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Original research
Coassessment framework to identify person-centred unmet needs in stroke rehabilitation: a case report in Norway
  1. Kari Jorunn Kværner1,2,
  2. Linn Nathalie Støme1,
  3. Jonathan Romm3,
  4. Karianne Rygh3,
  5. Frida Almquist3,
  6. Sveinung Tornaas4,
  7. Marianne Storen Berg3
  1. 1 C3 – Centre for Connected Care, Oslo University Hospital, Oslo, Norway
  2. 2 Department of Strategy and Entrepreneurship, BI Norwegian Business School, Oslo, Norway
  3. 3 Department of Service Design, Oslo School of Architecture, Oslo, Akershus, Norway
  4. 4 Department of Innovation, Sunnaas Sykehus HF, Nesoddtangen, Norway
  1. Correspondence to Professor Kari Jorunn Kværner, C3 - Centre for Connected Care, Oslo University Hospital, 0188 Oslo, Norway; uxkakv{at}


Objective To describe unmet needs and values in stroke rehabilitation using the Health Value Framework and the associated coassessment tool Health Value Spider, a framework designed to identify and prioritise unmet needs based on health technology assessment (HTA).

Setting The study took place at Oslo University Hospital, Norway, from February to April 2019. Participants in three consecutive workshops were recruited from Sunnaas Rehabilitation Hospital, Oslo Municipality, Hospital Procurement Trust and Oslo University Hospital. Twenty-four hospital workers (medical and allied health staff and administrative staff) participated in workshop 1 and 29 patients, user representatives and hospital workers in workshop 2. Twenty-one patients and hospital workers participated in workshop 3.

Interventions Stakeholder analysis and scenario building was performed in a coassessment setting where unmet needs were identified applying the Health Value Framework. Two of the authors are also the developers of the Health Value Framework (KJK and LNS).

Results In the two first workshops where health workers, patients and next of kin perspectives were elicited, three needs were identified: patient insecurity in patient journey transitions, lack of stroke rehabilitation expertise in primary care and invisible patient problems, such as fatigue and cognitive impairment. In workshop 3, 12 opportunity areas were identified. Four opportunity areas were selected by the stakeholders based on a prioritisation process: early discovery of cognitive impairment, rehabilitation continuity, empowered patients and next of kin and remote monitoring and digital touchpoints.

Conclusion Health Value Spider successfully identified and prioritised unmet needs and described associated values.

  • cardiovascular
  • economics
  • affordable
  • accessible

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  • Contributors KJK, JR, MSB, FA, KR and ST have substantially contributed to the conception or design of the work or the acquisition of data. KJK and LNS have substantially contributed to the analysis and interpretation of data and to the draft of the work. All authors have been contributing to the critical revision for important intellectual content and final approval of the submitted version. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding This study was supported by the Norwegian research Council (grant number: 237766/030). This funding has enabled design of the study and collection, analysis and interpretation of data and in writing the manuscript.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The Regional Committee for Medical Research Ethics, Region Eastern Norway provided information that consent was not needed.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. This is not a clinical trial, and there are no clinical data.

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