Stakeholder Perspectives on Facilitators of and Barriers to the Implementation of Internet of Things-Equipped Powered Wheelchairs in Sweden: Qualitative Case Study.
Johan Borg, Marie Elf, Anders Brantnell and 1 others
PMID 42684417WHAT IT FOUND
A qualitative case study of one Swedish center's rollout of IoT-monitored powered wheelchairs found that GDPR uncertainty and organizational coordination were the main barriers, not the technology itself.
It does not test whether the wheelchairs improve patient outcomes.
Key findings
01The regional application board initially rejected the IoT system because the data server was outside the EU and GPS data was classified as personal data; approval came only after the server was moved to Sweden, GPS was disabled, and two-factor authentication was added.
02The study explicitly did not include wheelchair users or frontline clinicians such as occupational therapists and physiotherapists; findings reflect only the perspective of those involved in planning, governance, and execution of the rollout.
03The authors conclude that implementation was a negotiated, iterative alignment of legal, organizational, technical, and relational factors rather than a single technical decision, and that no single factor was sufficient on its own.
STILL TO COME
How it was doneWhat they found
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What it does not show
Single center in one Swedish county; the authors note that transferability to other health systems, countries, or regulatory environments may be limited. Only 6 participants, all directly involved in the implementation process; wheelchair users, occupational therapists, physiotherapists, and policymakers were not interviewed, so the user-experience and clinical-integration perspectives are absent. Accounts are retrospective (interviews conducted 2024–2025 about events beginning in 2019–2023), introducing recall and social-desirability bias. GPT-5 was used to generate codes, themes, and subthemes; although the authors state they reviewed and refined the output, the degree of human oversight over the AI-generated structure is not fully transparent. The study describes one implementation with one supplier; the authors themselves note that regional variation and the limited number of suppliers constrain generalisability.
Declared interests
Funded by Vinnova, Sweden (grant 2021-04581). No conflicts of interest declared by the authors.
The easy way to misread this
Do not read this as evidence that IoT-equipped powered wheelchairs improve patient outcomes or reduce injury. The study is a qualitative account of how one Swedish organization got the technology through its legal and IT approval process; it contains no patient outcome data, no comparison group, and no clinical effectiveness measure. The 'benefits' reported (faster repairs, theft recovery) are stakeholder perceptions from the implementation team, not measured patient outcomes.