In recent years, an increasing number of initiatives, organisations, and institutes worldwide have adopted the model of “living labs.” At the same time, regional and national governments, along with international bodies such as the European Commission, have gradually embraced this concept and integrated it into their work programmes. A living lab typically involves the collaboration of multiple stakeholders in the co-creation, implementation, and evaluation of innovative services or products within real-life contexts. Today, living labs exist worldwide, with a particularly high concentration in Europe.
It should be noted that there is no standard definition of the concept of “the living labs”. However, according to the European Network of Living Labs (ENoLL), they are defined as “user-centered, open innovation ecosystems based on systematic user co-creation approach, integrating research and innovation processes in real-life communities and settings” (1).
The concept of the living lab can be applied across diverse contexts, ranging from citizen-driven innovation initiatives aimed at improving everyday life to the testing of human-centric technologies by pharmaceutical companies seeking to provide patients with affordable and user-friendly products, as well as projects developed by NGOs, citizen groups, and other actors in advanced societies (2).
These initiatives may be driven by different stakeholders such as providers, users, or enablers shaping the duration, focus, and outcomes of the innovation process (3). Overall, living labs provide a suitable environment for development, testing, and validation, fostering co-creation at every stage, from conceptualisation to commercialisation (4). They are often described as testbeds for innovative solutions, systems, and products, as they offer a collaborative platform that brings together diverse actors (5, 6).
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 living lab typically involves four key phases:
- Co-creation: joint design carried out by users and producers.
- Exploration: identification of emerging uses, behaviours, and market opportunities.
- Experimentation: implementation of real-life scenarios within user communities.
- Evaluation: assessment of concepts, products, and services based on socio-ergonomic, socio-cognitive, and socioeconomic criteria.
Living Labs: Bridging Stakeholders and Systems in Digital Health
Traditional healthcare models are under increasing pressure, caught between rising demand for services and limited financial resources (7). This situation creates a significant opportunity for innovation in digital health. Positioned at the intersection of biomedical science, behavioral science, computer science, and design, digital health interventions often challenge traditional evaluation models, which many technologists consider insufficient to capture their full value. Advancing the field will require stronger interdisciplinary collaboration (8).
The living lab model provides an opportunity to explore this complexity and shed light on the wider system, aiming to embed change with evidence-based models. Genuine stakeholder participation can be used as a tool for the ideation, development, and evaluation of digital health solutions toward optimizing the conditions within the system and refining the technology to match the requirements of the system. As a result, it will create a sustained and scalable technological change with rewards that are realized and provide benefits to all involved actors.
Bringing Digital Health to the Community: Lessons from Brighton
The lab resulted from the national Leading Places programme, which brought the University of Brighton together with Brighton and Hove City Council (9, 10). It aimed to develop strategies for self-managed care among older adults, focusing on medication management, self-monitoring, and coping with the emotional impact of multiple comorbidities.
The Digital Health Living Lab (DHLL) sought to prevent or delay the need for more intensive care and was implemented at a retirement housing scheme selected for its alignment with the target demographic and care needs. The DHLL was established as a retirement housing scheme, chosen by the city council because it met the demographic and caring needs requirements.
Residents attended a launch event where the DHLL concept and objectives were presented. They registered their interest, provided contact details, and supplied basic demographic information. Participant profiles were created through interviews, and stakeholder needs were explored via co-production workshops.
The project began with a systematic identification of stakeholders, including carers, general practitioners, local councils, and commissioners, considering their influence on residents’ health and social care. Insights from one-on-one interviews informed the prioritization of stakeholder needs by importance and timeframe. Project management activities included framing, risk analysis, and maintaining the risk register.
The laboratory collaborated with Kraydel Ltd. to develop Konnect, a user-friendly home communication system linking the user’s TV to a hub that connects via Wi-Fi or mobile 4G. The hub supports TV-based video calls through platforms like Vonage and Zoom. Early prototypes were tested in co-production workshops, and feedback guided further development. The final Konnect system also functions as a wellbeing monitoring platform, integrating sensors and Bluetooth-connected devices to transmit data to service providers for remote assessment.
Key Insights and Limitations of the DHLL Model
The project highlighted several insights. The opportunity to run activities in participants’ homes created a more authentic experience, while hosting DHLLs in community spaces proved cost-effective by using existing facilities. This model is largely self-sustaining, as residents can engage locally and stay connected without constant input from academic staff. On-site managers further support the process by easing recruitment and quickly restarting activities when new projects begin.
The team also identified some limitations. The residents involved did not fully reflect the wider community, as harder-to-reach groups (e.g., minorities or people with learning disabilities) were underrepresented. In addition, participation was voluntary, often attracting mainly tech-savvy individuals. To address this, future projects could expand to more sites and offer incentives to encourage broader involvement.
This case study showed that a DHLL can act as an open innovation ecosystem, bringing together diverse stakeholders to generate ideas and support the user-centered development of digital health solutions. Establishing DHLLs within communities and engaging the right partners offers a practical and effective way to achieve lasting benefits. In this context, wearable devices could further enhance this approach by enabling continuous data collection and offering real-world insights into people’s daily lives.
- Laura Avogaro FRESCI
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References
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9) Brighton.ac.uk. (2017). Leading the way in regional partnership working. Available online at: https://www.brighton.ac.uk/business-services/strategicpartnerships/leading-the-way-in-regional-partnership-working.aspx (accessed March 5, 2022).
10) Local.gov.uk. (2017). Leading Places. Available online at: https://www. local.gov.uk/topics/devolution/leading-places/leading-places-phase-1/brighton (accessed February 5, 2022).