Data from wearable devices (e.g., smartwatches) has already demonstrated significant potential to enhance patient care and generate value for healthcare organizations. However, to fully realize this potential, collaboration among all parties is essential, requiring a reassessment of how systems are designed and operated.
In this context, role-playing exercises offer a valuable approach. By simulating the development of a shared data space, particularly during early planning phases, these exercises help identify key stakeholders and uncover the challenges and opportunities involved in exchanging sensitive data across diverse cultural settings.
Although role plays are often associated with education and engaged students, their application extends well beyond the classroom. A role play is an interactive, often game-like activity in which participants assume different roles within a simulated scenario.
Guided by a script that defines the context and their character’s perspective, participants collaborate to enact the situation. Although the script provides a framework, participants have the freedom to make their own decisions throughout the exercise, even if these choices deviate from the original script.
Role plays exemplify the principle of “show, don’t tell’”, making them valuable also for helping policymakers understand stakeholders’ viewpoints. Role plays can be used both prospectively to explore and evaluate policy scenarios and retrospectively to investigate why certain policies have failed to deliver the anticipated outcomes.
Recreating the circumstances surrounding the strategies devised by participants and their resulting outcomes can offer valuable insights for real-world stakeholders. During the exercise, players assume the roles of other actors, setting aside their own beliefs and interests to better understand the perspectives and resources of their fellow players. These resources may vary widely and encompass financial, technical, human and knowledge-based assets.
A Role Play on the Interests Behind Making Wearable Data Available
A notable example of this approach was carried out within the European Health Data Space (EHDS), at the Joint Research Centre in Ispra, on September 27th 2024.
The EHDS is an EU initiative designed to facilitate secure and privacy-compliant sharing of health data to advance healthcare, research, and innovation. It aims to improve understanding of how data from wearable devices can be leveraged for public interest purposes.
In this scenario, the wearable data considered came only from devices that people would likely have purchased themselves to track exercise, sleep and other activities. Medical devices were not included.
The role play involved eight participants, each taking on a distinct stakeholder role and actively contributing to the debate. These roles included representatives of ministries of health, private insurers, data service providers, healthcare operators, consumers, and wearable device manufacturers.
To frame the exercise, two fictional Member States were created, loosely inspired by Italy and the Netherlands: “Ataly” and “The Underlands”. Ataly embodied a top-down, centralized health ecosystem, while the Underlands reflected a decentralized model where private actors drive data exchange and provide health insurance. Because health policy remains a Member State competence, certain roles were specific to one of the two countries.
The purposes of this approach were:
- to ensure that all participants developed a shared understanding of the scenario and the actors who needed to collaborate;
- to explore the roles that stakeholders would need to assume to make the scenario successful, including their incentives to participate.
Participants were expected to learn how to balance competing stakeholder interests and to recognize that no solution is likely to satisfy everyone completely.
Another key objective was to highlight where the drive for the use case should originate: even if the scenario promises significant value, it is unlikely to progress without someone willing to champion it and to assume the associated risks.
While recruiting participants in advance had been an option, the organizers deliberately chose them on the spot as a strategy aimed at creating energy in the room, setting the scene, and encouraging active participation.
The session was led by a facilitator, who introduced the exercise, guided participants in their stakeholder roles, and kept the discussion within defined boundaries. A moderator supported the process by using structured methods to help the parties reach an agreement and, when necessary, introduced targeted ‘interventions’ (e.g., offering external funding) to steer the debate. Two experts were also present to provide technical input and address any domain-specific questions raised during the session.
The role play was conducted over a full day, with the core scenario unfolding over 4-5 hours. The exercise was designed and supported by four members of the Data Space Support Centre (DSSC). The DSSC has been funded by the European Commission as part of the Digital Europe Programme. It is aimed at the public sector and at companies that want to create sovereign data spaces.
By the end of the day, participants had gained insight into the complex interplay of interests involved in making wearable data available for secondary use through the EHDS.
Although interactions between public and private actors remained cordial, the exercise revealed a clear divide between those prioritizing the public good and those focused on their own specific or private interests. Alliances emerged during the discussion, while the private sector, particularly insurers, was viewed with a degree of caution by many participants.
From Simulation to Opportunity
In the rapidly evolving field of health tech and wearables, the sharing and management of health data present intricate challenges involving privacy, security, and ethical responsibility. By using role-play to simulate real-world situations, we can explore these complexities from multiple perspectives, identify potential risks, and better understand the implications for all stakeholders involved.
This experiential approach not only raises our awareness but also strengthens our ability to develop thoughtful, transparent, and responsible strategies for handling sensitive health information.
- Laura Avogaro FRESCI
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