Human-centered design for advanced services: A multidimensional design methodology

Advanced services have caught the attention of industries and academics as a way to exploit new customer value propositions. However, the existing design methodologies for advanced services are limited to partially addressing one or some key design elements, hence causing confusion in practice. Moreover, human factors are not often addressed, even though the design for advanced services requires human-centered thinking. Aiming to advance the body of research, the current study aims to conceptually propose a multidimensional design methodology called DIMAND that captures the key design elements and their relations in a single-view structure in accordance with a human-centric approach. Specifically, DIMAND encapsulates the (i) life-cycle service design interrelated with other key design elements—(ii) stakeholder networks, (iii) new service development methods, and (iv) design skills—that must be considered to develop effective advanced service design. Based on a hybrid research design, DIMAND was conceptually developed through systematic reviews and structured analysis of existing design methodologies, as well as an elicitation of expert knowledge in the domain through the analytical hierarchy process (AHP). For validation, the average usability score of DIMAND as evaluated by 26 practitioners was 72.2, which falls into “excellence” on the simplified system usability scale (SUS), hence confirming its potential utility. As a result, DIMAND offers a novel and holistic guideline for design practitioners and engineers to obtain coherence in all the life-cycle design processes by simultaneously taking these key design elements and their relations into account, making the design of advanced services more practical

Emotional design: the development of a process to envision emotion-centric new product ideas

There is ample evidence, in many sectors, of the crucial importance of the emotional experiences in the interaction between users and products. Generating products with richer and significant emotional features is a complex challenge. In order to better face this challenge, professionals responsible for designing and developing new products could be facilitated with techniques and tools to understand emotions and to convey specific emotions in the new products. This paper presents the development of a process to support product design teams to envision emotion-focused new product ideas - Emotion-Driven Innovation (E-DI). We have adopted the process research methodology proposed by Platts, which encompasses four main steps: 1) state-of-the-art review, 2) process creation, 3) process development, and 4) process validation. This paper presents the results of the three first steps. The state-of-the-art literature review has been the foundation of the process creation step, which resulted in a three-phase workshop-based process: Emotion Knowledge Acquisition, Emotion Goal Definition, and Idea Generation. In the third step of the research methodology, the feasibility, usability, and utility have been tested through four studies which have involved master design students from Portugal and Italy. The results of these four tests show that Emotion-Driven Innovation process supports designers 1) to identify the occurrence of emotions in certain category of products present in the market, 2) to apply this information to make strategic decisions when defining the emotional intentions for the new product, and 3) to focus their creative thinking to develop strong and meaningful emotion-centric ideas

A Supporting Tool for Enhancing User’s Mental Model Elicitation and Decision-Making in User Experience Research

This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal of Human–Computer Interaction on April 18, 2022, available at: https://doi.org/10.1080/10447318.2022.2041885User Experience (UX) research is intended to find insights and elicit applicable requirements to guide usable designs. Card Sorting is one of the most utilized methods. It is used to uncover the user's mental model and increase the usability of existing products. However, although Card Sorting has been widely utilized, most applications are based on spreadsheets. Furthermore, existing tools are principally intended to obtain qualitative information or customized quantitative outcomes to improve the information architecture. In this paper, a supporting tool based on the Card Sorting method is presented and detailed, including a comprehensive use case showing the main features. The tool implements predictive analysis of results through advanced statistics and machine learning techniques, providing comprehensive reports that enable evaluators and UX researchers to obtain high-level knowledge and important quantitative clues to enhance decision-making. The tool has been evaluated with participants and evaluators, obtaining relevant usability results and feedback.This work was partially supported by the Spanish Government under grant number RTI2018- 095255-B-I00]; and the Madrid Research Council under Grant number P2018/TCS-4314

Product/Brand co-creation methodology crossing marketing, design thinking, creativity and management: ideas(r)evolution

This thesis introduce a new innovation methodology called IDEAS(R)EVOLUTION that was developed according to an on-going experimental research project started in 2007. This new approach to innovation has initial based on Design thinking for innovation theory and practice. The concept of design thinking for innovation has received much attention in recent years. This innovation approach has climbed from the design and designers knowledge field towards other knowledge areas, mainly business management and marketing. Human centered approach, radical collaboration, creativity and breakthrough thinking are the main founding principles of Design thinking that were adapted by those knowledge areas due to their assertively and fitness to the business context and market complexity evolution. Also Open innovation, User-centered innovation and later on Living Labs models emerge as answers to the market and consumers pressure and desire for new products, new services or new business models. Innovation became the principal business management focus and strategic orientation. All this changes had an impact also in the marketing theory. It is possible now to have better strategies, communications plans and continuous dialogue systems with the target audience, incorporating their insights and promoting them to the main dissemination ambassadors of our innovations in the market. Drawing upon data from five case studies, the empirical findings in this dissertation suggest that companies need to shift from Design thinking for innovation approach to an holistic, multidimensional and integrated innovation system. The innovation context it is complex, companies need deeper systems then the success formulas that “commercial “Design thinking for innovation “preaches”. They need to learn how to change their organization culture, how to empower their workforce and collaborators, how to incorporate external stakeholders in their innovation processes, hoe to measure and create key performance indicators throughout the innovation process to give them better decision making data, how to integrate meaning and purpose in their innovation philosophy. Finally they need to understand that the strategic innovation effort it is not a “one shot” story it is about creating a continuous flow of interaction and dialogue with their clients within a “value creation chain“ mindset; RESUMO: Metodologia de co-criação de um produto/marca cruzando Marketing, Design Thinking, Criativity and Management - IDEAS(R)EVOLUTION. Esta dissertação apresenta uma nova metodologia de inovação chamada IDEAS(R)EVOLUTION, que foi desenvolvida segundo um projecto de investigação experimental contínuo que teve o seu início em 2007. Esta nova abordagem baseou-se, inicialmente, na teoria e na práctica do Design thinking para a inovação. Actualmente o conceito do Design Thinking para a inovação “saiu” do dominio da area de conhecimento do Design e dos Designers, tendo despertado muito interesse noutras áreas como a Gestão e o Marketing. Uma abordagem centrada na Pessoa, a colaboração radical, a criatividade e o pensamento disruptivo são principios fundadores do movimento do Design thinking que têm sido adaptados por essas novas áreas de conhecimento devido assertividade e adaptabilidade ao contexto dos negócios e à evolução e complexidade do Mercado. Também os modelos de Inovação Aberta, a inovação centrada no utilizador e mais tarde os Living Labs, emergem como possiveis soluções para o Mercado e para a pressão e desejo dos consumidores para novos productos, serviços ou modelos de negócio. A inovação passou a ser o principal foco e orientação estratégica na Gestão. Todas estas mudanças também tiveram impacto na teoria do Marketing. Hoje é possivel criar melhores estratégias, planos de comunicação e sistemas continuos de diálogo com o público alvo, incorporando os seus insights e promovendo os consumidores como embaixadores na disseminação da inovação das empresas no Mercado Os resultados empiricos desta tese, construídos com a informação obtida nos cinco casos realizados, sugerem que as empresas precisam de se re-orientar do paradigma do Design thinking para a inovação, para um sistema de inovação mais holistico, multidimensional e integrado. O contexto da Inovação é complexo, por isso as empresas precisam de sistemas mais profundos e não apenas de “fórmulas comerciais” como o Design thinking para a inovação advoga. As Empresas precisam de aprender como mudar a sua cultura organizacional, como capacitar sua força de trabalho e colaboradores, como incorporar os públicos externos no processo de inovação, como medir o processo de inovação criando indicadores chave de performance e obter dados para um tomada de decisão mais informada, como integrar significado e propósito na sua filosofia de inovação. Por fim, precisam de perceber que uma estratégia de inovação não passa por ter “sucesso uma vez”, mas sim por criar um fluxo contínuo de interação e diálogo com os seus clientes com uma mentalidade de “cadeia de criação de valor

User data spectrum theory: Collecting, interpreting, and implementing user data in organizations

Organizations interested in increasing their user experience (UX) capacity lack the tools they need to know how to do so. This dissertation addresses this challenge via three major research efforts: 1) the creation of User Data Spectrum theory and a User Data Spectrum survey for helping organizations better invest resources to grow their UX capacity, 2) a new UX method and model for organizations that want to capitalize on spoken words from end users called Rapid Meaningful Scenarios (RMS), and 3) a recommendation for UX education in response to the current ACM SIGCHI education Living Curriculum initiative. The User Data Spectrum work is based on 30 interviews and 110 survey responses from UX stakeholders across 120 companies. These data informed the theory as well as a factor analysis performed to identify the most relevant items in the User Data Spectrum survey. The Rapid Meaningful Scenarios methodology was developed based on iterative UX experience with a real-world organization and refined to aid UX professionals in creating structured results based on end users\u27 words. The UX education recommendation integrates experience with the HCI curriculum at Iowa State University and curriculum discussions within the SIGCHI community over the past 5 years. The overall contribution of this research is a set of tools that will enable UX professionals and organizations to better strategize how to increase their UX capacity

Human‑centred design in industry 4.0: case study review and opportunities for future research

The transition to industry 4.0 has impacted factories, but it also afects the entire value chain. In this sense, human-centred factors play a core role in transitioning to sustainable manufacturing processes and consumption. The awareness of human roles in Industry 4.0 is increasing, as evidenced by active work in developing methods, exploring infuencing factors, and proving the efectiveness of design oriented to humans. However, numerous studies have been brought into existence but then disconnected from other studies. As a consequence, these studies in industry and research alike are not regularly adopted, and the network of studies is seemingly broad and expands without forming a coherent structure. This study is a unique attempt to bridge the gap through the literature characteristics and lessons learnt derived from a collection of case studies regarding human-centred design (HCD) in the context of Industry 4.0. This objective is achieved by a well-rounded systematic literature review whose special unit of analysis is given to the case studies, delivering contributions in three ways: (1) providing an insight into how the literature has evolved through the cross-disciplinary lens; (2) identifying what research themes associated with design methods are emerging in the feld; (3) and setting the research agenda in the context of HCD in Industry 4.0, taking into account the lessons learnt, as uncovered by the in-depth review of case studies

Automatic generation of software interfaces for supporting decisionmaking processes. An application of domain engineering & machine learning

[EN] Data analysis is a key process to foster knowledge generation in particular domains or fields of study. With a strong informative foundation derived from the analysis of collected data, decision-makers can make strategic choices with the aim of obtaining valuable benefits in their specific areas of action. However, given the steady growth of data volumes, data analysis needs to rely on powerful tools to enable knowledge extraction. Information dashboards offer a software solution to analyze large volumes of data visually to identify patterns and relations and make decisions according to the presented information. But decision-makers may have different goals and, consequently, different necessities regarding their dashboards. Moreover, the variety of data sources, structures, and domains can hamper the design and implementation of these tools. This Ph.D. Thesis tackles the challenge of improving the development process of information dashboards and data visualizations while enhancing their quality and features in terms of personalization, usability, and flexibility, among others. Several research activities have been carried out to support this thesis. First, a systematic literature mapping and review was performed to analyze different methodologies and solutions related to the automatic generation of tailored information dashboards. The outcomes of the review led to the selection of a modeldriven approach in combination with the software product line paradigm to deal with the automatic generation of information dashboards. In this context, a meta-model was developed following a domain engineering approach. This meta-model represents the skeleton of information dashboards and data visualizations through the abstraction of their components and features and has been the backbone of the subsequent generative pipeline of these tools. The meta-model and generative pipeline have been tested through their integration in different scenarios, both theoretical and practical. Regarding the theoretical dimension of the research, the meta-model has been successfully integrated with other meta-model to support knowledge generation in learning ecosystems, and as a framework to conceptualize and instantiate information dashboards in different domains. In terms of the practical applications, the focus has been put on how to transform the meta-model into an instance adapted to a specific context, and how to finally transform this later model into code, i.e., the final, functional product. These practical scenarios involved the automatic generation of dashboards in the context of a Ph.D. Programme, the application of Artificial Intelligence algorithms in the process, and the development of a graphical instantiation platform that combines the meta-model and the generative pipeline into a visual generation system. Finally, different case studies have been conducted in the employment and employability, health, and education domains. The number of applications of the meta-model in theoretical and practical dimensions and domains is also a result itself. Every outcome associated to this thesis is driven by the dashboard meta-model, which also proves its versatility and flexibility when it comes to conceptualize, generate, and capture knowledge related to dashboards and data visualizations

Let’s augment the future together!:Augmented reality troubleshooting support for IT/OT rolling stock failures

The railway industry is moving to a socio-technological system that relies on computer-controlled and human-machine interfaces. Opportunities arise for creating new services and commercial business cases by using technological innovations and traffic management systems. The convergence of Information Technology (IT) with Operational Technology (OT) is critical for cost-effective and reliable railway operations. However, this convergence introduces complexities, leading to more intricate rolling stock system failures. Hence, operators necessitate assistance in their troubleshooting and maintenance strategy to simplify the decision-making and action-taking processes. Augmented Reality (AR) emerges as a pivotal tool for troubleshooting within this context. AR enhances the operator’s ability to visualize, contextualize, and understand complex data by overlaying real-time and virtual information onto physical objects. AR supports the identification of IT/OT rolling stock system failures, offers troubleshooting directions, and streamlines maintenance procedures, ultimately enhancing decision-making and action-taking processes. This thesis investigates how AR can support operators in navigating troubleshooting and maintenance challenges posed by IT/OT rolling stock system failures in the railway industry

The Usefulness of Multi-Sensor Affect Detection on User Experience: An Application of Biometric Measurement Systems on Online Purchasing

abstract: Traditional usability methods in Human-Computer Interaction (HCI) have been extensively used to understand the usability of products. Measurements of user experience (UX) in traditional HCI studies mostly rely on task performance and observable user interactions with the product or services, such as usability tests, contextual inquiry, and subjective self-report data, including questionnaires, interviews, and usability tests. However, these studies fail to directly reflect a user’s psychological involvement and further fail to explain the cognitive processing and the related emotional arousal. Thus, capturing how users think and feel when they are using a product remains a vital challenge of user experience evaluation studies. Conversely, recent research has revealed that sensor-based affect detection technologies, such as eye tracking, electroencephalography (EEG), galvanic skin response (GSR), and facial expression analysis, effectively capture affective states and physiological responses. These methods are efficient indicators of cognitive involvement and emotional arousal and constitute effective strategies for a comprehensive measurement of UX. The literature review shows that the impacts of sensor-based affect detection systems to the UX can be categorized in two groups: (1) confirmatory to validate the results obtained from the traditional usability methods in UX evaluations; and (2) complementary to enhance the findings or provide more precise and valid evidence. Both provided comprehensive findings to uncover the issues related to mental and physiological pathways to enhance the design of product and services. Therefore, this dissertation claims that it can be efficient to integrate sensor-based affect detection technologies to solve the current gaps or weaknesses of traditional usability methods. The dissertation revealed that the multi-sensor-based UX evaluation approach through biometrics tools and software corroborated user experience identified by traditional UX methods during an online purchasing task. The use these systems enhanced the findings and provided more precise and valid evidence to predict the consumer purchasing preferences. Thus, their impact was “complementary” on overall UX evaluation. The dissertation also provided information of the unique contributions of each tool and recommended some ways user experience researchers can combine both sensor-based and traditional UX approaches to explain consumer purchasing preferences.Dissertation/ThesisDoctoral Dissertation Human Systems Engineering 201

Rethink Digital Health Innovation: Understanding Socio-Technical Interoperability as Guiding Concept

Diese Dissertation sucht nach einem theoretischem Grundgerüst, um komplexe, digitale Gesundheitsinnovationen so zu entwickeln, dass sie bessere Erfolgsaussichten haben, auch in der alltäglichen Versorgungspraxis anzukommen. Denn obwohl es weder am Bedarf von noch an Ideen für digitale Gesundheitsinnovationen mangelt, bleibt die Flut an erfolgreich in der Praxis etablierten Lösungen leider aus. Dieser unzureichende Diffusionserfolg einer entwickelten Lösung - gern auch als Pilotitis pathologisiert - offenbart sich insbesondere dann, wenn die geplante Innovation mit größeren Ambitionen und Komplexität verbunden ist. Dem geübten Kritiker werden sofort ketzerische Gegenfragen in den Sinn kommen. Beispielsweise was denn unter komplexen, digitalen Gesundheitsinnovationen verstanden werden soll und ob es überhaupt möglich ist, eine universale Lösungsformel zu finden, die eine erfolgreiche Diffusion digitaler Gesundheitsinnovationen garantieren kann. Beide Fragen sind nicht nur berechtigt, sondern münden letztlich auch in zwei Forschungsstränge, welchen ich mich in dieser Dissertation explizit widme. In einem ersten Block erarbeite ich eine Abgrenzung jener digitalen Gesundheitsinnovationen, welche derzeit in Literatur und Praxis besondere Aufmerksamkeit aufgrund ihres hohen Potentials zur Versorgungsverbesserung und ihrer resultierenden Komplexität gewidmet ist. Genauer gesagt untersuche ich dominante Zielstellungen und welche Herausforderung mit ihnen einhergehen. Innerhalb der Arbeiten in diesem Forschungsstrang kristallisieren sich vier Zielstellungen heraus: 1. die Unterstützung kontinuierlicher, gemeinschaftlicher Versorgungsprozesse über diverse Leistungserbringer (auch als inter-organisationale Versorgungspfade bekannt); 2. die aktive Einbeziehung der Patient:innen in ihre Versorgungsprozesse (auch als Patient Empowerment oder Patient Engagement bekannt); 3. die Stärkung der sektoren-übergreifenden Zusammenarbeit zwischen Wissenschaft und Versorgungpraxis bis hin zu lernenden Gesundheitssystemen und 4. die Etablierung daten-zentrierter Wertschöpfung für das Gesundheitswesen aufgrund steigender bzgl. Verfügbarkeit valider Daten, neuen Verarbeitungsmethoden (Stichwort Künstliche Intelligenz) sowie den zahlreichen Nutzungsmöglichkeiten. Im Fokus dieser Dissertation stehen daher weniger die autarken, klar abgrenzbaren Innovationen (bspw. eine Symptomtagebuch-App zur Beschwerdedokumentation). Vielmehr adressiert diese Doktorarbeit jene Innovationsvorhaben, welche eine oder mehrere der o.g. Zielstellung verfolgen, ein weiteres technologisches Puzzleteil in komplexe Informationssystemlandschaften hinzufügen und somit im Zusammenspiel mit diversen weiteren IT-Systemen zur Verbesserung der Gesundheitsversorgung und/ oder ihrer Organisation beitragen. In der Auseinandersetzung mit diesen Zielstellungen und verbundenen Herausforderungen der Systementwicklung rückte das Problem fragmentierter IT-Systemlandschaften des Gesundheitswesens in den Mittelpunkt. Darunter wird der unerfreuliche Zustand verstanden, dass unterschiedliche Informations- und Anwendungssysteme nicht wie gewünscht miteinander interagieren können. So kommt es zu Unterbrechungen von Informationsflüssen und Versorgungsprozessen, welche anderweitig durch fehleranfällige Zusatzaufwände (bspw. Doppeldokumentation) aufgefangen werden müssen. Um diesen Einschränkungen der Effektivität und Effizienz zu begegnen, müssen eben jene IT-System-Silos abgebaut werden. Alle o.g. Zielstellungen ordnen sich dieser defragmentierenden Wirkung unter, in dem sie 1. verschiedene Leistungserbringer, 2. Versorgungsteams und Patient:innen, 3. Wissenschaft und Versorgung oder 4. diverse Datenquellen und moderne Auswertungstechnologien zusammenführen wollen. Doch nun kommt es zu einem komplexen Ringschluss. Einerseits suchen die in dieser Arbeit thematisierten digitalen Gesundheitsinnovationen Wege zur Defragmentierung der Informationssystemlandschaften. Andererseits ist ihre eingeschränkte Erfolgsquote u.a. in eben jener bestehenden Fragmentierung begründet, die sie aufzulösen suchen. Mit diesem Erkenntnisgewinn eröffnet sich der zweite Forschungsstrang dieser Arbeit, der sich mit der Eigenschaft der 'Interoperabilität' intensiv auseinandersetzt. Er untersucht, wie diese Eigenschaft eine zentrale Rolle für Innovationsvorhaben in der Digital Health Domäne einnehmen soll. Denn Interoperabilität beschreibt, vereinfacht ausgedrückt, die Fähigkeit von zwei oder mehreren Systemen miteinander gemeinsame Aufgaben zu erfüllen. Sie repräsentiert somit das Kernanliegen der identifizierten Zielstellungen und ist Dreh- und Angelpunkt, wenn eine entwickelte Lösung in eine konkrete Zielumgebung integriert werden soll. Von einem technisch-dominierten Blickwinkel aus betrachtet, geht es hierbei um die Gewährleistung von validen, performanten und sicheren Kommunikationsszenarien, sodass die o.g. Informationsflussbrüche zwischen technischen Teilsystemen abgebaut werden. Ein rein technisches Interoperabilitätsverständnis genügt jedoch nicht, um die Vielfalt an Diffusionsbarrieren von digitalen Gesundheitsinnovationen zu umfassen. Denn beispielsweise das Fehlen adäquater Vergütungsoptionen innerhalb der gesetzlichen Rahmenbedingungen oder eine mangelhafte Passfähigkeit für den bestimmten Versorgungsprozess sind keine rein technischen Probleme. Vielmehr kommt hier eine Grundhaltung der Wirtschaftsinformatik zum Tragen, die Informationssysteme - auch die des Gesundheitswesens - als sozio-technische Systeme begreift und dabei Technologie stets im Zusammenhang mit Menschen, die sie nutzen, von ihr beeinflusst werden oder sie organisieren, betrachtet. Soll eine digitale Gesundheitsinnovation, die einen Mehrwert gemäß der o.g. Zielstellungen verspricht, in eine existierende Informationssystemlandschaft der Gesundheitsversorgung integriert werden, so muss sie aus technischen sowie nicht-technischen Gesichtspunkten 'interoperabel' sein. Zwar ist die Notwendigkeit von Interoperabilität in der Wissenschaft, Politik und Praxis bekannt und auch positive Bewegungen der Domäne hin zu mehr Interoperabilität sind zu verspüren. Jedoch dominiert dabei einerseits ein technisches Verständnis und andererseits bleibt das Potential dieser Eigenschaft als Leitmotiv für das Innovationsmanagement bislang weitestgehend ungenutzt. An genau dieser Stelle knüpft nun der Hauptbeitrag dieser Doktorarbeit an, in dem sie eine sozio-technische Konzeptualisierung und Kontextualisierung von Interoperabilität für künftige digitale Gesundheitsinnovationen vorschlägt. Literatur- und expertenbasiert wird ein Rahmenwerk erarbeitet - das Digital Health Innovation Interoperability Framework - das insbesondere Innovatoren und Innovationsfördernde dabei unterstützen soll, die Diffusionswahrscheinlichkeit in die Praxis zu erhöhen. Nun sind mit diesem Framework viele Erkenntnisse und Botschaften verbunden, die ich für diesen Prolog wie folgt zusammenfassen möchte: 1. Um die Entwicklung digitaler Gesundheitsinnovationen bestmöglich auf eine erfolgreiche Integration in eine bestimmte Zielumgebung auszurichten, sind die Realisierung eines neuartigen Wertversprechens sowie die Gewährleistung sozio-technischer Interoperabilität die zwei zusammenhängenden Hauptaufgaben eines Innovationsprozesses. 2. Die Gewährleistung von Interoperabilität ist eine aktiv zu verantwortende Managementaufgabe und wird durch projektspezifische Bedingungen sowie von externen und internen Dynamiken beeinflusst. 3. Sozio-technische Interoperabilität im Kontext digitaler Gesundheitsinnovationen kann über sieben, interdependente Ebenen definiert werden: Politische und regulatorische Bedingungen; Vertragsbedingungen; Versorgungs- und Geschäftsprozesse; Nutzung; Information; Anwendungen; IT-Infrastruktur. 4. Um Interoperabilität auf jeder dieser Ebenen zu gewährleisten, sind Strategien differenziert zu definieren, welche auf einem Kontinuum zwischen Kompatibilitätsanforderungen aufseiten der Innovation und der Motivation von Anpassungen aufseiten der Zielumgebung verortet werden können. 5. Das Streben nach mehr Interoperabilität fördert sowohl den nachhaltigen Erfolg der einzelnen digitalen Gesundheitsinnovation als auch die Defragmentierung existierender Informationssystemlandschaften und trägt somit zur Verbesserung des Gesundheitswesens bei. Zugegeben: die letzte dieser fünf Botschaften trägt eher die Färbung einer Überzeugung, als dass sie ein Ergebnis wissenschaftlicher Beweisführung ist. Dennoch empfinde ich diese, wenn auch persönliche Erkenntnis als Maxim der Domäne, der ich mich zugehörig fühle - der IT-Systementwicklung des Gesundheitswesens