Technology-enabled care at home and the challenge of socio-technical alignment: Evidence from Sweden
Morteza Ghobakhloo, Klas PalmObjective
Care at Home (CaH) is increasingly promoted as a digitally enabled response to pressure on health systems, but the concept remains fragmented. This study clarifies CaH as a socio-technical care configuration and examines the system-level conditions shaping its implementation in Sweden.
Methods
The study used a two-stage qualitative design. A systematic literature review of 340 articles identified recurring dimensions of CaH across service domains, stakeholders, functions, technologies, and design principles. Semi-structured expert interviews in Sweden were analysed thematically to examine implementation conditions across regional healthcare, municipal care, specialised care, digital infrastructure, and provider contexts.
Results
The review shows that CaH extends beyond relocating care to the home or providing a discrete digital service. It is a layered configuration linking value aims, stakeholder roles, service domains, care functions, technological enablers, and design principles. The interviews show that the main implementation barriers lie less in technological availability than in socio-technical alignment. Key conditions include cross-boundary governance, interoperable and modular infrastructure, aligned procurement and reimbursement logic, legal and operational clarity, organisational and professional readiness, and patient capability and support.
Conclusion
Technology-enabled CaH becomes viable when digital tools are embedded in coherent care pathways, shared responsibilities, and supportive institutional arrangements. The study contributes a conceptual and empirically grounded framework for understanding CaH as a digital health transformation challenge.