentation of data. This synergy is further enhanced by the introduction of a robust message queue mechanism, assuring data resilience and uninterrupted data streaming during network disruptions. With a steadfast commitment to security, our system employs stringent measures to ensure the integrity and confidentiality of sensitive patient data during transmission. This architecture represents a significant leap in healthcare technology, emphasizing the criticality of patient safety, data security, and meticulous data management. The implications of this study are profound, indicating a trajectory for future exploration into the integration of sophisticated data types and AI-driven models to further refine patient monitoring and healthcare outcomes.

The Japanese and Finnish healthcare systems have several longstanding challenges from the scattered data in storing databases due to location sensitivity and sometimes unequal services for their users. In addition to the data itself, location plays another role for the citizens living in urban or rural areas. They suffer from different well-being outcomes as stress and sedentary lifestyles have presented negative impacts on the urban dwellers. As remote work and technological solutions have become more common, in this conceptual research, we explore the general healthcare and living area challenges and how to make services more equal to everyone. We also discuss the possible telehealth solutions and how, for example, wearable body sensors’ use could offer improvements to the availability and accessibility of healthcare services.

The distribution and handling of controlled substances (CSs), i.e., narcotics, is strictly regulated to decrease the risk of abuse and drug diversion. In Finland, hospital pharmacies are mandated to keep records of CS distribution and consumption in healthcare through a labor-intensive paper-based process. After implementing a new electronic health record (EHR) system, a large university hospital started to streamline the process by transferring the CS documentation process from paper to digital format. Although the benefits of digital archiving, surveillance, and consumption monitoring are self-evident from the hospital pharmacy’s perspective the advantages at wards remain less explored. Therefore, our goal was to explore the usability and user experience (UX) of the recently implemented electronic narcotic consumption card (eNCC) solution built into the EHR system, and the related workflows of nurses, pharmacists, and physicians. The field study consisted of two parts and was conducted using observation, interviews, and survey methods in two wards. Our findings suggest that the digitalized process enables reliable real-time documentation of CSs and improves process efficiency, particularly for oral tablets and capsules. Considering diverse end-users’ perspectives is crucial when assessing the practical benefits of newly implemented digital solutions targeted at several healthcare professional groups. This approach enables a broader understanding of UX; supports development efforts, including usability improvements; and facilitates broader implementation. More research is needed to analyze the long-term impacts of the digital CSs’ consumption documentation workflow and surveillance at different healthcare units.

This paper explores digital health experience through focus on the experiences of diabetics who utilize digital health technology in their daily diabetes management. Theoretically, the paper draws from research on digital experience and from theoretical discussions concerned with digital health. Empirically, it analyzes three multimodal datasets using reflective thematic analysis. Three interlinked themes – always on, co-creation through interaction, and it makes things so much easier – are revealed. These themes reveal the key characteristics of users’ digital health experiences and highlight how users shape their experiences in their daily lives. The study contributes theoretically to digital experience literature within which user-centric, longitudinal studies are scarce. Practically, it demonstrates to health professionals and developers how digital health technology becomes integrated into their users’ lives.

Severe and chronic fatigue is a prevalent symptom in multiple chronic conditions. Its complexity, its multifaceted nature and its varied manifestations across different conditions require a nuanced approach for accurate assessment by healthcare professionals. In our research, informatics-savvy public health nurses from a Digital Health Services and Health Promotion Master’s program evaluated various visualizations of patient-generated health data which could potentially be collected through a mobile app designed for people with Multiple Sclerosis. The data visualization prototypes could be a tool to support fatigue assessment and effective communication during consultations and their design was based on prior suggestions from healthcare professionals with experience in fatigue assessment. The patient-generated health data represented in the prototypes comprised a combination of fatigue-related factors and physical activity tracked by Google Fit. This study presents the recommendations of the participants regarding various aspects linked to the visualizations of patient-generated health data, including their utility in the clinical setting, the most suitable types of data summaries, usability aspects and the possibility of meaningful interrelations between distinct types of data. The results of our study emphasize the importance of well-designed data visualizations to support healthcare professionals in decision-making and to improve patient participation in the chronic care process. The iterative design process of the prototypes ensures that the final visualizations have proper usability and the potential to become clinically relevant, and instrumental in the effective assessment of fatigue in chronic management.

Older adults are at risk of being excluded from digital society. They do not always find digital health services appealing, or they may have challenges with them. We investigated older adults´ emotional user experiences with digital health services and aimed to give designers tools to make digital health services more appealing for older adults. We interviewed 16 older adults about their experiences with digital health services. The use of digital health services brought joy and increased self-confidence. On the other hand, older adults had many negative emotional user experiences, including fear of pressing buttons and embarrassment of incompetence. In the future, designers should actively look for solutions that alleviate older adults´ fears and further encourage them to use digital health services. To enable that, proposals are made for designing digital health services.

This study addresses a crucial gap in current literature by examining the use of MyData-based health apps among individuals aged 50 and above in the UK and Nordic nations. With the advancement of personalized health technologies, understanding the factors influencing adoption among the elderly is essential. The research provides insights tailored to this demographic within the broader framework of digital health adoption. The primary scientific objective was to identify technological and health-related factors influencing the willingness of senior adults (50 and above) to use MyData-based preventive healthcare applications. The conditions for adoption, technological considerations, health-related variables, willingness to share MyData, and demographic variations were explored. Grounded in the Universal Theory of Acceptance and Use of Technology (UTAUT2) and Health Protection Motivation components, the research employed a quantitative approach, integrating a new concept called sharing personal data into the framework. Data collection occurred through an online survey in the UK and the Nordic region, yielding 374 responses from the Nordic sample and 1165 from the UK sample, resulting in a cleaned dataset of 1016. Findings revealed the significance of willingness to share MyData for both the UK and Nordic regions, with performance expectancy emerging as an outstanding technological factor for the Nordic population, but not for the UK. Across nations and genders, self-efficacy is portrayed as a strong driver in health-related aspects. These contribute to academic knowledge and have societal value by guiding the development of digital health solutions for the elderly, ultimately improving their quality of life and health outcomes.

Different electronic medical record systems (EMR) have established themselves as part of the Finnish health care service provision. There is a need to ensure health care professionals’ competence and training for such systems. The MEDigi project, aimed to modernize and harmonize the Finnish basic medical education, recognized EMR systems as a key competence area for medical professionals in eHealth topics. The project also led to the development of a new eHealth course and an EMR simulation environment targeted for medical students based on the Esko EMR system already in production use.

A new simulation environment was developed in cooperation with the Faculty of Medicine at University of Oulu and Esko Systems Ltd. The simulation environment was implemented as an optional exercise in a cross-institutional web-based course teaching eHealth topics to medical students in the spring 2023. Students’ experiences with the simulation environment and associated exercise were collected with a feedback survey using 5- and 10-point Likert scales.

An EMR simulation environment “TrainingEsko” was successfully implemented into the “Basics in eHealth for Medical Students” course. Up to 11 medical students took part in the exercise, of which two participated in the associated feedback survey. They expressed satisfaction with the performance of the simulation environment and the associated exercise.

Our initial experiences with the EMR simulation environment give support for the further use of the EMR simulation environment in future course implementations. According to the feedback the students found the environment effective and the exercises beneficial for learning about EMR systems.

Healthcare education needs to be reformed to sustain quality, faster response to crises and ensure a rapid and efficient graduation path for future healthcare professionals. In this study, our multidisciplinary team has developed and tested a Human-centred extended reality (XR) to solve challenges in healthcare by connecting humans to technology in a human-centred, ethical way and by empowering end users through social innovation. In our study, we aimed to develop an intuitive XR virtual simulation environment with realistic scenarios and metahuman avatars, enabling team interaction to test and analyse participants’ real-time adaptation through a combination of neurophysiological and behavioural data collected by wearable sensors. This novel research offers a solution to complement clinical placements of nursing and medical students and ensure that students achieve the required competencies even if unexpected situations or crises threaten to interrupt the practice of competencies in real-life environments. Furthermore, by utilising the neurophysiological data, we can assess the learning event based on analysis of the recorded signals. The XR solutions can reduce nursing and medical students’ stress levels and enhance their resilience to work effectively in collaborative interprofessional teams.

The evolution of the relationship between healthcare professionals and patients towards patient-centered care has emphasized the importance of understanding patients’ perspectives, values, and needs. This shift has transformed decision-making from a technical standpoint to a more holistic approach integrating moral influences, driven by empathy. This research explores the transformative role of empathy, facilitated by Virtual Reality (VR) technology, in healthcare practitioners’ interactions with patients. Inspired by VR's immersive capabilities, the novel specification entitled the Digital Empathic Design Voyage is presented as a foundation for operational virtual environments that empower humans to experience empathy. Through outcomes from literature and a qualitative study, this paper determines appropriate digital environment interactions relevant to a healthcare scenario. The research envisions a deeper understanding of patients, fostering human-oriented healthcare practices and solutions.

Long-term care (LTC) residents often have many health problems and functional limitations, and their sedentary behavior is common. Playing digital games is one way to improve the well-being, functioning, and activity of older people. The purpose of this study was to test a digital gaming intervention with a new device in an LTC environment before the larger effectiveness study. The aim was to produce information on the benefits of the digital gaming intervention for residents, the success of the implementation of the intervention and the factors affecting it. One LTC facility for older people participated in the study. The data was collected with a semi-structured thematic interview after an eight-week intervention. The interview data was analyzed using inductive content analysis. Staff experiences of the benefits of the intervention were classified into three main categories: The intervention enabled a new kind of physical activity, the intervention increased the social activity and brought residents together and the intervention brought joy and variety to the residents. Success of the intervention implementation was classified into three main categories: active participation of the residents in the gaming sessions, low involvement of staff in the implementation of the intervention and variable success of implementing the intervention protocol in the everyday life of LTC facility. Factors affecting the implementation formed nine main categories. This feasibility study highlighted important factors related to the implementation of the intervention, which must be considered in the future for the success of the effectiveness study.

This study used near-infrared spectroscopy to monitor dynamic spectral effects to radiotherapy aiming to monitor spectral response for clinical radiotherapy. Twenty-four patients with total fractions of 96 measurements were measured to evaluate the dynamic spectral status of radiotherapy response. Dynamic responses from absorbance measurement were found to be associated with effects of induced radiation to skin and it linearly correlates to the dose given. Whereas significantly no response was found in ex vivo samples. A spectrometer was used in near infrared range between 650 nm and 1100 nm wavelength in absorbance mode. The absorbance spectral dynamics were measured using one light source-detector probe attached to the forehead in human patients and chicken samples to compare their responses to irradiation. The absorbance measurements of the forehead (skin) show absorbance increase throughout the spectra during irradiation in patients and confirmed with repeatability whereas in corresponding irradiation of ex vivo chicken samples, no absorbance changes were detected. Since spectral range of 650 nm–950 nm is dominantly affected by hemodynamical changes in tissue this indicates the oxygenation of blood in patients is strongly affected by irradiation. Furthermore, the irradiation caused absorbance changes also between 950 nm to 1100 nm range which is dominated by water in tissue, however in ex vivo chicken no visible effects of irradiation were detected in this range either.

Digital twins for different healthcare applications are currently being studied actively since they could revolutionize research on customized and personalized healthcare and enable realistic evaluations of new medical devices and applications in early phase. This paper presents a study on the development of digital twins aiming to be utilized for the development of microwave technique-based brain tumor detection. Realistic anatomical models of the digital twins were designed based on magnetic resonance images (MRI) scanned from the brain with brain tumor. These twins aim to correspond to the human brain and brain tumor in terms of size, shape, and tissue dielectric properties. Furthermore, developed digital twins include both phantom models for measurement emulation as well as corresponding simulation models designed using electromagnetic simulation software. By using the developed digital twins, our aim is to evaluate microwave-based sensing technique for brain tumor detection. Evaluations were carried out using flexible ultrawideband (UWB) antennas which would be beneficial for practical solutions. Our simulation and emulation results show that microwave technique with flexible antennas has high potential for brain tumor detection.

Epilepsy is a chronic neurological disorder, requiring long-term treatment. The workload and impact of treatment causes a significant burden to patients. Digital care pathways may have potential for reducing treatment burden, but there also may be concerns of additional burden caused by digital healthcare. The aim of this study is to investigate the role of digital care pathway on treatment burden for patients with epilepsy. This was a single case study with the digital care pathway for epilepsy in the Wellbeing Services County of North Ostrobothnia (Pohde), in Finland, as a unit of analysis. The data was collected by observing an expert meeting of three clinicians. The meeting focused on five pre-defined domains of treatment burden: Medication burden, Time and travel burden, Financial burden, Social and emotional burden, and Healthcare access burden. The data was analyzed qualitatively and organized based on the pre-defined categories. The results suggest that the digital care pathway supports patients with treatment burden for all the pre-defined domains. Reported benefits include reduced travel, options for remote appointments, providing informational support and easier ways to contact healthcare professionals (HCPs). The main concerns clinicians had was could the use of digital care pathway cause rushed treatment decisions, difficulties of building trust and seeking support from HCPs, and difficulties of using the digital systems. A new theme emerged from the data, Diverse burdens, highlighting the variety of patients with epilepsy with differing needs for treatment.

The healthcare systems across the world are transitioning towards sustainable development of digital health solutions such as digital care pathway (DCP) to meet the growing needs of healthcare services. DCP is a digital health solution to provide facilities like making online appointments, ease of access to connect with a healthcare professional (HCP), sharing symptoms and tracking progress of the disease. In this paper, a team of researchers and healthcare professionals (HCP) examine and propose the sustainability goals for Digital Care Pathway for Epilepsy (DCPE) project from the economic, social, and environmental perspectives. The project is a DCPE for children, adolescents, and adult patients with epilepsy. The research methodology is a single case study approach based on the DCPE in Northern Ostrobothnia Wellbeing County (Pohde), in Finland as a unit analysis. Furthermore, the data was collected using feedback from a co-design session with four HCPs all working as clinicians in epilepsy care at Oulu University Hospital. The analysis from the co-design session resulted in various factors to achieve sustainability goals like reduction in travel to hospital, cost efficient, time saving, ease of access to connect with HCPs, and lower CO₂ emission. However, there are several challenges such as adaptation to the online treatment options, proper management, and scheduling of online appointments, and building trust in epilepsy patients for remote treatment. Despite the challenges, HCPs confirm that the DCPE can be useful for treating patients with epilepsy through remote consultation along with the traditional ways.

The users of hearing technology often need auditory training for getting used to their hearing devices and maximally benefiting from them. Because auditory training given by professionals is only sparsely available, there is a great need for materials and applications with which self-training is possible. Moreover, deaf and hard-of-hearing persons need to improve their speechreading skills to help in speech reception and children to strengthen their reading skills. We describe the background, contents, construction and features of two Finnish free applications: Auditory Track for auditory training and Optic Track for speechreading (lip reading) training. Both can be used by children and adults, even though the Auditory Track is mainly aimed at adults and the Optic Track at primary school age children. The features of both applications include exercises carefully selected based on extensive knowledge of the acoustic and visual characteristics of speech. In addition, during the implementation of both applications, careful attention has been paid to the usability, accessibility, gamification and construction of feedback systems. The applications developed can be used in independent training, clinical use and research.

Multiple Sclerosis (MS) necessitates tailored care along intricate pathways throughout a patient's lifetime. Visualizing these pathways enhances the collective understanding of care processes and fosters collaboration among stakeholders. This study employed a qualitative study to map and the Customer Journey Modeling Language (CJML) to model MS patient pathways. A total of six purposefully selected healthcare professionals working in specialized healthcare, at a hospital and separate rehabilitation center, contributed to the care process mapping, participating in both pre- and post-modeling in-depth interviews. CJML, designed to capture planned and actual journeys from the service users’ perspective was adapted in this study to showcase the service provider's viewpoints, revealing insights into the existing organization of MS care. Involving more than one service provision level in mapping and modeling care processes requires dealing with handovers and its associated challenges. The final visualizations illustrate potential areas for improvement, including the need for more standardized procedures, potentially leading to variations in the quality of care and/or inefficient processes. However, the mapping process highlighted the difficulties in visualizing the MS care pathway due to its highly personalized nature, including challenges with creating personas or case groups that would allow for a unified service model. Participants’ feedback on the visualizations was essential, illustrating the importance of member checking when dealing with complex concepts such as patient pathways and organization of care.

Multiple sclerosis (MS) is a common neurological disease that can impact not only individuals diagnosed with the condition but also their informal carers, i.e. family members and friends. This scoping review aimed to map the role that family members and friends of people with multiple sclerosis have had in digital health research. The scoping review was reported according to PRISMA-ScR. The search was done in Scopus, CINAHL, Pubmed, and Web of Science. A total of 14 studies met the inclusion criteria. These studies were about telemedicine, rehabilitative video games, online education, user research, and development. Usually, family members and friends had a side part in the research. One study focused exclusively on them, and in total, in eight studies family and friends were participants in the study. Otherwise, they were accompanying the person with multiple sclerosis, were seen as possible users of the digital solution or they appeared in results by someone else. In this scoping review, it was seen that informal carers can get support and information from digital sources, they are able to act as informal carers in digital environments, healthcare professionals can receive information from them and family and friends can help in remote assessments, and digital solutions can help informal carers and people with MS to connect in a new or better way. Our results highlight that digital health can bring benefits to family members, people with multiple sclerosis, and healthcare.

In the new healthcare paradigm, personalized digital care pathway enables the provision of tailored information and empowers patients. In healthcare, it is crucial to attend to patients’ physical and emotional requirements. Stress and heavy mental workload can be detrimental to managing chronic lifestyle disorders. However, a reliable, standardized, and widely used paradigm for incorporating mental workload into the digital care pathway for providing long-term personalized care is missing from the current care pathway. Therefore, this study aims to investigate the use of mental workload tools and mobile applications in personalized digital care pathways for managing lifestyle chronic diseases. The study was focused on determining and characterizing the variables that determine mental workload; and then, investigating the ways in which these variables might function as supplementary data sources to enhance the personalization of care pathway. Based on the proposed mental workload tool, data was collected from 304 employees in the manufacturing industry, software development department. An intelligent mobile application was developed to manage and classify mental workload. Ensemble learning algorithms were used for mental workload classification, among which Hard Voting Ensemble Model outperforms the other techniques with 0.97 accuracy. Based on the findings, the most variable factor of mental workload is psychological factors with a median of 3.25, suggesting that individual differences or specific psychological conditions can significantly affect mental workload. Regarding personalization for managing chronic diseases, the mental workload variables may be utilized to individually adjust digital treatments to the specific requirements of every patient in a person-centered care.

Digitalization is one of today’s megatrends, and the increased development and use of various digital services emphasize the importance of sufficient guidance, support, and digital skills. The purpose of this study was to describe factors that can lead to an increased possibility of digital exclusion of marginalized older people evaluated by gerontological social work professionals. The aim was to obtain knowledge for developing age-friendly digital literacy education for older people. The research was qualitative: data was collected from gerontological social work professionals (n = 23) through an open-ended electronic survey and analyzed by using inductive content analysis. Professionals considered that marginalized older people had personal difficulties reaching or adopting digital services with deteriorating cognitive and physical abilities, such as impaired functioning, a lack of motivation or fears, and missing equipment. The possibility of digital exclusion of older people can also be increased by external factors, such as a lack of support and counseling resources, and competence from professionals. Therefore, to be able to utilize digital services, marginalized older people need plenty of support from care workers which should be considered in the service time. In addition, the digitalization of services prevents marginalized older people from managing their own lives unnecessarily early. There is a need to develop facilitating services, and support for acquiring digital skills and advocacy.

The aim of the study was to find out how teachers and project actors experienced the implementation of the specialisation education in a digital learning environment. The methods were triangulation with paired t-test, ANOVA and content analysis of qualitative data. The results showed a statistical difference between the responses after the first and second implementation of specialisation education. The overall results show that teachers and project actors demonstrate a strong commitment to producing and developing student-centred and work-life-centred online specialisation education.

The goal of this secondary research was to create a model that aims at increasing the sense of meaningful life and human dignity in physiotherapy by utilizing remote and digital rehabilitation technologies, focusing on people with cerebrovascular accident (CVA) and multiple sclerosis (MS). The results of this qualitative research effort have been obtained using thematic analyses and inductive synthesis. Our primary research, which provides materials for the secondary analysis, is based on qualitative systematic literature reviews and a meta-synthesis of the perceived meaningfulness of physiotherapy. The outcome of the secondary analysis is a research-based model, which combines rehabilitees´ experiences and expectations towards physiotherapy, professionals’ competence needs, and the technological prerequisites for using digital rehabilitation technologies with CVA and MS rehabilitees. Maintenance of human dignity and promotion of the sense of meaningful life, and various issues related to them, were most meaningful for the rehabilitees. The essential prerequisites of meaningful use of re- mote and digital rehabilitation technologies in physiotherapy were enabling identification of the rehabilitees’ own current functioning, needs and goals, supporting their motivation and commitment, choosing relevant and meaningful activities, creating safe and variable environments, and enabling social interaction and relationships. As far as we know, this is the first model which combines neuro- logical rehabilitees’ experiences of physiotherapy with remote and digital technology’s potential. In the future, the usefulness of our novel research-based holistic and biopsychosocial physiotherapy model should be tested in real life situations.