open access articleBackground: Technology-enabled healthcare or smart health has provided a wealth of
products and services to enable older people to monitor and manage their own health conditions at
home, thereby maintaining independence, whilst also reducing healthcare costs. However, despite
the growing ubiquity of smart health, innovations are often technically driven, and the older user does
not often have input into design. The purpose of the current study was to facilitate a debate about
the positive and negative perceptions and attitudes towards digital health technologies. Methods:
We conducted citizens’ juries to enable a deliberative inquiry into the benefits and risks of smart health
technologies and systems. Transcriptions of group discussions were interpreted from a perspective
of life-worlds versus systems-worlds. Results: Twenty-three participants of diverse demographics
contributed to the debate. Views of older people were felt to be frequently ignored by organisations
implementing systems and technologies. Participants demonstrated diverse levels of digital literacy
and a range of concerns about misuse of technology. Conclusion: Our interpretation contrasted
the life-world of experiences, hopes, and fears with the systems-world of surveillance, e ciencies,
and risks. This interpretation o ers new perspectives on involving older people in co-design and
governance of smart health and smart homes