Odile-Florence Giger

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Giger
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Odile-Florence
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odile-florence.giger@unisg.ch

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    Barriers and facilitators of implementing value-based care: The case of SwissDiabeter
    (Sage Publications, 2025-05-06)
    Odile-Florence Giger  
    ;
    Elgar Fleisch  
    ;
    Tobias Kowatsch  
    ;
    Jovanova, Mia
    Objective Global spending on diabetes care soared to $966 billion in 2021, a 316% surge over the past 15 years. This sharp increase underscores a need for more efficient and cost-effective care strategies. Value-based care (VBC), which prioritizes patient outcomes while controlling expenses, presents a promising solution. However, its real-world implementation remains challenging, particularly in diabetes care. This study examines SwissDiabeter, a proposed diabetes clinic initiative in Switzerland inspired by a Dutch VBC-based Diabeter clinic. We examine key barriers and facilitators during Diabeter's implementation in the Netherlands and assess forthcoming challenges and enablers for SwissDiabeter in Switzerland. Methods We employ a deep, extensive embedded single-case design conducting 27 interviews with healthcare professionals, insurers, and patient groups in Switzerland and the Netherlands. The main interview data were complemented by various secondary sources to enhance contextual comprehension, widen perspectives, and validate findings. Results We identify four key factors for successful VBC adoption: leadership in driving change, financial restructuring, operational improvements, and enabling digital technologies. We next derive practical recommendations to guide the implementation of value-based diabetes care, redesigning financial incentives for healthcare providers, partnering up with key stakeholders such as insurers or policy makers, and measuring outcomes on a voluntary and anonymous basis. Conclusion This study enhances the global discourse on VBC by analyzing key barriers and facilitators in implementing SwissDiabeter, drawing insights from the Diabeter model in the Netherlands. Our findings highlight the need for strong leadership, financial incentives, digital infrastructure, and interdisciplinary collaboration to drive outcome-driven care. Beyond diabetes, these insights provide a framework for scaling VBC across chronic disease management, promoting cost-effective, high-quality healthcare.
    Type:journal article
    Journal:Digital Health
    Volume:11
    DOI:10.1177/20552076251336322
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/122902
    Scopus© Citations 4
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    Digital health technologies and innovation patterns in diabetes ecosystems
    (SAGE Publications, 2025-01)
    Odile-Florence Giger  
    ;
    Estelle Pfitzer
    ;
    Wasu Mekniran  
    ;
    Hannes Gebhardt
    ;
    Elgar Fleisch  
    Background The global rise in type-2 diabetes (T2D) has prompted the development of new digital technologies for diabetes management. However, despite the proliferation of digital health companies for T2D care, scaling their solutions remains a critical challenge. This study investigates the digital transformation of T2D ecosystems and seeks to identify key innovation patterns. We examine: (1) What are emerging organizations in digital diabetes ecosystems? (2) What are the value streams in digital T2D ecosystems? (3) Which innovation patterns are present in digital T2D ecosystems? Methods We conducted a literature review and market analysis to characterize organizations and value streams in T2D ecosystems, pre- and post-digital transformation. We used the e3-value methodology to visualize T2D ecosystems (RQ1 and RQ2) and conducted expert interviews to identify emerging innovation patterns in digital diabetes ecosystems (RQ3). Results Our analyses revealed the emergence of eight organization segments in digital diabetes ecosystems: real-world evidence analytics, healthcare management platforms, clinical decision support, diagnostic and monitoring, digital therapeutics, wellness, online community, and online pharmacy (RQ1). Visualizing the value streams among these organizations highlights the crucial importance of individual health data (RQ2). Furthermore, our analysis revealed four major innovation patterns within the digital diabetes ecosystem: open ecosystem strategies, outcome-based payment models, platformization, and user-centric software (RQ3). Conclusions Our findings illustrate the transition from traditional value chains in T2D care to platform-based and outcome-oriented models. These innovation patterns can inform strategic decisions for companies and healthcare providers, potentially helping anticipate new digital trends in diabetes care and across other chronic disease ecosystems.
    Type:journal article
    Journal:DIGITAL HEALTH
    Volume:11
    DOI:10.1177/20552076241311740
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/121937
    Scopus© Citations 12
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    Success Factors and Measures for Scaling Patient-Facing Digital Health Technologies from Leaders Insights
    (Springer Science and Business Media LLC, 2025-05-01)
    Pfitzer, Estelle
    ;
    Odile-Florence Giger  
    ;
    Christoph Kausch
    ;
    Kowatsch, Tobias  
    Abstract Background Europe’s healthcare systems face a triple burden: the rise of non-communicable diseases (NCDs), an aging population, and a shortage of healthcare professionals. NCDs, the leading causes of death, disproportionately affect older adults, placing significant pressure on healthcare services. By 2050, nearly 30% of Europe’s population will be aged 65 or older, up from 20% in 2023. These challenges demand urgent solutions to sustain healthcare systems. Patient-facing digital health technologies (DHTs), such as Digital Diagnostics and Digital Therapeutics, offer promising tools to address this burden by empowering patient self-management, reducing strain on healthcare professionals, and enhancing system efficiency. Despite their potential, the scaling and adoption of DHTs remain limited. This study investigates: (RQ1) What key factors drive success across different patient-facing DHT categories? and (RQ2) How can companies implement these factors? Methods Following COREQ guidelines, we conducted semi-structured interviews with 29 executives and founders of European DHT companies targeting NCDs. Participants were identified using PitchBook, focusing on revenue-generating companies with over 20 employees. Virtual interviews were conducted in English between May and September 2024, lasting an average of 28 minutes (range: 21–40). Data saturation determined the sample size. Thematic analysis was performed, with two researchers independently coding the data to ensure reliability. Success factors were categorized as internal (e.g., employees) or external (e.g., partnerships). Ethical approval was obtained, and data was anonymized. Results We identified 19 success factors for scaling patient-facing DHTs. Health & Wellness companies prioritized business model flexibility (80%), while Digital Therapeutics relied on regulatory compliance (100%). Validation of health impact was critical across categories, emphasized by all respondents in Digital Diagnostics and Digital Therapeutics. Other key factors included customer awareness, strategic partnerships, and investor alignment, highlighting the importance of tailored growth strategies. Conclusion This study provides a structured framework for scaling patient-facing DHTs, emphasizing category-specific strategies aligned with operational, regulatory, and consumer demands. It offers actionable guidance for founders and executives to allocate resources effectively and adapt to diverse market contexts. By addressing the unique challenges of scaling DHTs, this work contributes to advancing digital health research and improving healthcare system resilience.
    Type:journal article
    Journal:BMC Health Services Research
    Volume:25
    Issue:632
    DOI:10.21203/rs.3.rs-5914625/v1
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/121887
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    The longevity landscape: mapping stakeholder priorities for healthy aging among high-income countries
    (Springer Science and Business Media LLC, 2025-12-19)
    Wasu Mekniran  
    ;
    Odile-Florence Giger  
    ;
    Elgar Fleisch  
    ;
    Tobias Kowatsch  
    ;
    Jovanova, Mia
    Objective Global population aging presents significant economic and social challenges, requiring coordinated efforts to enhance healthy lifespans. However, little is known about how stakeholders prioritize healthy aging initiatives. We aimed to examine how a sample of stakeholders prioritize determinants of healthy aging, and what gaps or inconsistencies exist in stakeholder focus on these determinants? Methods We conducted a first systematic analysis of the value propositions of 56 stakeholders, including governments, companies, research centers, opinion leaders, communities, and multilateral organizations, identified through Web of Science, PitchBook, and Crunchbase. Guided by the National Academy of Medicine's All-of-Society framework, we assessed stakeholder emphasis on four determinants of healthy aging: public health systems, social factors, physical infrastructure, and work and education. Results Public health system reform emerged as the most emphasized determinant, with significant focus on investing in geroscience and developing tailored primary care for older adults. In contrast, critical social and infrastructural factors-such as digital literacy, housing, transportation, financial security, and loneliness-received limited attention among stakeholders. Conclusions These findings highlight the need for cross-sector partnerships to address these overlooked determinants and ensure a holistic approach to healthy aging. Future research should explore collaborative strategies to bridge these gaps to meet the diverse needs of aging populations. Highlights-The study systematically examines 56 stakeholders, highlighting the need for cross-sector partnerships to address neglected areas and adopt a holistic healthy aging approach.-Identified stakeholders prioritize public health reform, focusing on geroscience and tailored primary care for older adults.-Key social and infrastructural factors like loneliness, financial security, and housing are largely overlooked.
    Type:journal article
    Journal:BMC Public Health
    Volume:25
    Issue:1
    URL:https://link.springer.com/article/10.1186/s12889-025-25498-8
    DOI:10.1186/s12889-025-25498-8
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/124766
    Scopus© Citations 1
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    A care quality dashboard for general practitioners managing patients with diabetes mellitus type 2: user-centered design and prototype evaluation
    (Springer Science and Business Media LLC, 2026-05-09)
    Ackermann, Lola Jo
    ;
    Odile-Florence Giger  
    ;
    Principe, Marinja
    ;
    Brändle, Michael
    ;
    Jovanova, Mia
    Background Diabetes mellitus type 2 (T2D) is a growing burden in Switzerland, where general practitioners (GPs) face increasing workload. To evaluate the quality of T2D care, the Swiss Society of Endocrinology and Diabetology (SGED) developed the SGED score to help GPs overview aggregated patient parameters at the practice level. However, the practical use of the SGED score is hampered by paper-based workflows and fragmented documentation. Currently, no dashboard exists to specifically visualize the SGED score, which overviews aggregated population parameters such as HbA1c or blood pressure. To address this gap, this study examined: (1) what functional requirements healthcare professionals consider essential for such a potential SGED dashboard, and (2) how do healthcare professionals evaluate the usability and clinical relevance of an iteratively developed dashboard prototype. Methods We employed an iterative, user-centered three-step approach involving 10 semi-structured interviews with 14 Swiss T2D healthcare professionals. Step 1 involved defining the project scope, identifying predefined functional requirements, and developing an initial SGED score dashboard prototype. Step 2 collected user-generated requirements and prioritized all requirements using the “Must Have”, “Should Have”, “Could Have”, “Won’t Have” (MoSCoW) method. In step 3, the high-fidelity Figma dashboard prototype was iteratively refined based on the requirements and interviewee feedback. Results Key functional requirements of the digital SGED score included reminder and alert functions for missing or overdue SGED-relevant assessments, color-coded critical values such as low nephropathy screening rates, demographic overviews, trend analyses of SGED indicators at practice level, benchmarking within practice networks, and exportable reports. Additional needs emerged for patient-level views, integrated checklists, inclusion of comorbidities, and personal or practice-specific goal-setting features. Iterative refinements based on user feedback improved clarity, usability, and visual appeal. Some participants highlighted the dashboard’s intuitive design, clear and diverse visualizations, and benchmarking functionalities, describing it as both engaging and efficient. Others raised concerns about limited suitability for daily clinical workflows, potential integration challenges with existing systems, and the need for interactive, patient-centered features to support routine care. Conclusion The proposed SGED score dashboard could enhance T2D care through features like population overviews, long-term visualizations, and anonymized benchmarking, meaning the ability to compare a practice’s SGED performance with those of other practices. Successful clinical adoption will heavily depend on interoperability and seamless integration into existing workflows. The identified requirements provide a foundation for future digital T2D management systems.
    Type:Article
    Journal:BMC Medical Informatics and Decision Making
    DOI:10.1186/s12911-026-03492-3
    URI:https://alexandria.unisg.ch/handle/20.500.14171/126073
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    Digital Quality Monitoring for Type 2 Diabetes in Swiss Primary Care: Qualitative Interview Study
    (JMIR Publications Inc., 2026-05-12)
    Odile-Florence Giger  
    ;
    Ackermann, Lola Jo
    ;
    Principe, Marinja
    ;
    Meier, Simon
    ;
    Elgar Fleisch  
    Background: General practitioners (GPs) manage most type 2 diabetes (T2D) cases worldwide but face increasing workloads. To support guideline-based T2D care, the Swiss Society of Endocrinology and Diabetology (SSED) developed a quality monitoring tool for GPs to track and document patient clinical outcomes, such as glycated hemoglobin testing, blood pressure measurement, and diabetes-related complications in primary care. By aggregating these elements, the SSED score provides a structured way to assess adherence to recommended standards of diabetes care. Although this approach shows promise for improving health outcomes, the score is currently available in paper format and creates an additional administrative burden for physicians. Objective: This study examined challenges in T2D management in Swiss primary care, assessed limitations of the current SSED quality score, and identified strategies to enable the potential digital implementation and wider adoption of a digital SSED quality score in routine practice. Methods: A total of 38 qualitative interviews were conducted with 39 participants, representing 4 stakeholder groups relevant to digital T2D care: health care professionals (n=12), individuals with T2D (n=12), software developers (n=10), and health insurer representatives (n=5). Data were analyzed using thematic analysis. Results: Participants highlighted persistent challenges in T2D management, including time pressure for health care professionals, fragmented care, and a lack of personalized support for individuals with T2D. Barriers to digital quality monitoring included poor integration with GP systems, misaligned incentives, and limited relevance to multimorbidity. Suggested facilitators included embedding digital tools, such as a digital SSED score, into existing workflows, optimizing task shifting for GPs, integrating patient-centered features, and improving data sharing. Conclusions: A digital SSED score could support GPs by integrating patient-entered data, generating automated alerts, and enabling pharmacy-based follow-up. Successful adoption is likely to depend on GP workflow integration, system interoperability, and aligned incentives. Involving stakeholders early is essential to ensure that new digital tools meet the needs of both individuals with T2D and GPs.
    Type:Article
    Journal:Journal of Medical Internet Research
    Volume:28
    DOI:10.2196/82960
    URI:https://alexandria.unisg.ch/handle/20.500.14171/126074
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    Transforming NCD Business Models in Switzerland: CSS Insurance Perspective
    (2024)
    Odile-Florence Giger  
    ;
    Christopher Bensch
    ;
    Tobias Kowatsch  
    The worldwide incidence of non-communicable diseases (NCDs) is increasing, prompting exploration into technological advancements that present fresh prospects for treating and managing NCDs. Numerous well-established companies have been working in the field of NCD management, providing digital tools for the efficient management. Although there are many digital health companies nowadays, building them up at scale is difficult due to a heterogeneous, inefficient, and fragmented healthcare system. Therefore, we engaged in a conversation with Christopher Bensch, healthcare expert at CSS – one of Swiss’ largest health insurers – to understand better which business models may improve the management of NCDs. The insights are structured along the business model framework of the “Magic Triangle”. We found that the integration of healthcare providers is crucial when implementing the business model. Furthermore, new business models should be launched lean, pragmatic, and improved along the innov ation process within the given regulatory rules rather than waiting for the regulatory environment to change.
    Type:conference contribution
    Journal:Proceedings of the 17th International Joint Conference on Biomedical Engineering Systems and Technologies
    DOI:10.5220/0012400100003657
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/119624
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    A Care Quality Dashboard for General Practitioners Managing Patients with Diabetes Mellitus Type 2: User- Centered Design and Evaluation of a Prototype
    (Springer Science and Business Media LLC, 2026-01-12)
    Lola Jo Ackermann
    ;
    Odile-Florence Giger  
    ;
    Marinja Prinicpe
    ;
    Brändle, Michael
    ;
    Mia Jovanova
    Background Diabetes mellitus type 2 (T2D) is a growing burden in Switzerland, where general practitioners face increasing workload. To evaluate the quality of T2D care, the Swiss Society of Endocrinology and Diabetology (SGED) developed the SGED score. However, its practical use is hampered by paper-based workflows and fragmented documentation. Currently, there is no dashboard specifically for the visualization of the SGED score, which overviews aggregated population parameters such as HbA1c or blood pressure. To address this gap, this study derived functional requirements for a dashboard and developed a high-fidelity prototype through an iterative, user-centered design process, in collaboration with healthcare professionals. This approach explores how such a dashboard needs to align with clinical needs to enhance usability and promote adoption in routine T2D management. Methods An iterative, user-centered three-step approach was employed, involving 14 semi-structured interviews with Swiss T2D healthcare professionals. Step 1 involved defining the project scope and identifying functional requirements. Step 2 collected more requirements and prioritized all of them using the “Must Have”, “Should Have”, “Could Have”, “Won’t Have” (MoSCoW) method. In step 3, a high-fidelity Figma dashboard prototype was developed and iteratively refined based on the requirements and user feedback. Results Key functional requirements included reminder and alert functions, color-coded critical values, demographic overviews, trend analyses, benchmarking within networks, and exportable reports. Additional needs emerged for patient-level views, integrated checklists, inclusion of comorbidities, and personal or practice-specific goal-setting features. Iterative refinements based on user feedback improved clarity, usability, and visual appeal. Some participants highlighted the dashboard’s intuitive design, clear and diverse visualizations, and benchmarking functionalities, describing it as both engaging and efficient. Others raised concerns about limited suitability for daily clinical workflows, potential integration challenges with existing systems, and the need for interactive, patient-centered features to support routine care. Conclusion The proposed dashboard could enhance T2D care through features like population overviews, long-term visualizations, and anonymized benchmarking. Successful clinical adoption will heavily depend on interoperability and seamless integration into existing workflows. The identified requirements provide a foundation for future digital T2D management systems.
    Type:working paper
    Journal:Research Square
    DOI:10.21203/rs.3.rs-8347867/v1
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/124908