Insights into the Circular (re)Design of Medical Wearbale Sensors

Insigh s in o he
Ci cula ( e)Design
o Medical Wea able Senso s
Insigh s in o he Ci cula ( e)Design o
Medical Wea able Senso s
MSc G adua ion Thesis
In eg a ed P oduc Design
Del Uni e si y o Technology
Facul y o Indus ial Design Enginee ing
Au ho
Ma hijs Bul
4446151
Supe iso y Team
Chai : Ruud an Heu
Men o : Tama a Ho eling
Hi! You’ e abou o ead my mas e ’s hesis which I
used o g adua e wi hin In eg a ed P oduc Design a
he TU Del .
In my sea ch o a hesis, I knew I wan ed sus ainabili y
o play a cen al ole. Th oughou my s udies, I had
encoun e s wi h ci cula design, bu I ne e go a
chance o del e in o i . This hesis p o ided me wi h
he oppo uni y o explo e ci cula p oduc design and
unde s and how we, as designe s, can educe ou
en i onmen al impac by emb acing he p inciples o
he ci cula economy.
I hold he belie ha ou ield inhe en ly con ibu es
o pollu ing. A e all, he p oduc s we c ea e equi e
manu ac u ing, ma e ials, and e en ually, end up
as some o m o was e. I also i mly belie e ha as
p oduc designe s, we ha e a mo al esponsibili y
o design o a be e wo ld. This in ol es no only
c ea ing p oduc s ha en ich people's li es bu also
p oduc s ha con ibu e posi i ely o he en i onmen ,
o ou en i onmen .
Wi h his hesis, I hope o inspi e you o apply ci cula
design o you p ojec . Le 's wo k oge he owa ds a
sus ainable u u e!
I•P e ace
4
I wan o hank my supe iso s, Ruud and Tama a, o
hei con inuous suppo h oughou he hesis. I could
always coun on you hones eedback and you
suppo when I needed i a he igh imes.
I wan o hank Hans and e e yone a Philips o sha ing
hei knowledge, pe spec i es and insigh s on he
Heal hdo and how i can be imp o ed. Special hanks
o Suzanne and he people a Games o Heal h o
hei aluable inpu on my concep s.
A massi e shou ou o my pa en s o pu ing me on his
ea h, eeding me and suppo ing me, o all he hou s
spen p oo eading my wo k me e hou s be o e he
deadline is due.
Finally, a big hug o all my iends om IO. Thank you o
suppo ing me om day one, all he way up o his inal
momen . You li ed me when I was down, and pulled
me ou when I was s uck. I could no ha e go en o his
poin wi hou any o you.
II•Acknowledgeme ns
5

III•Glossa y
Ci cula Economy A sys em whe ein he alue o ma e ials and esou ces is main ained
inde ini ely, u he explained in Chap e 3.
Ci cula Flows o Ci cula Loops Desc ibes how a p oduc cycles h ough a ci cula sys em
Ci cula i y A way o desc ibing how good some hing i s in he ci cula economy.
Cleaning Ac o emo ing di and deb is om inanima e objec , bu no disin ec ing o
s e ilising.
C i icali y How c i ical i is ha a de ice is, clean, disin ec o s e ilised.
Disin ec ion The p ocess o educing mic oo ganisms om inanima e objec s o sa e le els
E-was e Elec onic p oduc s ha ha e become obsole e and a e iewed as a was e
Impac En i onmen al impac o a p oduc , o en measu ed in Kg/CO2
Li e Cycle Analysis (LCA) Assessmen me hod o analyse he impac o a p oduc
Medical wea able senso (MWS) Small medical p oduc ha wi elessly measu es biosignals, also e e ed o
as ‘senso ’
O iginal Equipmen Manu ac u e (OEM) An o ganisa ion ha makes de ices o o he o ganisa ions.
S e ilisa ion The p ocess o killing all mic oo ganisms om inanima e objec s
Sus ainabili y En i onmen al sus ainabili y, u he de ined in Sec ion 3.1.
6
This hesis is execu ed wi hin he con ex o he DiCE
p ojec : Digi al heal h in Ci cula Economy (Eu opean
Commission, n.d.). The Eu opean- unded p ojec
“aims o add ess he issue o inc easing digi al heal h
was e” (WEEE Fo um, 2023) and in ol es 20 di e en
o ganisa ions, including he TU Del and Philips. The
p ojec aims o guide he medical sec o owa ds a
mo e sus ainable u u e.
IV•Digi al Heal h in Ci cula Economy
7
This hesis p esen s ecommenda ions
based on a case s udy ocused on he
ci cula edesign o he Philips Heal hdo .
The s udy add esses a knowledge gap by
o e ing insigh s in o he ci cula design o
p oduc s like he Heal hdo . The p oposed
edesign o he Heal hdo ’s sys em led o
a subs an ial educ ion o CO2 emissions,
wi h po en ial o u he imp o emen s.
Philips Heal hdo
The Philips Heal hdo (Figu e I) is a medical wea able
senso designed o wi elessly cap u e bio measu emen s
and ansmi hem o hospi als. Once used, he senso
becomes inac i e and is disca ded as was e. While
simila eusable senso s exis , only wo we e iden i ied
du ing esea ch.
Resea ch
L e a u e esea ch was conduc ed conce ning he
ci cula economy, i s design s a egies and business
models. A comp ehensi e analysis o he Heal hdo ’s
p oduc jou ney was pe o med, complemen ed by a
as - ack Li e Cycle Analysis (LCA). The LCA e ealed
he high CO2 impac o i s elec onics, highligh ing he
impo ance o ex ending hei usage. Based on he
ou comes o hese analyses, equi emen s and c i e ia
we e de ined, which o med he ounda ions o he
p oposed solu ion.
SecondSense
The p oposed solu ion, SecondSense, consis s o wo
componen s: SenseFlow and SenseCab (Figu e II &
III). SenseFlow desc ibes he senso li ecycle wi hin he
sys em, while SenseCab enables easy ep ocessing.
In he SenseFlow sys em, used senso s a e collec ed,
cleaned, and placed in he SenseCab o da a emo al,
disin ec ion and cha ging.
Li e Cycle Analysis
A compa ison be ween SecondSense and he o iginal
Heal hdo was conduc ed using an LCA (see Figu e
IV). SecondSense shows educ ions in CO2 emissions
a e only h ee uses, wi h 45% and 60% educ ions
V•Execu i e Summa y
Figu e I: Philips Heal hdo (Philips, n.d.-d)
8
P oduc Use
In e nal use
Ex e nal use
Rep ocessing
Fac o y
Reuse Phase
SecondSense
Use Phase
P epa a ion
Figu e II: SeconSense Sys em
9
1 • P oblem De ini ion
Heal hca e is an impo an pa o ou
daily li es; om small incon eniences o
li e-sa ing p ocedu es, we all ha e been
in ouch wi h he heal hca e sys em a
some poin . Heal hca e is he e o p o ec
us om ha m and o heal us, bu in doing
so i c ea es an eno mous amoun o was e
ha is hu ing us and ou plane in he long
un.
Heal hca e sec o has, in ac , a la ge impac on ou
ecosys em. To illus a e, 4,4% o all global emissions
come om he heal hca e sec o (Heal h Ca e Wi hou
Ha m, 2019), and in he Ne he lands, his numbe ises
o 7% (Gup a S a egis s, 2019). When i comes o
was e, he a e age Eu opean hospi al gene a es 2,4kg
o was e pe pa ien pe day (Singh e al., 2022). While
hese numbe s a e high, he sec o is ac i ely ying o
become mo e ci cula , wi h ini ia i es such as “Samen
naa een ci culai ziekenhuis” [To a ci cula hospi al
oge he ] (de Zo gambassade, 2022).
Wi h he heal hca e indus y becoming sma e and
mo e digi ized, you can also expec he amoun o
elec onic was e o ise. Acco ding o he Eu opean
Pa liamen , e-was e is one o he as es -g owing was e
s eams while less han 40% o his was e is ecycled
(Eu opean Pa liamen , 2020). The global a e age is
e en lowe , wi h only 17% being collec ed and ecycled
p ope ly (Fo i e al., n.d.). Gene al e-was e p oduc s
o en end up s ockpiled a home and oo o en end up
a he incine a o (Miliu e-Plepiene, 2021).
E-was e is a dange ous was e s eam as i con ains
oxic and ha m ul ma e ials ha a e de imen al o
bo h humans and he en i onmen (Lin e al., 2022;
Ogunsei an, 2022; Wi u & Tucho, 2022). Al hough
medical p oduc s se e o make us be e , un o una ely,
hey a e no excep ion o his was e s eam (Le eb e e
al., 2011; Ogunsei an, 2022).
Heal hdo
In 2021, Philips in oduced he Heal hdo (Figu e 1.1): a
small Medical Wea able Senso (MWS) ha measu es
he pa ien ’s hea a e and uploads his o he hospi al,
so ha pa ien s can be moni o ed emo ely om hei
own home (Philips, n.d.-d). Wi h he in oduc ion o
he Heal hdo , Philips aims o imp o e heal hca e by
allowing ansi ional ca e, as i ees up bed space
16

Figu e 1.1: Philips Heal hdo being applied (Philips, n.d.-b)
which could educe hospi al emissions. Howe e , a e
i s use he Heal hdo ’s ba e y is emp y and he de ice
has o be disposed o . So his imp o emen in ca e
comes a he cos o ano he disposable elec onic
de ice.
While Philips al eady has made imp o emen s o his
wi h a ci cula successo , which con ains eusable
elec onics, I belie e ha we can do his mo e
sus ainably. Wi h his hesis, I aim o inspi e designe s,
enginee s and anyone else in ol ed in he de elopmen
o medical p oduc s o c ea e mo e ci cula solu ions, o
educe he impac we ha e on ou wo ld.
1.1 Medical wea able senso s
The Heal hdo can be ca ego ised as a medical
wea able senso (MWS), bu wha de ines a medical
wea able senso ? This is a g oup o p oduc s ha sense
bio measu emen s om pa ien s, such as hea a e o
ECG signals, wi elessly. They a e commonly a ached
o he pa ien using an adhesi e pa ch and moni o
he pa ien wi hou he use o ex e nal de ices o an
ex ended amoun o ime. Some ha e da a connec i i y
o allow con inuous moni o ing by hospi al s a , and
o he eco d da a o be ead and analysed la e .
Wells e .al (2022) de ine a ca ego y o ‘wea able
senso s’ as ollows: “a de ice wo n on he ex e nal
body su ace, unencumbe ed by wi es, o he
con inuous and non-in asi e de ec ion o biosignals
17
(such as mo emen , hea a e, espi a o y a e, and
oxygen sa u a ion).”. This de ini ion is used by Wells o
de ine he Heal hdo bu also includes p oduc s such
as sma wa ches, which he also compa es in his pape .
While his de ini ion cap u es he sensing side o he
Heal hdo , i also allows non-medical p oduc s o en e
he ca ego y. Fo his eason, he e m ‘medical’ was
added o his de ini ion, c ea ing he ollowing wo king
de ini ion o his hesis:“A medical de ice wo n on he
ex e nal body su ace, unencumbe ed by wi es, o he
con inuous and non-in asi e de ec ion o biosignals
(such as mo emen , hea a e, espi a o y a e, and
oxygen sa u a ion).”
1.1.1 The cu en s a e o he medical wea able
senso ma ke
The e a e se e al MWS on he ma ke , see
Figu e 1.2, howe e , mos seem o ope a e in
he US ma ke . Li le in o ma ion was ound on
he adop ion o hese de ices in he Eu opean
heal hca e sec o . Mos de ices a e single-use
de ices, bu Vi alink and Philips’ BioTeleme y
we e wo companies ha I ound ha c ea e
eusable senso s. In e es ingly enough, mos o
hese ECG senso s appea o ma ke hemsel es
mo e owa ds a ‘medical consume ’, a he han
di ec ly on hospi al use. This likely indica es
ha he e is no medical eusable senso on he
ma ke ha is ocused on euse a e hospi al use.
Howe e , please no ha his is a high-le el scan,
and u he ma ke esea ch should be done o
conclude on his.
Vi alpa ch - Vi alconnec
Single-Use De ice
ECG
(Vi alconnec , n.d.)
Zio XT - iRhy hm
Single-Use De ice
ECG
(iRhy hm, n.d.)
Figu e 1.2: Medical Wea able Senso s om di e en manu ac u e s
18
Wea able ECG moni o - Vi alink
Reusable De ice
ECG
(Vi alink, n.d.)
Heal hdo - Philips
Single-Use De ice
Vi als
Philips, n.d.-d)
ePa ch - BioTeleme y
Reusable De ice
ECG
(BioTeleme y, n.d.)
AT Pa ch - ATSens
Single-Use De ice
ECG
(ATsens, n.d.
Cen oid - Masimo
Single-Use De ice
Vi als
(Masimo, n.d.)
19
This chap e ou lines he pu pose and
app oach o his hesis. I begins by
de ining he hesis's objec i e, ollowed
by an explana ion o i s s uc u e. The
esea ch ques ions a e p esen ed, and a
de ailed desc ip ion o he case s udy is
p o ided. Las ly, he p ocess o gene a ing
insigh s is illus a ed.
Wi h my hesis, I aim o p esen insigh s o designe s
ha can be used in he design p ocess o imp o e he
ci cula i y o MWS. I will do his by i s analysing an
exis ing medical wea able senso , he Philips Heal hdo ,
a e which a p oposal o a ci cula edesign is
made. The inal insigh s a e p esen ed in he o m o
ecommenda ions and can be ound in Sec ion 12.4.
I aim o add ess he knowledge gap ha exis s when i
comes o designing ci cula MWS. A he ime o w i ing
no p e ious wo k was ound ha speci ically ocuses on
he design o ci cula and small medical elec onics like
he Heal hdo . One mas e hesis was ound ha ocused
on he Heal hdo , which ocused on engaging pa ien s
in a ci cula Heal hdo ( an Hame s eld, 2019).
The main deli e ables o he hesis we e ecommenda ions
o designe s ega ding he ci cula design o MWS
and a concep ha shows how a ci cula Heal hdo and
i s sys em could look like. Some co e ac i i ies include
he analysis o he cu en Heal hdo and he c ea ion
o a ci cula sys em. Ou o scope we e ac i i ies such
as embodimen and pa ien in e ac ions, as hese
we e ound o no add signi ican alue o his hesis in
pa icula o a e al eady co e ed in he DiCE p ojec
elsewhe e. In Appendix A he ull scope can be seen.
I is impo an o emphasize, ha he concep p esen ed
in Chap e 9 is de eloped o c ea e ecommenda ions
o designe s, based on a case s udy whe e he
Heal hdo is used as a e e ence design. I se es as an
inspi a ion and a ision o wha a ci cula sys em could
look like and does no o e a closing design.
2.1 Thesis S uc u e
To b ing s uc u e o my hesis I used he Re lec i e
T ans o ma i e Design P ocess (RTDP) (Hummels &
F ens, 2009), wi h some elemen s om In eg a ed
C ea i e P oblem Sol ing (iCPS) (Buijs & an de Mee ,
2013). RTDP di e en ia es be ween i e phases, as
seen in Figu e 2.1, be ween which you mo e lexibly
2 • Aim and App oach
Figu e 2.1: RTDP and he p ocess low be ween phases
using e lec ions. The me hod ocuses on in o ma ion
and in o ma ion lows, which sui s he esea ch h ough
design app oach o his hesis. iCPS has a clea e
di ision be ween phases, which I ound did no wo k
o me in his p ojec ; he lexibili y o RTDP had my
p e e ence. Howe e , I did use he p ojec managemen
and o e iew s eps om iCPS as an addi ion o he
20
“..p esen insigh s o designe s ha
can be used in he design p ocess o
imp o e he ci cula i y o MWS”
The aim o his hesis is o

RTDP me hod. Fo a mo e de ailed compa ison, see
Appendix B.
2.2 Resea ch Ques ions
This hesis is guided by he ollowing esea ch ques ion:
Wha should designe s keep in mind when designing
ci cula MWS? Wi h he ollowing sub-ques ions o
suppo he p ocess:
RQ1. Wha is he ci cula economy?
RQ1.1 Wha de ines he ci cula economy
RQ1.2 How do you design o he ci cula economy
RQ2. Wha is he cu en s a us o he Heal hdo ?
RQ2.1 Wha is he en i onmen al impac o he
Heal hdo ?
RQ2.2 Who a e he s akeholde s in he sys em?
RQ2.3 Wha a e he ba ie s and oppo uni ies o a
ci cula sys em?
RQ3. Wha could a ci cula MWS look like?
RQ3.1 Wha could a ci cula sys em look like?
RQ3.2 Wha could a ci cula Heal hdo look like?
2.3 Knowledge Acquisi ion
To ga he li e a u e I pe o med an explo a i e sea ch
on da abases such as Google Schola , PubMed and
ScienceDi ec o a a ie y o keywo ds. Selec ed
pape s we e scanned o hei ele ance and ead
i ound ele an . Some unpublished o con iden ial
backg ound knowledge was used, howe e , all da a
p esen ed in his hesis a e acqui ed om public sou ces.
Fu he mo e, I had (in o mal) con e sa ions wi h people
a Philips (n=3), Games o Heal h (n=3), he E asmus
MC (n=2) and he LUMC (n=1) o gain in o ma ion
no ound in pape s and o alida e indings. Da a was
collec ed by aking no es and in some cases, audio
eco dings (n=3).
2.4 Resea ch Th ough Design: a
Case S udy App oach
To gene a e insigh s on how MWS can become ci cula ,
I selec ed a case s udy app oach as my me hod. In
his case s udy I wen h ough he design p ocess, om
p oblem analysis o concep selec ion, and e lec ed
upon my p ocess o gene a e hese insigh s. I ha e
looked a di e en eco e y lows, how hey a ec
ci cula i y and how o choose be ween hese op ions.
The Heal hdo cu en ly on he ma ke is a single-use
de ice, meaning ha a e i s use i is disposed o . Fo
easons s a ed ea lie , his needs o change. The new
Heal hdo 5.0 is al eady an imp o emen , ea u ing a
eusable p in ed ci cui boa d (PCB), bu I hink we can
go u he ; I hink ha he Heal hdo has g ea po en ial
o euse. O he medical elec onics al eady ha e shown
ha i is possible o euse comple e de ices (see Sec ion
1.1), so why shouldn’ he Heal hdo be eusable oo?
Fo hese easons, I belie e ha he Heal hdo makes a
good i as he subjec o his hesis.
Bu how can i be made ci cula ? Does i e en make
sense o make i ci cula ? Is euse e en he bes op ion?
This leads o he ollowing design challenge: “... o
imp o e he ci cula i y o he Philips Heal hdo “
2.4.1 Design p ocess
Fo he design p ocess, I used he double diamond
me hod as a guideline. The p ocess had an i e a i e
na u e, when needed choices we e made ea lie , la e
o e isi ed. The ou phases we e used in conjunc ion
wi h he RTDP desc ibed ea lie . This p ocess can be
seen in Figu e 2.2, wi h e e ences o ele an sec ions.
2.5 Insigh Gene a ion
To come o insigh s, I e lec ed on my p ojec and
discussed his wi h pee s, as well as pe spec i es. In
hese e lec i e momen s I ocussed on he ac i i ies ha
I had done and wha s ood ou o me, and especially
ocussed on why I did i . I ocussed on inding ensions
be ween ac i i ies, and I ansla ed he esul s o hese
e lec ions in o insigh s. I used pe spec i es o ake on
di e en mindse s o di e en eade s, o example,
a ‘business’ pe spec i e o a ‘ma e ials-enginee ’
pe spec i e, o y and ind insigh s ha I o he wise
would ha e missed. Insigh s a e p esen ed in he o m
o ake-aways a he end o hei ele an chap e s. An
o e iew can be ound in Appendix C.
22
Figu e 2.2: Gene al design p ocess ollowed in his hesis
Con ex analysis
Disco e
De ine
De elop
Deli e
Con e sa ions wi h expe s
Idea ion
Scena ios
P oduc jou ney
weigh ed c i e a
R-s a egies
B ains o m
How-To’s
Wha is possible? Wha does i do?
Scampe
Mo phological Cha
How will he sys em wo k?
Whe e will i be eused?
Wha will i look like? Final Design
Wha is i s impac ?
How big wil i be?
Wha should he p oduc do?
How will i be eused?
Wha does he
senso do?
23
Pa wo:
he ci cula economy
3 • Wha is he Ci cula Economy
4 • Designing o he Ci cula Economy
con ex analysis
Pa h ee

5 • The Philips Heal hdo
6 • S akeholde s
7 • Ba ie s and Oppo uni ies
8 • Design Requi emen s and C i e ia
In his chap e , he Heal hdo is looked a
in mo e de ail. Fi s , a de ailed look a he
p oduc is gi en, a e which i s p oduc
jou ney is analysed. Finally, a as - ack
li e-cycle analysis is pe o med o assess
i s en i onmen al impac .
The Philips Heal hdo is cu en ly deployed by Philips
and used in hospi als in he Ne he lands. The senso
is cu en ly on e sion 3.1 and is a medical de ice
classi ied as a Class IIa p oduc (Eu opean Commission,
2023). I measu es hea a e, espi a o y a e and
pa ien ac i i y, which is hen uploaded o he hospi al
(Philips, n.d.-c), howe e , his also means ha pe sonal
da a is s o ed on he de ice. I is a single-use de ice
and can be used o up o 14 days.
Cu en ly, Philips is de eloping a new, ci cula e sion
called he Heal hdo 5.0. This e sion ea u es a la ge
ba e y which can be used o up o 30 days, bu wha
is mo e signi ican , is ha a e i s use he PCB can be
emo ed and eused (pe sonal communica ion, 14-03-
2023). Wi hin he con ex o DiCE, e sion 5.0 is he
subjec o esea ch owa ds collec ion, e e se logis ics
and emanu ac u ing. Howe e , due o con iden iali y
cons ain s, his hesis ocuses on a edesign o he
Heal hdo 3.1; any e e ence o he ‘Heal hdo ’ in his
hesis e e s o his e sion (3.1) unless s a ed o he wise.
The Heal hdo consis o i e majo pa s – a PCB,
a ba e y, an uppe and lowe casing, and a skin-
adhesi e pa ch – and some smalle componen s, which
can be seen in Figu e 5.1-5.3. I weighs 12 g ams, has
an IP55 a ing and LoRa connec i i y (Philips, n.d.-c). I is
glued oge he , making ecycling e y di icul . I comes
packaged in a blis e , oge he wi h a simple ins uc ion
manual, and is shipped ou in boxes con aining 30 uni s.
5.1 P oduc Jou ney
To gain insigh in o how he Heal hdo is used and i s
sys em wo ks, a p oduc jou ney was c ea ed.
In a con e sa ion wi h Philips, ou possible scena ios
we e desc ibed ha he Heal hdo migh go h ough,
see Figu e 5.4. They can be ca ego ised in o p e-
ope a i e use (scena ios 1 and 2) and pos -ope a i e
use (scena ios A and B). While he Heal hdo can be
used o o he ea men s as well (Philips, n.d.-d), i was
decided o ocus on a su ge y con ex due o he scope
o his hesis.
Scena io 2 desc ibes a si ua ion whe e he Heal hdo
is used o ending; collec ing da a be o e ea men
o es ablish a baseline. Cu en ly, scena io 1 is
p edominan ly used, which is why scena io 2 was
le ou o scope. Scena ios 1A and 1B we e u he
de eloped in o a p oduc jou ney, which can be seen
in Figu e 5.5. I is assumed he Heal hdo is used 50% in
scena io 1A and 50% in scena io 1B. In Appendix E a
de ailed p oduc jou ney can be ound.
5 • The Philips Heal hdo
Figu e 5.1: The Philips Heal hdo . (Philips, n.d.-d)
34
Figu e 5.2: Dimension o he Heal hdo , on a 1:1 scale. Figu e 5.3: Exploded iew o he Heal hdo . Image cou esy o
Philips (Pe sonal communica ion, 08-08-2023)
Table 5.1: Componen s and weigh s o he Philips Heal hdo . Da a
cou esy o Philips (pe sonal communica ion, 08-08-2023)
Pa ID Name Mass (g ams)
1 Casing, Top ~ 2
2 Memb ane il e <<1
3 Seal Tape (including
he elease line )
<<1
4 Ba e ies 2*1.68 = 3.36
5 PCB ~ 3
6 Casing, Bo om ~ 2
7 Skin Adhesi e
Assembly
~1
8 Ci cui B eake Tab <<1
9 P oduc Label <<1
10 Glue (0.04 mL) <<1
To al 12
55mm
45mm
33mm 11mm
40mm
35
p e-ope a i e
Scena io 1
Scena io 2
Scena io A
Scena io B
in-hospi al pos -ope a i e
Doc e de e mines
pos -ope a i e use o
Heal hdo
Pa ien is
ope a ed
Nu se places
Heal hdo
Pa ien lea es
hospi al
Pa ien applies
p e-sen heal hdo Pa ien s ays
in-hospi al
Pa ien emo es and
disposes he
Heal hdo
Nu se emo es and
disposes he
Heal hdo
Doc e de e mines p e-
and pos -ope a i e use
o Heal hdo
Scena io 1
In his scena io he Heal hdo is only used o
pos -ope a i e moni o ing. This means ha
be o e going o he hospi al o su ge y, he
doc o s de e mine ha a Heal hdo is used
a e su ge y bu he pa ien has no in e ac ion
wi h he p oduc . A e he su ge y, he p oduc
is placed on he pa ien .
Scena io 2
In his scena io he Heal hdo is used o
p e-ope a i e ending and pos -ope a i e
moni o ing. The doc o s de e mine ha
es ablishing a baseline o inding ends in
hea - and espi a o y a es is necessa y, and
send he pa ien a Heal hdo . The pa ien hen
has o place and ac i a e he Heal hdo
hemsel es. In he hospi al, he Heal hdo is
emo ed om he pa ien p e-su ge y, and
a e su ge y a new one is placed.
Scena io A
In his scena io, he pa ien is capable o
going home immedia ely (<24h) a e su ge y.
The Heal hdo is placed on he pa ien , which
allows he hospi al o moni o he pa ien
emo ely.
This scena io is e y pa ien depended. Philips
no ed ha some pa ien s ha e o wea i o
only 2-4 days, while o he pa ien s a e
equi ed o wea i o up o 14 days.
Scena io B
In his scena io, he pa ien is equi ed o s ay
in he hospi al o moni o ing. The Heal hdo is
applied he e o allow he pa ien o mo e
eely h ough he hospi al, and no o be
hinde ed by wi es. Be o e lea ing he hospi al,
he Heal hdo is emo ed om he pa ien .
Figu e 5.4: Possible use scena ios o he Heal hdo
36
P oduc Use
Heal hdo is s o ed
un il i ’s needed Heal hdo is scanned
when placed o
ac i a e i
Heal hdo is placed
on he pa ien
Heal hdo s a e
manu ac u ed and
assembled a he
ac o y
Fac o y
In e nal use
Ex e nal use
Philips Heal hdo
A e 14 days, he
Heal hdo is
emo ed
Pa ien goes home
wi h he applied
Heal hdo
A e 14 days, he
Heal hdo is
emo ed
The Heal hdo is
disposed o
Figu e 5.5: The Heal hdo ’s p oduc jou ney
37

Re lec ion
A i s , I decided o ocus solely on scena io 1A, as
his is he mos common-use scena io o he Heal hdo .
Howe e , in a la e con e sa ion wi h Philips whe e
concep s we e discussed, i became appa en ha
changing he scena io you design o will subsequen ly
change he ci cula sys em you design. In his case,
adding scena io 1B o he scope changes whe e he
Heal hdo ends a e i s li e, changing he op ions o
you collec ion sys em. Fo his eason, bo h scena ios
1A and 1B we e included in he inal p oduc jou ney.
5.2 Li e Cycle Analysis
Al hough he Heal hdo is a ela i ely s aigh o wa d
p oduc , i is s ill aluable o analyse i s en i onmen al
impac s. To ge an o e iew o he impac o he
di e en componen s, I pe o med a as - ack Li e
Cycle Analysis (LCA) using he 2023 Idema da abase
(S ich ing Sus ainabili y Impac Me ics, n.d.-a). This
me hod is used o quickly ge a ough e alua ion
o he eco-bu dens o a p oduc h oughou i s li e
cycle (S ich ing Sus ainabili y Impac Me ics, n.d.-b).
Howe e , i ’s impo an o no e ha due o he na u e
o his as - ack LCA, se e al assump ions had o be
made. As a esul , no speci ic amoun s o CO2 a e
men ioned, bu app oxima ions a e o e ed ins ead.
In his LCA, only he Heal hdo ’s p ima y pa s men ioned
p e iously a e aken in o accoun , he weigh o which
is gi en in Table 5.1. No enough de ail is known on
he weigh s o he o he pa s, and i is assumed hey’ e
oo small o ha e a signi ican impac . The casing o he
Heal hdo is made om an ABS + PA blend, which due
o lack o da a is simpli ied o ABS.
In his analysis one li e cycle o he Heal hdo is acked,
acco ding o he p oduc jou ney om Figu e 5.3. I
is assumed ha i is p oduced a Philips in Eindho en
and anspo ed o he E asmus MC in Ro e dam. As
p e iously desc ibed in Sec ion 5.1, i is assumed ha
50% o he use cases a e ou side he hospi al. I is
assumed he pa ien a els 5 km (CBS, 2023) om he
hospi al o hei home by ca . Fo i s end-o -li e, a wo s -
case scena io o incine a ion is assumed, in pa due
o a lack o da a on he eco-impac s o he ecycling
o PCBs. Packaging was no aken in o accoun as
no de ailed in o ma ion was a ailable. The esul s o
he LCA can be seen in Figu e 5.6, and a de ailed
calcula ion can be ound in Appendix F.
As expec ed, he PCB has by a he bigges impac on
he sus ainabili y impac o he Heal hdo . Elec onics a e
challenging o ecycle, and wi h hei high p oduc ion
impac – o e 150 imes ha o ABS, acco ding o he
Idema da abase – i makes sense o keep hem cycling
o as long as possible, which will be done wi h he new
Heal hdo 5.0. Because he Heal hdo is so ligh and
small, he anspo mo emen s ba ely show up on he
g aph. I is assumed ha anspo om he ac o y o
he hospi al will ha e mo e impac i he packaging is
coun ed.
5.3 Take-Aways
I6: I is impo an o choose he igh scena io and
con ex , as small changes he e can d as ically
in luence he ou come o you design.
I7: LCA’s a e a aluable ool o unde s and whe e
he impac lies in you p oduc , o why you
p oduc isn’ ci cula . I you could only sa e one
componen , which one would i be and why? Fo
example, he PCB has he bigges impac on he
Heal hdo , so i makes sense o make his pa las
as long as possible.
I8: LCA’s can be icky, as mino changes in you
assump ions can d as ically change i s ou comes.
Tes di e en assump ions in you LCA o see how
hese a ec he impac o you p oduc .
38
Figu e 5.6: The Heal hdo ’s LCA esul s
0
300
600
900
120 0
1500
End o Li e
T anspo
Skin Adhesi e
Housing
Ba e y
PCB
0
5
10
15
20
End o Li e
T anspo
Skin Adhesi e
Housing
gCO2 emissions
gCO2 emissions
Heal hdo CO2 emissions
39
In his chap e , he wo co e s akeholde s
o his p oduc - he O iginal Equipmen
Manu ac u e (OEM) and he hospi al - will
be discussed, ollowed by an explo a ion
o he possibili ies o he hospi al.
The OEM – in his con ex Philips – is esponsible
o manu ac u ing he p oduc . Philips is a company
p oducing bo h heal hca e and consume p oduc s,
p ima ily ocusing on heal h- ela ed i ems (Philips,
n.d.-a). They need o ensu e a high le el o quali y, ake
esponsibili y o he p oduc ’s sa e y and need o be a
eliable pa ne .
The hospi al – in his case s udy he E asmus MC in
Ro e dam – uses he p oduc . The E asmus MC is a
uni e si y medical cen e specializing in deli e ing
complex medical ca e, wi h o e 30.000 pa ien s being
admi ed each yea (E asmus MC Founda ion, n.d.-a).
They a e accoun able o p o iding quali y heal hca e
and p ocu ing he p oduc s ha suppo his goal.
While he E asmus MC manages i s own s e ilisa ion
depa men , smalle hospi als commonly ely on hi d-
pa y se ice p o ide s o his. These se ice p o ide s
ake ca e o he collec ion, cleaning and s e ilisa ion o
used su gical equipmen . Al hough he E asmus MC
se es as he example hospi al in his hesis, concep s
shown la e in Chap e 10 will conside 3 d pa y
se ices as well.
Wi hin he hospi al, he doc o , nu se and pa ien s
a e also s akeholde s in his sys em. Howe e , he
equi emen s o doc o s, nu ses and pa ien a e
al eady pa o he hospi al’s equi emen s, as a esul
o hei in e nal p ocesses. As such hey a e iewed as
seconda y s akeholde s o he hospi al.
6.1 Possibili ies o he Hospi al
Du ing a con e sa ion wi h he p ocu emen depa men
om he E asmus MC (pe sonal communica ion, 02-
05-2023), i became clea ha logis ics in a hospi al
a e complex and demanding. An example was gi en
ha illus a ed ha hospi als a e al eady qui e axed
when i comes o cleaning: cleaning mo e clo hing,
such as gowns, would in ol e addi ional collec ion,
sepa a ion, and washing p ocesses, adding o he
exis ing wo kload. Simila ly, ano he idea o sepa a e
a ype o plas ic o ecycling would equi e a second
was e handle , as he cu en was e handle could no
6 • S akeholde s
40
manage his ype o plas ic. Tha means ha ins ead
o one you now ha e wo people going h ough he
hospi als o pick up was e, which u he bu dens he
sys em.
When discussing whe he he hospi al would be willing
o be he p oduc owne , an in e es ing pe spec i e
was aised ega ding he manu ac u e ’s in en . I an
OEM c ea es a eusable p oduc bu would s ill use a
linea model (e.g., buy mo e sell mo e), i may no show
genuine in en owa ds ci cula i y om Philips, leading
o conce ns abou us and quali y o he de ice.
In a second con e sa ion wi h a sus ainabili y manage
om he E asmus MC (pe sonal communica ions, 27-
06-2023), i was men ioned ha he hospi al al eady
euses some po able de ices, no ably he Hol e
moni o s, which a e wea able ECG de ices which
moni o he pa ien o up o 48 hou s.
A e use, he de ices a e e u ned o he polyclinic
whe e he da a is downloaded and analysed. Cleaning
o hese kinds o de ices is simple and can be done
by anyone using alcohol wipes. The Heal hdo could
ollow a simila cleaning schedule. Al e na i ely, he
Cen al S e ilisa ion Se ice also disin ec s p oduc s,
such as endoscopes. Howe e , no all hospi als ha e
an in e nal s e ilisa ion se ice.
6.2 Take-Aways
I9: Ci cula i y equi es a b oade mindse . I
signi ican ly changes he app oach, scope and
bounda ies o you p ojec , equi ing a mo e
holis ic app oach.
I10: In eg a e you s akeholde s in he design
p ocess. S akeholde s hold aluable knowledge,
hey ha e ideas on wha is and isn’ possible,
bo h in he cu en sys ems and he sys em you
a e designing. Wi hin a s akeholde , di e en
depa men s will gi e you di e en pe spec i es,
possibili ies and in o ma ion.
I11: The s akeholde s a e going o execu e you
sys em, in ol ing hem in you p ocess migh make
i easie o hem o accep he solu ion.
I12: The ci cula ac ions and in en ions o an OEM
hold meaning o he buye . I an OEM emains he
owne o he p oduc , i demons a es hei ac i e
in ol emen in he p oduc ’s ci cula i y, while i i
is sold ia a linea model you could ques ion hei
in en .
41
design
Pa ou

9 • Design o he Fu u e Ci cula Sys em: SecondSense
10
• Designing SenseFlow
11 • Designing SenseCab
In his chap e , I p esen SecondSense, a
po en ial solu ion o make MWS ci cula .
Fi s , he concep is in oduced, and hen
i s seconda y pa s a e discussed in mo e
de ail. Finally, a compa ison is made wi h
he o iginal Heal hdo .
SecondSense is a p oduc -se ice-sys em, which allows
easy and quick euse o mul iple MWS. I consis s o
wo pa s: SenseFlow and he SenseCab. SenseFlow
desc ibes how he senso s low h ough he ci cula
sys em, while he SenseCab enables easy ep ocessing
o he senso s.
Wi h SenseFlow, medical wea able senso s a e e u ned
o he hospi al a e use whe e hey a e cleaned and
p epa ed o he nex use. The manu ac u e emains he
owne o he senso , being esponsible o he quali y o
he senso s and o wha happens a he senso ’s end-
o -li e. The hospi al cleans and con ols he senso s, a e
which hey a e placed in he SenseCab. The SenseCab
is a uni e sal de ice ha can upda e, cha ge and
disin ec di e en senso s om di e en manu ac u e s,
and makes hem eady o euse. When a senso is
needed, simply g ab he senso and he equi ed pa ch,
and you’ e eady o sense!
9.1 Con ex : i e yea s om now
Fo he design o SecondSense i was decided o
design o use in a u u e con ex , as emo e moni o ing
– o eleheal h – is expec ed o become mo e common
in he u u e o a a ie y o ea men s (Siwicki, 2023).
Mo e eleheal h would lead o mo e senso s being used
in and ou o hospi als. Fo his eason, a u u e con ex
i e yea s ahead om now was chosen. In his con ex ,
i is assumed ha he e a e mul iple medical wea able
senso s ha a e eusable. These senso s a e used bo h
in e nally and ex e nally and need o be managed by
he hospi al.
9 • Design o he Fu u e
Ci cula Sys em: SecondSense
50
P oduc Use
In e nal use
Ex e nal use
Rep ocessing
Fac o y
Reuse Phase
SecondSense
Use Phase
P epa a ion
Figu e 9.1: An o e iew o he SecondSense sy em
51
Touch sc een
F os ed Glass
Figu e 9.2: F on iew o a closed SenseCab:
52
Wi eless Cha gin
Mul iple senso s
Figu e 9.3: Angled iew o an open SenseCab
53

9.2 SenseFlow
The SecondSense sys em’s ci cula low is called
SenseFlow. I consis s o wo co e phases: he use phase
and he ep ocessing phase. The use phase desc ibes
he use o he senso , bo h in e nal and ex e nal o he
hospi al. The ep ocessing phase ocusses on cleaning
and p epa ing he senso o ano he use, as well as
handling he ejec ed senso s. This low is desc ibed in
Figu e 9.4, and u he de ailed in he ollowing sec ions.
The business model is based on he access and
pe o mance model om Bocken (2016). The OEM
– he e Philips – s ays owne o he MWS, while he
hospi al pays pe use. This gi es he OEM con ol o e
he end-o -li e o he senso , educing spillage, and
incen i ises he OEM o design long-las ing p oduc s;
he mo e a senso can be used, he mo e p o i hey
make.
The ac ions equi ed by he s akeholde s – The hospi al
and he OEM, Philips – can be summa ized by he
ollowing lis :
• The hospi al applies he Heal hdo on he pa ien
• The hospi al emo es in e nally used Heal hdo s
om he pa ien
• The pa ien sends hei ex e nally used Heal hdo s
back o he Hospi al
• The hospi al akes ca e o collec ing he used
Heal hdo s, inspec ing hem and cleaning hem
• Philips p o ides suppo , supplying new pa ches and
– when needed – new Heal hdo s
• Philips akes ca e o old and ejec ed Heal hdo s
9.2.1 Use phase
The use phase o SenseFlow desc ibes how he senso
is used, om applica ion o collec ion. When a senso
is needed, a nu se akes he equi ed senso – in his
case, a Heal hdo – om he SenseCab, along wi h he
equi ed pa ches and o he ma e ials. The nu se hen
places he Heal hdo on he pa ien and ac i a es i ,
linking i o he pa ien . I he pa ien s ays in he hospi al,
he Heal hdo is emo ed by a nu se when i is no
longe needed. The used pa ch is disposed o and he
Heal hdo is e u ned o he policlinic o be ep ocessed.
When he pa ien goes home wi h he Heal hdo , he
pa ien emo es he Heal hdo when i is no longe
needed. A e emo ing i , hey sepa a e he Heal hdo
om he pa ch – which is disposed o – and he
Heal hdo is sen back o he hospi al.
As you migh no ice, he use phase is s ill la gely simila
o he p oduc jou ney desc ibed in Sec ion 5.1. This
is because no signi ican changes we e made o he
wo king o he senso ; he applica ion and use s ay he
same. The di e ence is ha some ex a p epa a ion is
needed be o e use and he senso has o be collec ed
a e use.
9.2.2 Rep ocessing Phase
The ep ocessing phase o SenseFlow desc ibes how
he senso is p epa ed o ano he use. When he
Heal hdo is e u ned o he policlinic, i is inspec ed
o damages and cleaned wi h an alcohol wipe. The
Heal hdo is hen scanned o check i i is s ill sa e o use,
and is placed in he SenseCab. In he SenseCab, he
Heal hdo is upda ed and pe sonal da a is emo ed, i
is UV-disin ec ed and inally cha ged, all au oma ically.
When i is ime o use he Heal hdo , i is scanned again
o egis e i s mo emen and p epa ed wi h a new
pa ch.
Heal hdo s ha don’ make he sa e y check a e
collec ed sepa a ely and sen back o Philips. He e
hey a e aken apa , he PCB is checked o see i i can
las ano he li e cycle and he casing o he senso is
ecycled. Philips sends new Heal hdo s and pa ches o
he hospi al o be used again.
9.3 SenseCab
The SenseCab is he enable o he SenseFlow sys em;
i allows easy ep ocessing o he used senso s (Figu e
9.5-9.11) The SenseCab is esponsible o cha ging,
emo ing and upda ing da a, and disin ec ing he
senso s. The senso s a e placed inside he cabine on
a wi eless cha ging pla e, whe e hey a e cha ged,
pe sonal da a is emo ed and so wa e is upda ed. The
cabine con ains UV-LEDs which disin ec he senso s
du ing hei cha ge (Messina e al., 2015). The os ed
glass on doo p o ec s he nu ses om ha m ul UV
ligh . When in e ac ing wi h he SenseCab, he UV ligh s
u n o and he glass doo u ns anspa en o a quick
o e iew o he senso s and hei s a uses. The ouch
sc een on he on allows he s a o see he de ailed
s a us o he senso s inside wi hou opening he cabine ,
while he LED ings o e a quick s a us upda e.
54
Re u ned Heal hdo s
a e disman eld
The PCB’s a e
checked i hey
could go h ough
ano he use cycle
Failed
Heal hdo s a e
eplaced wi h
new ones
New pa ches
and packaging
is supplied
P oduc Use
In e nal use
Ex e nal use
Rep ocessing
Reuse Phase
SenseFlow
Use Phase
Heal hdo is s o ed
un il i ’s needed Heal hdo is scanned
when placed o
ac i a e i
Heal hdo s ha don’ make he
check a e sen back o Philips
Heal hdo is placed
on he pa ien
The SenseCab checks
i he senso is s ill sa e
o use
The Heal hdo is
scanned wi h he
SenseCab, which
doumen s hei a i al
A e 14 days, he
Heal hdo is
emo ed
The Heal hdo is
sepe a ed om
i s s icke
The Heal hdo is
so ed o euse
The s icke is
disposed o
The Heal hdo is
so ed sepe a ely
and b ough o he
policlinic
The Sensecab emo es and upda es
da a, disin ec s, and cha ges he
Heal hdo , as well as any o he
MWS
Heal hdo is
p epa ed wi h
packaging and
s icke s pe hospi al
p o ocol
P epa a ion
The Heal hdo is
eady o euse!
The Heal hdo is
sepe a ed om
i s s icke
Pa ien goes home
wi h he applied
Heal hdo
A e 14 days, he
Heal hdo is
emo ed
The Heal hdo is
packaged and
shipped back
The s icke is
disposed o
Fac o y
Figu e 9.4: SecondSense's ci cula low, SenseFlow, wi h desc ip ion o i s ac i i ies.
55
16 Senso s
The SenseCab can handle 16 senso s
a once, as demons a ed he e by
di e en dummy senso s
Figu e 9.5: F on iew o an open SenseCab
56
Wi eless Cha ging Puck
Magne s hold he senso s agains
he wi eless cha ging puck, which
cha ges he senso and connec s i o
he SenseCab.
Figu e 9.6: Close up iew o he SenseCab's cha ging puck
57
gCO2 emissions
0
500
1000
1500
2000
2500
3000
3500
Heal hdo SecondSense
1x 2x 3x 4x 5x 6x 7x 8x 9x 10x
Pa ien - Hosp ial T anspo *
Skin Adhesi e*
Cleaning
Sha e in he casing
Incine a ion
T anspo *
Housing*
Ba e y
PCB
* alues a e low, no isisble in g aph
CO2 impac compa ison be ween he Heal hdo and SecondSense
Figu e 9.12: CO2 impac compa ison be ween he Heal hdo and SecondSense
64

Figu e 9.13: Nigh iew o he SenseCab
65
In his chap e , he design p ocess which
led o SenseFlow is desc ibed. Fi s , an
o e iew is gi en o he p ocess, a e
which he subsequen design s eps a e
desc ibed in mo e de ail. Finally, wo inal
concep s a e desc ibed, and a gumen s
a e gi en o he choice o SenseFlow.
10.1 Design P ocess
The design p ocess ha was ollowed can be oughly
desc ibed in Figu e 10.1, which shows he di e en
phases and includes e e ences o hei ele an sec ions.
Fi s , in he Idea ion phase, he li e a u e desc ibed in
Chap e 4 was used as a s a ing poin , which esul ed
in sys em possibili ies (Sec ion 10.2). These whe e hen
used o c ea e concep s (Sec ion 10.3), a e which
a choice was made o he inal design, SenseFlow,
desc ibed p e iously.
10 • Designing SenseFlow
Idea ion
Chap e 10.2
Chap e 4
Chap e 10.3 Chap e 9.2
Concep ing
Fi s I e a ion
Li e a u e Resul s Sys em Possibili ies
Second I e a ion
Fac o y Rep ocessing
Hosp ial Rep ocessing
Final I e a ion
Final Sys em
Li e a u e
i e a e + scampe
c i e ia
Ci cula S a egies
Business Models
Design Re iew LCA
c i e ia
Mo phological cha
WWWWWH
A. Reuse
B. Repai
1. Reuse
o
o i s
hen
hen
o
2. Repai
3. Remanu ac u e
C. Remanu ac u e
9R Hie a chie
Designing SenseCab
Fac o y
Re u ned Heal hdo s
a e disman eld
The PCB’s a e
checked i hey
could go h ough
ano he use cycle
Failed
Heal hdo s a e
eplaced wi h
new ones
P epa a ion
Ex e nal euse low
3 d Pa y
Philips
Packaging
The Heal hdo
is packeged
wi h new
pa ches and
packaging
In e al use
Ex e nal use
Heal hdo is s o ed
un il i ’s needed Heal hdo is scanned
when placed o
ac i a e i
Heal hdo is placed
on he pa ien A e XX days, he
Heal hdo is
emo ed The Heal hdo is
sepe a ed om
i s s icke
The Heal hdo is
so ed o euse
and shipped
The s icke is
disposed o
The Heal hdo is
sepe a ed om
i s s icke
Pa ien goes home
wi h he applied
Heal hdo
A e 30 days, he
Heal hdo is
emo ed
The Heal hdo is
packaged and
shipped back
The s icke is
disposed o
The Heal hdo is
checked o hei
quali y and sa e y
The Heal hdo is
scanned so hei
a i al is documen ed
The heal hdo is cleaned
( oge he wi h o he
senso s in a uni e sal
machine)
The Heal hdo is cha ged,
upda ed and pe sonal
da a is emo ed
The Heal hdo is
eady o euse!
New pa ches
and packaging
is supplied
In e nal anspo
Reuse Phase
Use Phase
P oduc Use
Re u ned Heal hdo s
a e disman eld
The PCB’s a e
checked i hey
could go h ough
ano he use cycle
Failed
Heal hdo s a e
eplaced wi h
new ones
New pa ches
and packaging
is supplied
P oduc Use
In e nal use
Ex e nal use
P epa a ion
Reuse Phase
Hospi al euse low
Use Phase
Heal hdo is s o ed
un il i ’s needed Heal hdo is scanned
when placed o
ac i a e i
Heal hdo s ha don’
make he check a e sen
back o Philips
Heal hdo is placed
on he pa ien
The Heal hdo is cha ged,
upda ed and pe sonal
da a is emo ed
The Heal hdo is
checked o hei
quali y and sa e y
The Heal hdo is
scanned so hei
a i al is documen ed
A e XX days, he
Heal hdo is
emo ed
The Heal hdo is
sepe a ed om
i s s icke
The Heal hdo is
so ed o euse
The s icke is
disposed o
The Heal hdo is
so ed sepe a ely
and b ough o he
Cen al Disin ec ion
Se ice
The heal hdo is cleaned and
inspec ed oge he wi h o he
senso s in a uni e sal machine?
Heal hdo is
p epa ed wi h
packaging and
s icke s pe hospi al
p o ocol
Packaging
The Heal hdo is
eady o euse!
The Heal hdo is
sepe a ed om
i s s icke
Pa ien goes home
wi h he applied
Heal hdo
A e 30 days, he
Heal hdo is
emo ed
The Heal hdo is
packaged and
shipped back
The s icke is
disposed o
P oduc Use
In e nal use
Ex e nal use
Rep ocessing
Fac o y
Reuse Phase
SecondSense
Use Phase
P epa a ion
P oduc Use
Re u ning
P oduc Reuse
P oduce
Package
Heal hdo is s o ed
un il i ’s needed
Heal hdo s ha don’
make he check a e
ecycled
New pa ches and
packaging is
supplied and pu
oge he wi h he
Heal hdo
Failed Heal hdo s
a e eplaced wi h
new ones
Heal hdo is placed
on he pa ien
A clean and eady
o go heal hdo
The Heal hdo is
checked o hei
quali y and sa e y
The Heal hdo
a i es a he
ac o y
Pa ien goes home
wi h he applied
Heal hdo
A e 30 days, he
Heal hdo is
emo ed
The Heal hdo is
sepe a ed om
i s s icke
The s icke is
disposed o
The Heal hdo is
packaged and
shipped back
The heal hdo is
cleaned and inspec ed
mechanically
Heal hdo is eady
o use again
Recycle
Reuse Phase
Use Phase
P oduc Use
Re u ning
P oduc Reuse
Reuse Phase
Use Phase
P oduce
Recycle
Heal hdo is s o ed
un il i ’s needed
Heal hdo s ha don’
make he check a e sen
back o Philips
New pa ches
and packaging
is supplied
Failed Heal hdo s
a e eplaced wi h
new ones
Heal hdo is placed
on he pa ien
A clean and eady
o go heal hdo
The Heal hdo is
checked o hei
quali y and sa e y
The Heal hdo
a i es a he
Hospi al
Pa ien goes home
wi h he applied
Heal hdo
A e 30 days, he
Heal hdo is
emo ed
The Heal hdo is
sepe a ed om
i s s icke
The s icke is
disposed o
The Heal hdo is
packaged and
shipped back
The heal hdo is
cleaned and inspec ed
By hand
Heal hdo is
p epa ed wi h
packaging and
s icke s
P epa a ion
Figu e 10.1: High-le el o e iew o he p ocess o designing SenseFlow
66
Idea ion
Chap e 10.2
Chap e 4
Chap e 10.3 Chap e 9.2
Concep ing
Fi s I e a ion
Li e a u e Resul s Sys em Possibili ies
Second I e a ion
Fac o y Rep ocessing
Hosp ial Rep ocessing
Final I e a ion
Final Sys em
Li e a u e
i e a e + scampe
c i e ia
Ci cula S a egies
Business Models
Design Re iew LCA
c i e ia
Mo phological cha
WWWWWH
A. Reuse
B. Repai
1. Reuse
o
o i s
hen
hen
o
2. Repai
3. Remanu ac u e
C. Remanu ac u e
9R Hie a chie
Designing SenseCab
Fac o y
Re u ned Heal hdo s
a e disman eld
The PCB’s a e
checked i hey
could go h ough
ano he use cycle
Failed
Heal hdo s a e
eplaced wi h
new ones
P epa a ion
Ex e nal euse low
3 d Pa y
Philips
Packaging
The Heal hdo
is packeged
wi h new
pa ches and
packaging
In e al use
Ex e nal use
Heal hdo is s o ed
un il i ’s needed Heal hdo is scanned
when placed o
ac i a e i
Heal hdo is placed
on he pa ien A e XX days, he
Heal hdo is
emo ed The Heal hdo is
sepe a ed om
i s s icke
The Heal hdo is
so ed o euse
and shipped
The s icke is
disposed o
The Heal hdo is
sepe a ed om
i s s icke
Pa ien goes home
wi h he applied
Heal hdo
A e 30 days, he
Heal hdo is
emo ed
The Heal hdo is
packaged and
shipped back
The s icke is
disposed o
The Heal hdo is
checked o hei
quali y and sa e y
The Heal hdo is
scanned so hei
a i al is documen ed
The heal hdo is cleaned
( oge he wi h o he
senso s in a uni e sal
machine)
The Heal hdo is cha ged,
upda ed and pe sonal
da a is emo ed
The Heal hdo is
eady o euse!
New pa ches
and packaging
is supplied
In e nal anspo
Reuse Phase
Use Phase
P oduc Use
Re u ned Heal hdo s
a e disman eld
The PCB’s a e
checked i hey
could go h ough
ano he use cycle
Failed
Heal hdo s a e
eplaced wi h
new ones
New pa ches
and packaging
is supplied
P oduc Use
In e nal use
Ex e nal use
P epa a ion
Reuse Phase
Hospi al euse low
Use Phase
Heal hdo is s o ed
un il i ’s needed Heal hdo is scanned
when placed o
ac i a e i
Heal hdo s ha don’
make he check a e sen
back o Philips
Heal hdo is placed
on he pa ien
The Heal hdo is cha ged,
upda ed and pe sonal
da a is emo ed
The Heal hdo is
checked o hei
quali y and sa e y
The Heal hdo is
scanned so hei
a i al is documen ed
A e XX days, he
Heal hdo is
emo ed
The Heal hdo is
sepe a ed om
i s s icke
The Heal hdo is
so ed o euse
The s icke is
disposed o
The Heal hdo is
so ed sepe a ely
and b ough o he
Cen al Disin ec ion
Se ice
The heal hdo is cleaned and
inspec ed oge he wi h o he
senso s in a uni e sal machine?
Heal hdo is
p epa ed wi h
packaging and
s icke s pe hospi al
p o ocol
Packaging
The Heal hdo is
eady o euse!
The Heal hdo is
sepe a ed om
i s s icke
Pa ien goes home
wi h he applied
Heal hdo
A e 30 days, he
Heal hdo is
emo ed
The Heal hdo is
packaged and
shipped back
The s icke is
disposed o
P oduc Use
In e nal use
Ex e nal use
Rep ocessing
Fac o y
Reuse Phase
SecondSense
Use Phase
P epa a ion
P oduc Use
Re u ning
P oduc Reuse
P oduce
Package
Heal hdo is s o ed
un il i ’s needed
Heal hdo s ha don’
make he check a e
ecycled
New pa ches and
packaging is
supplied and pu
oge he wi h he
Heal hdo
Failed Heal hdo s
a e eplaced wi h
new ones
Heal hdo is placed
on he pa ien
A clean and eady
o go heal hdo
The Heal hdo is
checked o hei
quali y and sa e y
The Heal hdo
a i es a he
ac o y
Pa ien goes home
wi h he applied
Heal hdo
A e 30 days, he
Heal hdo is
emo ed
The Heal hdo is
sepe a ed om
i s s icke
The s icke is
disposed o
The Heal hdo is
packaged and
shipped back
The heal hdo is
cleaned and inspec ed
mechanically
Heal hdo is eady
o use again
Recycle
Reuse Phase
Use Phase
P oduc Use
Re u ning
P oduc Reuse
Reuse Phase
Use Phase
P oduce
Recycle
Heal hdo is s o ed
un il i ’s needed
Heal hdo s ha don’
make he check a e sen
back o Philips
New pa ches
and packaging
is supplied
Failed Heal hdo s
a e eplaced wi h
new ones
Heal hdo is placed
on he pa ien
A clean and eady
o go heal hdo
The Heal hdo is
checked o hei
quali y and sa e y
The Heal hdo
a i es a he
Hospi al
Pa ien goes home
wi h he applied
Heal hdo
A e 30 days, he
Heal hdo is
emo ed
The Heal hdo is
sepe a ed om
i s s icke
The s icke is
disposed o
The Heal hdo is
packaged and
shipped back
The heal hdo is
cleaned and inspec ed
By hand
Heal hdo is
p epa ed wi h
packaging and
s icke s
P epa a ion
67
10.2 Ci cula S a egies and
Business Models
The i s s ep in he design p ocess was choosing he
ci cula s a egy and business model, as hese play a
c ucial ole in he design o you sys em. The ci cula
s a egy ou lines how you sys em will align wi h he
ci cula economy, such as whe he you will p io i ise
euse o emanu ac u ing. On he o he hand, he
business model desc ibes he oles and ac ions o
s akeholde s, including esponsibili ies, owne ship, and
cleaning p ocesses. The choices made he e will ha e a
signi ican impac on he design o bo h you sys em and
he accompanying senso .
To iden i y sui able ci cula s a egies and business
models, hey we e assessed on he equi emen s om
Chap e 8, he esul s o which can be seen in Table 10.1
& 10.2. I was ound ha euse, epai and emanu ac u e
a e h ee i ing ci cula s a egies. Likewise, access and
pe o mance, classic long-li e model, and encou age
su iciency a e h ee sui able business models. Toge he ,
hese could esul in a ci cula senso .
The h ee ci cula s a egies we e oge he in o one
solu ion, based on he ine ia p inciple: “Do no epai
wha is no b oken, do no emanu ac u e some hing
ha can be epai ed, do no ecycle a p oduc ha can
be emanu ac u ed. Replace o ea only he smalles
possible pa in o de o main ain he exis ing economic
alue o he echnical sys em.”(S ahel, 2010). This led o
idea ion on ques ions such as: Who will be esponsible?
Who will clean he senso ? Who will own he senso ?
To gi e Philips an incen i e o design sus ainable and
long-las ing p oduc s, hey should aim o a s eady
e enue om he concep in his business model. In a
mo e linea economic model (e.g. buy mo e sell mo e),
no ma e how du able he Heal hdo is, Philips would
need o con inuously sell mo e p oduc s o gene a e
e enue. Conside ing ha he access and pe o mance
model is he only one among he h ee op ions ha
p o ide a con inuous e enue s eam, i appea s o be
he bes i o his case.
Table 10.1: 9R-S a egies assessed on hei i o he equi emen s om Chap e 8
Ci cula S a egies Desc ip ion
Less e-was e when
compa ed o
cu en concep
Less CO2 when
compa ed o
cu en concep
Fi s De ini ion
gi en in Chap e 3
Enables mul iple
uses o PCB's
Re use
Desc ip ions gi en in
Figu e 3.2
Y Y Y -
Re hink Y Y Y -
Reduce Y Y Y N
Reuse Y Y Y Y
Repai Y Y Y Y
Remanu ac u e Y Y Y Y
Repu pose Y Y Y N
Recycle M M M N
Reco e M N N N
68
Table 10.2: Business models assessed on hei i o he equi emen s om Chap e 8
Business Models Desc ip ion
Less e-was e when
compa ed o
cu en concep
Less CO2 when
compa ed o
cu en concep
Fi s De ini ion
gi en in Chap e 3
Enables mul iple
uses o PCB's
Access and pe o mance P o iding he capabili y o se ices o sa is y use needs wi hou needing o own
physical p oduc s Y Y Y Y
Classic long-li e Business models ocused on deli e ing long-p oduc li e, suppo ed by
design o du abili y and epai o ins ance Y Y Y Y
Ex ending p oduc alue
Exploi ing he esidual alue o p oduc s - om manu ac u e o
consume s, and hen back o manu ac u ing – o collec ion o p oduc s
be ween dis inc business en i ies
Y Y M M
Encou age su iciency
Solu ions ha ac i ely seek o educe end-use consump ion h ough
p inciples such as du abili y, upg adabili y, se ice, wa an ies and
epa abili y and a non-consume is app oach o ma ke ing and sales
Y Y Y Y
Ex ending esidual alue
Exploi ing he esidual alue o esou ces: collec ion and sou cing o
o he wise “was ed” ma e ials o esou ces o u n hese in o new o ms o
alue
M M M N
Indus ial symbiosis
A p ocess- o ien a ed solu ion, conce ned wi h using esidual ou pu s
om one p ocess as eeds ock o ano he p ocess, which bene i s om
geog aphical p oximi y o businesses
M M M N
69

10.3 Two Concep Designs
The chosen s a egies and business model we e used o
s a he idea ion p ocess, which le o mul iple concep s
desc ibed in Appendix G. The wo inal concep s a e
desc ibed he e: Hospi al Rep ocessing and Fac o y
Rep ocessing.
Bo h concep s a e ocussed on he euse o he
Heal hdo h ough ep ocessing. They sha e he same
use phase, which is la gely simila o he one desc ibed
in Sec ion 5.2, aside om changes in p epa a ion and
he ac ha he Heal hdo is now collec ed a e use,
ins ead o disposed o .
Addi ionally, bo h concep s sha e he same business
model: a p oduc -se ice-sys em. Philips is and will
emain he owne o he Heal hdo s. E e y ime he
hospi al ac i a es a Heal hdo , Philips ges a no i ica ion
and can bill he hospi al o i s use. The hospi al does
no pay o new Heal hdo s, as his is p o ided by he
se ice elemen .
Finally, he wo concep s di e in hei ep ocessing
phases. The hospi al concep is ocussed on in e nal
ep ocessing in he hospi al, whe eas he ac o y
concep is ocussed on ex e nal ep ocessing.
10.3.1 Hospi al Rep ocessing
This concep ocuses on in e nal ep ocessing, as can
be seen in Figu e 10.2. A e use, he Heal hdo is so ed
in e nally whe e i is ep ocessed, ei he a he Cen al
S e ilisa ion Se ice o a he policlinic, depending
on hospi al p e e ence. Rejec ed Heal hdo s a e
e u ned o he ac o y, which supplies he hospi al wi h
eplacemen Heal hdo s and new pa ches.
Key S akeholde Ac ions
• The hospi al collec s Heal hdo s used in he hospi al
in e nally
• The pa ien sends hei used Heal hdo s o he
hospi al
• The hospi al akes ca e o collec ing he used
Heal hdo s, inspec ing hem and cleaning hem
• Philips p o ides suppo , new pa ches and – when
needed – new Heal hdo s
• Philips akes ca e o old and ejec ed Heal hdo s
Re u ned Heal hdo s
a e disman eld
The PCB’s a e
checked i hey
could go h ough
ano he use cycle
Failed
Heal hdo s a e
eplaced wi h
new ones
New pa ches
and packaging
is supplied
P oduc Use
In e nal use
Ex e nal use
Rep ocessing
Reuse Phase
Hospi al Rep ocessing
Use Phase
Heal hdo is s o ed
un il i ’s needed Heal hdo is scanned
when placed o
ac i a e i
Heal hdo s ha don’
make he check a e sen
back o Philips
Heal hdo is placed
on he pa ien
The Heal hdo is cha ged,
upda ed and pe sonal
da a is emo ed
The Heal hdo is
checked o hei
quali y and sa e y
The Heal hdo is
scanned so hei
a i al is documen ed
A e 14 days, he
Heal hdo is
emo ed
The Heal hdo is
sepe a ed om
i s s icke
The Heal hdo is
so ed o euse
The s icke is
disposed o
The Heal hdo is
so ed sepe a ely
and b ough o he
Cen al S e lisa ion
Se ice
The heal hdo is cleaned and
inspec ed oge he wi h o he
senso s in a uni e sal machine?
Heal hdo is
p epa ed wi h
packaging and
s icke s pe hospi al
p o ocol
Packaging
The Heal hdo is
eady o euse!
The Heal hdo is
sepe a ed om
i s s icke
Pa ien goes home
wi h he applied
Heal hdo
A e 14 days, he
Heal hdo is
emo ed
The Heal hdo is
packaged and
shipped back
The s icke is
disposed o
70
Re u ned Heal hdo s
a e disman eld
The PCB’s a e
checked i hey
could go h ough
ano he use cycle
Failed
Heal hdo s a e
eplaced wi h
new ones
New pa ches
and packaging
is supplied
P oduc Use
In e nal use
Ex e nal use
Rep ocessing
Reuse Phase
Hospi al Rep ocessing
Use Phase
Heal hdo is s o ed
un il i ’s needed Heal hdo is scanned
when placed o
ac i a e i
Heal hdo s ha don’
make he check a e sen
back o Philips
Heal hdo is placed
on he pa ien
The Heal hdo is cha ged,
upda ed and pe sonal
da a is emo ed
The Heal hdo is
checked o hei
quali y and sa e y
The Heal hdo is
scanned so hei
a i al is documen ed
A e 14 days, he
Heal hdo is
emo ed
The Heal hdo is
sepe a ed om
i s s icke
The Heal hdo is
so ed o euse
The s icke is
disposed o
The Heal hdo is
so ed sepe a ely
and b ough o he
Cen al S e lisa ion
Se ice
The heal hdo is cleaned and
inspec ed oge he wi h o he
senso s in a uni e sal machine?
Heal hdo is
p epa ed wi h
packaging and
s icke s pe hospi al
p o ocol
Packaging
The Heal hdo is
eady o euse!
The Heal hdo is
sepe a ed om
i s s icke
Pa ien goes home
wi h he applied
Heal hdo
A e 14 days, he
Heal hdo is
emo ed
The Heal hdo is
packaged and
shipped back
The s icke is
disposed o
Figu e 10.2: Hospi al ep ocessing concep
71
10.3.2 Fac o y Rep ocessing
This concep ocusses on ex e nal ep ocessing, as
can be seen in Figu e 10.3. A e use, he Heal hdo is
sen o ei he he OEM’s ac o y o a 3 d pa y se ice
p o ide , whe e he Heal hdo is ep ocessed – his
would depend on he loca ion o he ac o y ela i e o
he hospi al. The 3 d pa y se ice p o ide would send
ejec ed Heal hdo s back o he OEM ac o y, while
he OEM ac o y would be he sole p o ide o new
pa ches and eplacemen Heal hdo s.
Key S akeholde Ac ions
• The hospi al akes ca e o collec ing he in e nally
used Heal hdo s and sends hem o ei he Philips o
a 3 d pa y
• The pa ien sends hei used Heal hdo di ec ly o
Philips o a 3 d pa y.
• A he collec ion acili y, he Heal hdo s a e
inspec ed, cleaned and p epa ed.
• Philips p o ides suppo , new pa ches and – when
needed – new Heal hdo s
• Philips akes ca e o old and ejec ed Heal hdo s
10.3.3 Concep Re iews
Bo h concep s we e e iewed in wo sessions, one
wi h ep esen a i es om Philips (n=1) and Games o
Heal h (n=3) and one wi h a ep esen a i e om he
E asmus MC (n=1).
The i s opic ha came up was he chosen scena io. Fo
his hesis, a scena io whe e he Heal hdo is sen back
o he hospi al was chosen, due o he scope. Howe e ,
wha i he Heal hdo would be e u ned a a ‘ us wo hy
medical loca ion’, such as a pha macy o a gene al
p ac i ione ? This would change how he Heal hdo
would be e u ned, and in u n, also a ec how i would
be ep ocessed. Fo example, he pha macy could also
do ep ocessing, o will he pha macy so he de ices
pe hospi al? A change in scena io can ha e a la ge
impac on you design.
A second opic ha was discussed is he
in e changeabili y o he di e en pa s o he concep s.
You can spli each concep in o wo lows and combine
hese, see Figu e 10.4. Fo his hesis, he choice is made
o jus one sys em. Howe e , in p ac ice i migh be
desi able o hospi als o be gi en a choice on how
o euse hese p oduc s. Smalle hospi als migh p e e
ex e nal ep ocessing because hey lack in as uc u e,
while la ge hospi als migh ha e no issues wi h ha and
can handle a sho e loop.
Finally, he opic o uni e sali y came up. All pa ies
ag eed ha in a sys em like his, MWS should be
compa ible wi h he same sys em o make i easible.
I a hospi al has o ep ocess mul iple di e en senso s
and hey would all ha e a unique cable, machine and
ep ocessing s eps, his would become an impossible
ask. This is why i is impo an o use o de elop a
s anda d which is sha ed amongs di e en senso s. A
eal-wo ld example is he s anda dized phone cha ge .
Mos eade s o his hesis will emembe he chaos
o he i s phones all using di e en cha ging cables.
Nowadays almos all o hem use he same cha ge ,
making i easy o echa ge a a ie y o di e en phones.
In he con e sa ion wi h he E asmus MC, some conce ns
came up. Mos no ably he ques ion o ‘how do you
make su e ha you ha e enough Heal hdo s?”. I you
un ou o Heal hdo s, do you ge sen mo e senso s?
O a e you able o ack we e hey a e in use? This is
impo an o he hospi al o know because p ocedu es
a e planned based on he a ailable ma e ial, and
is some hing ha he sys em should accommoda e.
Howe e , o his hesis, i was de e mined ou o scope
o in eg a e his in o he cu en concep .
72
Fac o y
Re u ned Heal hdo s
a e disman eld
The PCB’s a e
checked i hey
could go h ough
ano he use cycle
Failed
Heal hdo s a e
eplaced wi h
new ones
Rep ocessing
Fac o y Rep ocessing
3 d Pa y
Philips
Packaging
The Heal hdo
is packaged
wi h new
pa ches and
packaging
In e al use
Ex e nal use
Heal hdo is s o ed
un il i ’s needed Heal hdo is scanned
when placed o
ac i a e i
Heal hdo is placed
on he pa ien A e 14 days, he
Heal hdo is
emo ed The Heal hdo is
sepe a ed om
i s s icke
The Heal hdo is
so ed o euse
and shipped
The s icke is
disposed o
The Heal hdo is
sepe a ed om
i s s icke
Pa ien goes home
wi h he applied
Heal hdo
A e 14 days, he
Heal hdo is
emo ed
The Heal hdo is
packaged and
shipped back
The s icke is
disposed o
The Heal hdo is
checked o hei
quali y and sa e y
The Heal hdo is
scanned so hei
a i al is documen ed
The heal hdo is cleaned
( oge he wi h o he
senso s in a uni e sal
machine)
The Heal hdo is cha ged,
upda ed and pe sonal
da a is emo ed
The Heal hdo is
eady o euse!
New pa ches
and packaging
is supplied
In e nal anspo
Reuse Phase
Use Phase
P oduc Use
Figu e 10.3: Fac o y ep ocessing concep
73
11.2 Design Challenges
To c ea e an enable o he SenseFlow sys em, i is
impo an o know wha inhibi s o blocks he ci cula i y
o he sys em. To achie e his, I iden i ied challenges
in he sys em by aking on he pe spec i e o di e en
s akeholde s, use s and opics. The esul s om his
b ains o m we e hen o ganised in o clus e s on he
SenseFlow map, which esul ed in mul iple design
challenges, which can be ound in Figu e 11.2. A lis
o challenges and addi ional maps pe pe spec i e
Appendix H. I is impo an o no e ha his o e iew
is no exhaus i e, and o he designe s may iden i y
di e en challenges om he same pe spec i es.
While many o hese challenges a e impo an o he
success o his sys em, I can only ocus on h ee due o
he scope o his hesis. To de e mine hese challenges, I
i s il e ed hem on hei ele ance o he scope and hen
selec ed he mos c i ical ones. C i icali y, in his con ex ,
e e s o he challenges' impo ance o he success o
he sys em and he ex en o he knowledge gap hey
p esen . Fo ins ance, challenge 6 How do you know
whe e you de ices a e' add esses he need o de ice
con ol and p e en ion o de ice loss. Howe e , since
simila sys ems a e al eady in use wi hin hospi als, his
may no ep esen a signi ican knowledge gap. The
esul s o his p ocess can be ound in Appendix H.
The chosen challenges a e ansla ed in o he ollowing
design challenges:
11.2.1 Design Challenge 1
Design a solu ion whe e mul iple MWS om di e en
b ands can be cleaned and p epa ed e icien ly.
This design challenge is based on challenges 16 and
17 and ocuses on he p epa a ion o he Heal hdo .
P epa a ion in ol es asks such as cha ging, modi ying
da a, and making i eady o ano he use.
Sub challenges
• How do you clean he de ice?
• How do you cha ge he de ice?
• How do you communica e wi h he de ice?
11.2.2 Design Challenge 2
Design a solu ion whe e mul iple MWS om di e en
b ands can be quickly checked o hei quali y and
unc ioning
This design challenge is based on challenge 14 and
ocuses on con olling he quali y and sa e y o he
Heal hdo . The Heal hdo should be inspec ed o ensu e
ha i is s ill sa e and unc ional o euse.
Sub challenges
• How do you make su e i is no damaged?
• How do you make su e i s ill has uses le ?
• How do you make su e i is s ill unc ioning p ope ly?
2. How do you minimize
down ime in s o age?
3. How does he
pa ien know he de ice
is sa e?
7. How does he de ice
communica e ha i is
unc ioning no mally?
1. How do you gua an ee
supply o de ices and
supplemen s
5. Wha does he
pa ien need when
hey ake he de ice
home?
4. How do you
know how o apply
he senso ? 6. How do you know
whe e you de ices
a e?
8. How do you educe
he impac o he used
disposables?
8. How do you educe
he impac o he used
disposables? 9. How do you make
su e he pa ien
e u ns he used
de ice?
12. How can you
op imize he
ep ocessing?
16. How o op imise
he cleaning p ocess
o mul iple de ices?
10. How do you
ship he used
de ice back?
14. How do you know
i he used de ice is
s ill sa e o use?
11. How do you so
he used de ice in he
hospi al?
23. How can you
ins il us in
emanu ac u ed
componen s?
17. How do you euse he
cleaned de ice?
18 How do you
p epa e he
cleaned de ice?
13. How do you
know wha o do
wi h he de ice?
15. How o collec
he ejec ed de ices?
19. How do you
make su e you
ge ejec ed
de ices back?
22. How can you
p oduce you de ice
wi h he leas e amoun
o impac ?
20. How do you
disassemble/
emanu ac u e
ejec ed de ices?
21. Wha do you
wi h componen s
ha can' be
emanu ac u ed?
80

2. How do you minimize
down ime in s o age?
3. How does he
pa ien know he de ice
is sa e?
7. How does he de ice
communica e ha i is
unc ioning no mally?
1. How do you gua an ee
supply o de ices and
supplemen s
5. Wha does he
pa ien need when
hey ake he de ice
home?
4. How do you
know how o apply
he senso ? 6. How do you know
whe e you de ices
a e?
8. How do you educe
he impac o he used
disposables?
8. How do you educe
he impac o he used
disposables? 9. How do you make
su e he pa ien
e u ns he used
de ice?
12. How can you
op imize he
ep ocessing?
16. How o op imise
he cleaning p ocess
o mul iple de ices?
10. How do you
ship he used
de ice back?
14. How do you know
i he used de ice is
s ill sa e o use?
11. How do you so
he used de ice in he
hospi al?
23. How can you
ins il us in
emanu ac u ed
componen s?
17. How do you euse he
cleaned de ice?
18 How do you
p epa e he
cleaned de ice?
13. How do you
know wha o do
wi h he de ice?
15. How o collec
he ejec ed de ices?
19. How do you
make su e you
ge ejec ed
de ices back?
22. How can you
p oduce you de ice
wi h he leas e amoun
o impac ?
20. How do you
disassemble/
emanu ac u e
ejec ed de ices?
21. Wha do you
wi h componen s
ha can' be
emanu ac u ed?
Figu e 11.2: O e iew o design challenges
81
11.3 Concep Designs
Nex , a b ains o m session was done on he sub-
challenges, he esul s o which can be ound in Appendix
I. This esul ed in he ollowing ou concep s: The Au o
P o, he Sma Scan + Wall Cha ge, he SenseCab
and S anda dised Ba e ies. The ou concep s can be
seen in Figu e 11.3 and a e desc ibed in he ollowing
pa ag aphs, wi h a mo e de ailed desc ip ion and
image a ailable in Appendix J.
Au oP o is an au oma ic ep ocessing machine. Senso s
a e placed on op, a e which he machine disin ec s
and cha ges he senso . Senso s ha a e eady o use
can be ound in a collec ion box, while ejec ed senso s
a e ejec ed in a sepa a e con aine .
Sma Scan + Wall Cha ge is a combina ion o wo
p oduc s. A basic wi eless cha ging wall o e s a s a ing
poin , by cha ging he de ices, while a nu se cleans and
upda es he de ices. A second de ice, he Sma Scan,
can be pu chased la e and akes ca e o upda ing he
de ice and doing a isual inspec ion. AI will be able o
de e mine whe he o no a senso is s ill sa e, leading o
many mo e uses han he p esc ibed 10.
SenseCab is an all-in-one solu ion. The senso is placed
inside, whe e i is au oma ically disin ec ed, upda ed
and cha ged. A sc een shows he in o ma ion on he
s a us o he senso s, and he UV ligh s a e u ned o
when he cabine is opened.
S anda dised Ba e ies use sha ed ba e ies be ween
MWS. This allows MWS o quickly e u n o use. A e
a quick disin ec ion, eplace he emp y ba e y wi h a
ully cha ged ba e y. The emp y ba e y is cleaned and
placed in a cha ging wall. The nu se has o manually
scan he MWS o manage i s da a.
11.4 Concep Compa ison
To choose be ween hese ou concep s, I ha e
compa ed hem o he c i e ia ou lined in Chap e
8 using he da um me hod (Boeijen e al., 2013, p.
147). In his me hod, one o he concep s is used as a
e e ence (da um) agains which he o he concep s a e
compa ed. This was done wice, using S anda dised
Ba e ies and SenseCab as he da um, bo h weigh ed
and unweigh ed. One da um is shown in Table 11.1, as
all ou da ums ga e he same ou come. These can be
ound in Appendix K.
Based on he esul s o he da ums and suppo ing
a gumen s, I ha e selec ed SenseCab as he inal
concep . I ou pe o ms he o he concep s by a small
ma gin, and in addi ion o ha , I belie e i is a concep
ha is bo h ealis ic and imaginable, while also inspi ing
a u u e pe spec i e.
11.5 Final I e a ion
Finally, a las i e a ion was done o he design on he
SenseCab. I ha e analysed he concep o iden i y he
majo challenges, he p ocess and esul s o which can
be ound in Appendix L. This esul ed in he inal design,
shown in Figu e 11.4 and p esen ed in Chap e 9. These
challenges can be summa ised as ollows:
1. Cha ging: How will he de ice cha ge and s ay
a ached o he cabine ?
2. In e ac ion: How do you know he s a us o he
de ice?
3. In e ace: Wha in o ma ion does he in e ace sha e
wi h he use ?
4. Design: Wha will he aes he ics o he cabine look
like?
82
Figu e 11.3: Fou concep s o he design challenges
83
De ice C i e ia
S anda dised
Ba e ies
SenseCab
Sma Scan +
Wall Cha ge
Au oP o
1 The solu ion should c ea e as li le CO2 impac as possible 3 2 1 1
2The solu ion should c ea e as li le e-was e as possible 3 2 2 2
3The solu ion should wo k as an example o o he MWS 3 5 4 4
4The de ice should be as easily eusable as possible 3 4 4 5
5Machines ha he hospi al has o pu chase should be as cheap as possible 3 2 1 1
6The solu ion should be as main ainence ee as possible 3 3 3 1
7 The solu ion should be as simple as possible 3 4 4 5
8 The de ice should minimize cycle imes 3 2 2 1
9 The de ice has o be checked o i s quali y as quickly as possible 3 3 4 4
10 The solu ion should ins il he maximum amoun o us in he hospi al s a 3 4 5 4
11 The solu ion should ake up as li le space as possible 3 3 3 3
12 The solu ion should be as ime e icien as possible 3 4 3 5
13 The solu ion should ha e a minimal chance o ailing 3 4 2 1
14 The solu ion should esis ampe ing om he pa ien 3 4 4 4
15 The solu ion gi es he maximum o m- eedom o he OeM's design eam 3 5 4 3
Table 11.1: One da um me hod o compa e he ou concep s
84
11.6 Take-Aways
I24: The de ice is an enable o he sys em. Iden i y
he challenges ha he sys em has and de e mine
which ones you de ice should sol e.
I25: The design p ocess o he de ice doesn’ di e
much om a egula design p ocess. I is based
on he equi emen s ha esul om he sys em
designed p e iously.
I26: The design o he sys em de e mines ci cula i y a
a high le el: How will you p oduc s ay in he loop
and ge used as much as possible? The design o
he p oduc de e mines he ci cula i y a a lowe
le el: How much impac is c ea ed when using he
p oduc , and how easily can i be ep ocessed o
emanu ac u ed?
Figu e 11.4: SenseCab's inal concep design
85

ecommenda ions
Pa i e
12 • Conclusion and Recommenda ions
13 • Limi a ions and Fu he Resea ch
14 • Pe sonal Re lec ion
This chap e concludes he hesis. Fi s ,
he design goal and me hodology a e
desc ibed, a e which he esea ch
ques ions om Chap e 2 a e answe ed.
Recommenda ions a e gi en o designe s
wo king wi h Medical Wea able Senso s
(MWS), and inally, he implica ions o
his hesis a e desc ibed.
12.1 Design Goal
The Heal hca e sec o has a la ge en i onmen al
oo p in ; 7% o Du ch na ional CO2 emissions a e
c ea ed by heal hca e (Gup a S a egis s, 2019),
wi h an a e age o 2,4kg o was e pe pa ien pe
day (Singh e al., 2022). Wi h he in oduc ion o he
Heal hdo , a medical wea able senso , Philips aims o
imp o e heal hca e by allowing ansi ional ca e, which
ees up bed space and can educe hospi al emissions.
Medical wea able senso s (MWS) a e a g oup o
medical de ices ha wi elessly sense bio measu emen s,
such as hea a e o ECG signals. While hese de ices
can imp o e heal hca e by allowing ansi ional ca e,
many a e single-use de ices ha a e disposed o a e
use, adding o he al eady la ge amoun o hospi al
was e. They a e especially ha m ul because hey
con ain elec onics, which a e oxic o bo h humans and
he en i onmen (Lin e al., 2022; Ogunsei an, 2022;
Wi u & Tucho, 2022).
The ci cula economy is one way o educe he CO2
emissions and e-was e gene a ed by hese p oduc s.
Howe e , no p e ious esea ch was ound ha
speci ically add esses he ci cula design o MWS. To
add ess his knowledge gap, his hesis aims o p esen
insigh s o designe s o be used in he design p ocess o
imp o e he ci cula i y o MWS. This p ocess is guided
by he esea ch ques ion “Wha should designe s
keep in mind when designing ci cula MWS?”, and is
suppo ed by he ollowing:
1. RQ1: Wha is he ci cula economy?
2. RQ2: Wha is he cu en s a us o he Heal hdo ?
3. RQ3: Wha could a ci cula MWS look like
12.2 Me hodology
To answe hese ques ions, a case s udy was execu ed,
ocussing on he edesign o a MWS. In his case
s udy, he design challenge is o mula ed as ollows: “ o
imp o e he ci cula i y o he Philips Heal hdo ”.
Ini ially, an explo a ion o exis ing li e a u e was
pe o med o gain an unde s anding o he ci cula
economy and o ind exis ing solu ions o design
s a egies and business models. Subsequen ly, an
analysis o he Heal hdo and i s con ex was conduc ed
o iden i y ba ie s and oppo uni ies, which esul ed in
design equi emen s o a ci cula edesign. Fu he mo e,
a Li e-Cycle Analysis (LCA) analysed he Heal hdo ’s
eco-impac .
These esul s we e used as a basis o he de elopmen
o SecondSense, a p oposed ci cula MWS sys em
consis ing o wo pa s: SenseFlow and SenseCab.
Th ough a compa a i e LCA, SecondSense’s
en i onmen al impac s we e compa ed wi h he
Heal hdo , showing majo educ ions in CO2 emissions.
Conclusi ely, he insigh s gene a ed du ing he design
p ocess we e used o c ea e ecommenda ions o
designe s.
12 • Conclusion and
Recommenda ions
88
12.3 Findings
This sec ion answe s he h ee esea ch ques ions
desc ibed in Chap e 2.
RQ1: Wha is he ci cula economy
The ci cula economy e e s o a sys em ha is es o a i e
by in en ion (Ellen MacA hu Founda ion, 2013a), and
unlike he linea ‘ ake-make-was e’ model, ensu es
ha esou ces a e kep in use as long as possible. A
common amewo k o isualise he p inciples o he
ci cula economy is he Adap ed Value Hill (Figu e
12.1). I illus a es he ule o humb ha he sho e you
keep he ci cula loop, he mo e alue you main ain
and he mo e ci cula you become. The amewo k
combines he Value Hill (Ach e be g e al., 2016),
wi h he 9R model (Po ing e al., 2017). Howe e , i is
impo an o no e ha his is a simpli ied e sion o he
ci cula economy. These amewo ks a e explained in
mo e de ail in Chap e 3.
The e a e many de ini ions o he ci cula economy;
in one ins ance, 114 di e en de ini ions we e ound in
di e en pape s (Ki chhe e al., 2017). Fo his hesis, an
adap ion o Geisendo & Pie ulla’s (2018) de ini ion is
used: “ he alue o p oduc s and ma e ials is main ained, Figu e 12.1: Adap ed Value Hill (Me abolic Ins i u e, 2021)
89
Figu e 12.4: F on iew o he SenseCab du ing a disin ec ion cycle
96

12.4 Recommenda ions o
Designing Ci cula MWS
Based on he ou comes o he case s udy,
ecommenda ions a e o mula ed ha add ess he
knowledge gap ha exis s when i comes o designing
ci cula MWS, desc ibed abo e. They o e a s a ing
poin o designe s and enginee s o c ea e ci cula
solu ions o MWS.
12.4.1 Ci cula design s. classic design
FFi s , a b ie compa ison is gi en o highligh he
di e ences be ween a ‘ci cula design p ocess’ and a
‘classic design p ocess’.
While ci cula sys ems can be complex, hei ci cula
design p ocess is in essence simila o a ‘classic’ p oduc
design p ocess. Ini ially, a con ex is de e mined,
subsequen ly, p oduc equi emen s a e se up and
inally, a concep is de eloped. Howe e , in a ci cula
design p ocess, he e is a conside a ion no only o he
p oduc ’s use phase bu also o how he p oduc – in
whole o in pa – can be e ained wi hin he ci cula
loop. A ci cula design p ocess demands ex ended
e o , as i in ol es designing a sys em ha e ains he
de ice, in addi ion o designing he de ice i sel . I adds
complexi y o he p ocess.
Ci cula sys ems a e complex because hey desc ibe
mo e han a linea sys em, as is illus a ed by he
di e ence be ween Figu e 12.2 and 12.4. Howe e ,
designing o he ci cula economy doesn’ ha e o be
complex, as a s uc u ed app oach is main ained.
The ollowing sec ions desc ibe wo se s o
ecommenda ions o designing ci cula MWS, wi h
applicabili y ex ending o he design o o he ci cula
p oduc s.
12.4.2 Unde s and he p inciples o he
ci cula economy and how o design o i
To e ec i ely design o he ci cula economy,
comp ehending i s co e p inciples is a mus . Thus, he
i s se o ecommenda ions cen es on c ea ing an
unde s anding o he ci cula economy.
R1: Gain a solid unde s anding o he basic
p inciples o he ci cula economy
Mul iple amewo ks exis ha desc ibe he p inciples
o he ci cula economy. A good s a ing poin is he
Adap ed Value Hill, desc ibed abo e in Sec ion 12.3.1,
as i is in ui i e ye comp ehensi e. Howe e , i is also
simpli ied and should be conside ed a ule o humb.
Chap e 3 o his hesis desc ibes he p inciples o he
ci cula economy in mo e de ail.
R2: Resea ch ci cula design s a egies and
business models o he design challenge
The e is an ex ensi e amoun o esea ch, which
desc ibes e ec i e combina ions o design s a egies
and business wi hin he ci cula economy. The second
ecommenda ion is he e o e o esea ch and choose
ci cula design s a egies, ele an o you design
challenge. In Chap e 4 ci cula design s a egies and
business models a e desc ibed in mo e de ail, and
in Sec ion 10.2, a po en ial app oach o choosing
be ween s a egies and business models is desc ibed.
R3: De e mine wha de ines ci cula economy
As discussed in Sec ion 3.1, he e a e a ied
in e p e a ions o how he ci cula economy is de ined,
which is why i is ecommended o de e mine wha
de ini ion o he ci cula economy is used. Fi s ly, a
de ini ion aids decision-making by aligning pe spec i es
on wha is ci cula ; secondly, i can be used o c ea e
equi emen s and c i e ia, bo h a a sys em and concep
le el.
97
12.4.3 S uc u e you design p ocess
The second se o ecommenda ions cen es on
s uc u ing he ci cula design p ocess. To design a
ci cula MWS, he design in ol es bo h a sys em and
a p oduc . The sys em consis s o a ci cula s a egy,
ou lining how he p oduc will emain in he ci cula
loop, and a business model, desc ibing how an OEM
can gene a e p o i . The p oduc , in his con ex a senso ,
unc ions as an enable , designed o acili a e ac ions
p esc ibed by he sys em o ensu e i s in eg a ion wi hin
he ci cula loop.
R4: Fi s , de e mine how he sys em is going o
be ci cula , hen design he p oduc so ha i
enables his sys em.
The ci cula i y o he p oduc is p ima ily de e mined
by he sys em, which shapes he equi emen s o he
p oduc . Fo his eason, i is ecommended o i s
de e mine how he p oduc will become ci cula , by
de e mining he s a egy o he sys em. This esul s in
design equi emen s and c i e ia, desc ibing wha he
p oduc should acili a e.
As men ioned ea lie , a s uc u ed app oach is
necessa y when designing ci cula MWS. In his
sec ion, a s uc u ed app oach based on he ou come
o his hesis is sugges ed.
R4.1 Take addi ional ca e when de e mining he
bounda ies.
Begin by es ablishing he p ojec ’s con ex and
bounda ies. Desc ibe aspec s such as p oduc use,
use , s akeholde and po en ial ep ocessing en i ies.
Scoping and bounda ies a e impo an in any design
p ojec ; howe e , his s udy e ealed ha e en sligh
adjus men s o hese bounda ies could yield in a
comple ely di e en sys em, as de ailed in Sec ion 5.1.
This subsequen ly a ec s he p oduc as well.
R4.2 De e mine a de ailed sys em ou line
Nex , de e mine he ci cula s a egy and business
model. A ecommended s a ing poin is he li e a u e
men ioned in Chap e 4. These ac o s collec i ely shape
he unc ioning o he sys em, which in u n dic a es he
equi emen s and c i e ia o he p oduc . Fo ins ance,
i he chosen ci cula s a egy ocuses on ep ocessing,
he de ice needs o be able o wi hs and cleaning,
whe eas a emanu ac u ed-o ien ed app oach would
demand easy disassembly.
Because he sys em lays he g oundwo k o
de ining p oduc equi emen s, i is a mus o c a a
comp ehensi e summa y o suppo ing ac i i ies. I
ecommend de eloping a high-le el o e iew o he
sys em a a minimum, simila o Figu e 12.3. This ou line
should desc ibe he necessa y ac ions needed o
main ain he p oduc wi hin he sys em. In his con ex ,
in ol ed s akeholde s should be de e mined and hei
associa ed asks.
R4.3 Analyse he sys em o o mula e equi emen s
Wi h he sys em de ined, analyse i o o mula e
equi emen s and c i e ia. The p oduc ’s cen al ole
wi hin he sys em in ol es enabling he ac ions equi ed
by s akeholde s o sus ain ci cula i y. I modi ying an
exis ing p oduc , mino adjus men s migh su ice o align
i wi h hese equi emen s.
R4.4 In eg a e he classic design p ocess in o he
ci cula sys em
A his poin , p oduc equi emen s ha e been
de e mined which leads o a ci cula p oduc . The
p ocess shi s owa ds a mo e con en ional design
p ocess. I is ecommended o use a me hod amilia
o you o he gene a ion o ideas, concep s and inal
design. Howe e , emain mind ul o he ci cula i y
objec i es de ined ea lie .
98
12.4.4 Final no es
Th oughou he design p ocess, wo ac i i ies s and ou
ha can boos ci cula i y.
R5: Use as - ack LCAs o concep ual insigh s
The i s ac i i y e ol es a ound using Fas -T ack
LCA’s o quickly e alua e concep s, gaining insigh s
on en i onmen al impac wi hin he designs. This helps
de e mine wha pa s o he cu en p oduc a e mos
wo hwhile o sa e, whe e imp o emen s lie as well as
compa e ideas and concep s o hei ci cula i y.
R6: In ol e s akeholde s in he design p ojec
The second ac i i y ocuses on in ol ing s akeholde s
in he p ojec . S akeholde s hold aluable knowledge
o any design p ojec . In a ci cula sys em, hey a e
especially ele an , gi en hei amilia i y wi h he sys em.
Mo eo e , hey become cen al ac o s in he ci cula
sys em; o ins ance, hey migh collec and ep ocess
you p oduc . In ol ing hem in he design p ocess can
inc ease he likelihood o hese s akeholde s adap ing
he solu ion.
12.5 Implica ions
Finally, he implica ion o his hesis on he design o
ci cula MWS, he en i onmen and academia a e
desc ibed, concluding his hesis.
12.5.1 The po en ial o ci cula MWS
Fi s ly, his hesis has demons a ed ha a simple ye
e ec i e solu ion can be used o euse MWS wi h
minimal changes o i s design. A uni e sal solu ion ha
could be used ac oss pla o ms is p oposed, enabling
easy ep ocessing o a a ie y o senso s wi hin a
high-pe o mance en i onmen like hospi als. I o e s
aluable insigh s and ecommenda ions o he design
p ocess, se ing as an inspi a ion o u u e designe s.
Mo eo e , i in oduces companies like Philips o
inno a i e possibili ies, ha ex end beyond hei cu en
ci cula i y e o s, and sugges s ha coope a ion
be ween OEMs is impo an in a ci cula economy.
12.5.2 En i onmen
Secondly, he SecondSense concep illus a es ha a
ci cula sys em in which MWS a e eused can yield
a subs an ial CO2 educ ion. The hesis highligh s
possible imp o emen s ha could u he dec ease
hese emissions. Addi ionally, i unde lines he bene i s
o localised euse, encou aging OEMS o explo e new
solu ions aimed speci ically a eusing de ices wi hin a
hospi al se ing.
12.5.3 Academia
Las ly, he hesis unde lines how academic esea ch
ocused on ci cula design s a egies and business
models con ibu es o and can be u ilised in a p ac ical
applica ion o ci cula design. This is achie ed by
using academic esea ch as a s a ing poin o he
de elopmen o a ci cula sys em. Fu he mo e, his hesis
adds o his esea ch by p o iding ecommenda ions
o designe s, which can be used as a s a ing poin o
u u e ci cula design p ocesses, no jus o he design
o MWS.
In conclusion, he implica ions o his hesis could ex end
beyond he design SecondSense and ha e been
demons a ed o add alue o he design o medical
wea able senso s, he en i onmen and academia.
99
Due o he na u e o his hesis, assump ions
and limi a ions na u ally come in o play.
In his chap e , he limi a ions o his hesis
a e discussed, and ecommenda ions
o u he esea ch a e gi en. Fi s , he
limi a ions o he scope and bounda ies o
his hesis a e examined, ollowed by he
alida ion p ocess wi h s akeholde s and
he LCA esul s. Las ly, cons ain s ela ed
o he ecommenda ions a e add essed.
13.1 Scope and Bounda ies
Gi en he cons ained ime ame o his hesis, i was no
possible o co e all aspec s o he. This led o scoping,
whe e he ollowing elemen s we e conside ed ou o
scope, o he ollowing easons.
13.1.1 Medical Regula ions
Fi s ly, medical egula ions and laws we e no aken
in o accoun . These egula ions dic a e he ules and
s anda ds o which medical de ices should adhe e.
Fo ins ance, a eusable de ice has o be ce i ied o
a ce ain amoun o euse, and may no be eused
beyond his limi .
While he assump ion ha SecondSense aligns wi h
egula ions seems easonable, as eusable MWS we e
ound, i is no e i ied. I is plausible ha majo changes
o he design need o happen, po en ially impac ing
he ci cula i y o he de ice o e en p e en ing he
de ice om becoming ci cula . Fu he esea ch in o he
egula ions ha apply o MWS, and SecondSense in
speci ic, is ecommended.
13.1.2 Re u n Loca ion
Secondly, an ea ly decision ega ding he e u n
me hod o he Heal hdo was necessa y in his hesis.
Based on p io wo k and he DiCE con ex , i was
p esumed ha he Heal hdo is e u ned ia pos al
se ice. As discussed in Sec ion 10.3, a di e en e u n
loca ion will likely yield a di e en sys em. Fu he
esea ch is ecommended o alida e he cu en e u n
me hod as well as o explo e al e na i e op ions, such
as pha macy o gene al p ac i ione -based e u ns. This
a ea is scheduled o esea ch wi hin DiCE and was
hus excluded om his hesis's scope.
13.1.3 Economical Viabili y
Thi dly, he economic iabili y o he concep is no
analysed in his hesis. While a back-o - he-en elope
es ima ion sugges s iabili y, due o he senso being
able o be sold mul iple imes despi e highe cos s, no
conclusions a e d awn. Fu he esea ch is ecommended
o assess he concep ’s economic iabili y.
13 • Limi a ions and
Fu he Resea ch
100
13.2 Valida ion wi h S akeholde s
While he concep is an imp o emen in en i onmen al
impac , i is no alida ed by s akeholde s. Al hough
concep s o SenseFlow we e discussed and alida ed
in con e sa ions wi h s akeholde s, he SenseCab design
is based solely on he esul s o hese con e sa ions. The
SenseCab, he inal i e a ion o SenseFlow, and hei
combina ion a e no alida ed by s akeholde s o use s.
Subsequen esea ch is ecommended o e alua e he
de ice wi h he s akeholde s men ioned in his hesis.
13.3 Li e Cycle Analysis Resul s
Fas - ack LCAs we e used o compa e concep s and
alida e indings. Howe e , as no ed in he epo ,
esul s o as - ack LCAs a e indica i e, as hey ely
on assump ions and da abases ha may migh no
accu a ely e lec he ac ual si ua ion. S ill, hese LCAs
a e p esumed o o e a easonable indica ion, and i
is belie ed ha a de ailed LCA will yield simila esul s.
De ailed LCAs we e beyond he scope o he hesis due
o ime cons ain s. Fu he esea ch is ecommended
o be e unde s and he en i onmen al impac s o he
Heal hdo and he SecondSense sys em.
13.4 Recommenda ions
Finally, limi a ions also apply o he ecommenda ions
p esen ed ea lie . These ecommenda ions a e based
on my pe sonal expe iences. While e o s we e
unde aken o ensu e objec i e ecommenda ions,
inhe en biases a e di icul o elimina e en i ely.
This hesis ma ks my i s en u e in o a ci cula design
p ojec o his scale, meaning i was a lea ning p ojec .
Consequen ly, he ecommenda ions pa ially e lec
my pe sonal pe spec i e and lea ning p ocess. Pee
s uden s p o ided eedback on hese ecommenda ions,
howe e , hey we e no alida ed. Fu he esea ch is
ad ised o he alida ion o hese ecommenda ions,
such as co-c ea ion sessions in ol ing designe s and
enginee s.
101

In his inal chap e , I will e lec on my
pe sonal p ocess: wha did I lea n, wha
would I do again and wha would I do
di e en ly?
Fi s o all, hank you so much o eading my hesis.
These 100 pages and eigh een housand wo ds a e
he esul o hal a yea o ha d wo k, swea and ea s
– no blood, luckily. I hope you ound i inspi ing, and
ha i mo i a es you o design ci cula and sus ainable
solu ions.
A ques ion mos people ask a mas e 's s uden a e
hei g adua ion, is ei he ‘Would you do i again?’
o ‘Would you wan o con inue wi h you p ojec ?’. I
would ha e o answe yes o bo h. I ho oughly enjoyed
lea ning mo e abou he ci cula economy, de eloping
his sys em and especially seeing ha i con ibu es o a
be e wo ld. I eel ha I can look back wi h p ide on
bo h my lea ning p ocess, as well as my esul .
In his hesis, I lea ned ha ci cula design is complex
and equi es a di e en , addi ional p ocess. Howe e ,
as long as you ha e a clea goal, i doesn’ ha e o be
di icul . I ound he p ojec challenging, as I’ e ne e
wo ked wi h sus ainabili y a his scale and I’ e ne e
designed a sys em, le alone o his complexi y.
I I would do he hesis again, I would epea he design
p ocess. I belie e i was he igh p ocess o s a wi h,
by de e mining and designing he sys em and ollowing
ha up wi h equi emen s and he p oduc . While i was
a s uggle a imes o balance design s a egies and
business models, which I expec o become be e wi h
mo e expe ience.
The bigges change ha I would make o his hesis nex
ime, conce ns he s uc u e. I hink he design goal wi h
which I s a ed his p ojec was a li le unde ined o me,
and i I’d do he p ojec again I would u he de ine he
p ojec goal, c ea ing a mo e conc e e design goal. I
always el s uc u e is essen ial o me, howe e , I also
belie e ha because I had his open p ojec , I could
c ea e he esul I ha e now. Maybe i is ime o e hink
his.
Wha I would do di e en ly in my design p ocess, is o
in ol e s akeholde s mo e and do LCAs ea lie in he
design p ocess.
I was di icul o connec o hospi als. Pa ially, because
i was di icul o ge in ouch wi h he igh pe son, bu
also because I hink I was oo busy ying o unde s and
he sys em be o e alking o s akeholde s and expe s.
Howe e , alking wi h expe s would ha e likely helped
me unde s and he sys em as well. Once alking o hem,
I go use ul in o ma ion and insigh s. Fo me, his is a
lesson o be mo e in ouch wi h s akeholde s and b ing
hei expe ise in o play ea lie , ins ead o ying o do i
all by mysel .
In my p ocess, I would use mo e LCAs. I hink i I could
ha e used LCAs a mo e poin s in he p ocess, and
would ha e go en mo e aluable insigh s ou o hem.
Howe e , now ha I ha e expe ience wi h LCAs, I
expec o use hem mo e in my decisions in he u u e.
Wi h his e lec ion, I close my hesis. This ma ks he
momen whe e I go om being a s uden in design o
an ac i e p ac i ione , o make i as ci cula as possible.
Howe e , I wan o ne e s op lea ning.
Again, hank you so much o eading. I you wan o
lea n mo e abou his opic, eel ee o shoo me a
message.
Kind ega ds,
Ma hijs
14 • Pe sonal Re lec ion
102
103
e e ences
MAIN CHALLENGES
CORE
INTERESTING
OUT OF BOUNDS
Analysis o 
ci cula i y
op ions
C ea ion o 
insigh s
How is he cleaning
p ocess going o
wo k in de ail
Defining
ci cula i y ( o 
his p ojec )
Design o 
cleaning
machine(s)
Cleaning
echnologies
P oduc
Jou ney
Who can/has
o do wha
Gene al cleaning
p ocesses
Cleaning
p ocess jou ney
Concep ing o 
he edesigned
heal hdo
De ailing o 
embodimen o 
p oduc ion
Embodimen o 
he edesigned
heal hdo
De ailed
de elopmen o 
logis ical solu ions
Exis ing solu ions
o logis ical
p oblems
Cu en Equipmen
cleaning p ocesses
Laws ega ding
cleaning
concep c ea ion
o logis ical
solu ions
Exis ing business
models
C ea ing new
business
oppo uni ies
A sus ainable p odcu also included
buying and using only he i emas ha 
you eally need. Howe e , ha 
beha iou is un ela ed o he design o 
he Heal hdo , as i s a medical descision
no a com o /luxu y one
Pu chasing
o de ice
Nudging he
pa ien o e u n
he p oduc
Collec ion
o MWS
Analysing he
cu en 
Heal hdo
A al inzameling
in ziekenhuizen?
MWS used in
he Ne he lands
S akeholde
analysis
Analysis o 
cu en hospi al
sys ems
Cases udy o 
Medical Wea able
Senso s
Analysing
cu en MWS
A • Scope

To s uc u e he p ojec , I will use he Re lec i e
T ans o ma i e Design P ocess (RTDP) wi h elemen s
om he in eg a ed C ea i e P oblem Sol ing model
(iCPS). Bo h me hods eel e y simila o me and ha e
elemen s I like; wha I like abou RTDP is ha i p o ides
s uc u e be ween ac i i ies by asking me o e lec in
be ween ac i i ies o de e mine he nex , and wha I like
abou iCPS is ha i implies p ojec managemen and
equi es a g ea e o e all iew o he p ojec . In he
images below bo h models can be seen (RTDP on he
le , iCPS on he igh ).
B.1 In eg a ed C ea i e P oblem
Sol ing
In eg a ed C ea i e P oblem Sol ing is “a s uc u ed,
i e a i e model ha helps wi h de eloping no els and
use ul solu ions o open p oblems in g oups” (Del
Design Guide, 2020). I consis s o ou ac i i ies:
Con en inding, in o ma ion inding, accep ance
inding and p ojec managemen . Con en inding is
subdi ided in o h ee p ocesses: P oblem inding, idea
inding and solu ion inding. The p ojec managemen
p ocess uns con inuously and manages when he
o he h ee p ocesses a e done. These a e managed
simul aneously and execu ed wi hou a p esc ibed
o de . I is up o me o de e mine which p ocess is done
and when.
Wha I like abou his p ojec is ha he e is a ocus on
p ojec managemen o de e mine which p ocess needs
o be done and when. Wha I dislike is ha i does no
con ain a (dedica ed) alida ion p ocess and ha he
h ee phases eel sepa a ed om each o he . The Del
Design Guide calls his sepa a ion essen ial.
B.2 Re lec i e T ans o ma i e
Design P ocess
This me hod is new o me and comes om he design
acul y in Eindho en ha “gi es s uden s g ip on
he design p ocess ye lea es oom o inno a ion”
(Hummels & F ens, 2009). In his me hod, he designe
has i e ac i i ies o choose om, wi hou a speci ic
o de . These ac i i ies a e idea ing, en isioning,
alida ing, analysing and doing. The ac i i ies a e
spli be ween D i e ( e ical axis), which ocuses on
in o ma ion ga he ing, and S a egies (ho izon al axis),
which ocuses on in o ma ion gene a ion. I would be up
o me o de e mine which me hod is bes a ha momen .
Essen ial o he model is he e lec ion ha akes place
when swi ching be ween ac i i ies.
Wha I like abou his model is ha i is ocused on
in o ma ion and i s low, seeing how bo h axes a e
cen ed on in o ma ion collec ion. I like his pe spec i e
on in o ma ion. I eels e y ocussed on explo ing and
gaining new knowledge, bu because you c ea e
his ision as well i gi es you some handles o keep
i ele an . Wha I dislike is ha i eels like i misses a
managing elemen o a momen whe e you s ep back
and look a he bigge pic u e.
B.3 Compa ison
I ha e analysed bo h me hods o see how hey compa e
o one ano he , and I ha e a emp ed o combine bo h
me hods in o one isual. In compa ing he wo me hods
and while making his isual I lea ned mo e abou bo h
me hods and how hey a e simila and di e en .
RTDP is ocused on he low o in o ma ion, how you
ga he i and how you gene a e i . This in o ma ion is
hen sp ead ac oss he di e en ac i i ies by doing,
en isioning, analysing, alida ing o idea ing. iCPS is
ocused on c ea ing a s uc u e o wo k e icien ly wi h
a eam. I dedica es h ee di e en oles ( acili a o ,
p oblem owne and esou ce g oup), whe eas RTDP
does no ocus on a g oup o an indi idual. iCPS
B • Re lec i e T ans o ma i e
Design P ocess
ocuses on p ojec managemen i s and o emos , and
om ha managing pe spec i e you look a wha he
nex ac i i y is going o be.
I looked a wha ac i i ies/p ocesses and how hey i
in o one ano he . I ound ha accep ance inding (iCPS)
can’ easily be placed in he RTDP model. In o ma ion
is a majo pa o RTDP bu eels like a smalle pa o
iCPS, pe haps because he models sha e a di e en
pe spec i e on wha in o ma ion is.
B.4 Conclusion
I will use he RTDP model wi h he p ojec managemen
and accep ance inding pa s o he iCPS model
because I p e e he eedom and in o ma ion low o
RTDP.
I plan o use he RTDP me hod in combina ion wi h
sp in s o manage my p ojec . Wi h a ision o guide
me and o be able o e lec on (e.g. am I s ill wo king
owa ds my goal), I will use weekly sp in s o se up my
ac i i ies. Combined wi h weekly sp in s o manage
ac i i ies. I know ha ha ing a clea -cu goal makes a
p ojec much easie o me, so hese e lec ions will be
a key ac i i y.
I also wan o y ou co-c ea ion sessions. I hink in his
p ojec , wi h i s wide each and being a big sys em,
ge ing expe s oge he in a co-c ea ion session will
be e y aluable and will gi e many good insigh s.
How I’m going o apply his in my p ojec is ye o be
de e mined.
I1: The e a e many in e p e a ions o wha he ci cula
economy means. Deciding on a de ini ion ha i s
he ision o you and you eam can help you in
making decisions, howe e , keep he discussion
open as you will likely un in o si ua ions whe e
you de ini ion is no closing.
I2: Models such as he 9R model and he adap ed
alue hill o e a good bu simple s a ing poin o
designing o he Ci cula Economy.
I3: Ci cula i y can some imes be coun e in ui i e.
Valida e you ideas wi h ools such as he Li e-
Cycle Analysis (LCA), u he desc ibed in Sec ion
5.2.
I4: A lo o esea ch is done on how o design o
he ci cula economy which o e s a g ea s a ing
poin . T y o ind examples o you p oduc – o
some hing simila – ha al eady ea u e ci cula
economy ac ions.
I5: The ci cula economy equi es you o design he
sys em and con ex o you p oduc , mo e han
you migh be used o om a classic p oduc design
p ocess.
I6: I is impo an o choose he igh scena io and
con ex , as small changes he e can d as ically
in luence he ou come o you design.
I7: LCA’s a e a aluable ool o unde s and whe e
he impac lies in you p oduc , o why you
p oduc isn’ ci cula . I you could only sa e one
componen , which one would i be and why? Fo
example, he PCB has he bigges impac on he
Heal hdo , so i makes sense o make his pa las
as long as possible.
I8: LCA’s can be icky, as mino changes in you
assump ions can d as ically change i s ou comes.
Tes di e en assump ions in you LCA o see how
hese a ec he impac o you p oduc .
I9: Ci cula i y equi es a b oade mindse . I
signi ican ly changes he app oach, scope and
bounda ies o you p ojec , equi ing a mo e
holis ic app oach.
I10: In eg a e you s akeholde s in he design
p ocess. S akeholde s hold aluable knowledge,
hey ha e ideas on wha is and isn’ possible,
bo h in he cu en sys ems and he sys em you
a e designing. Wi hin a s akeholde , di e en
depa men s will gi e you di e en pe spec i es,
possibili ies and in o ma ion.
I11: The s akeholde s a e going o execu e you
sys em, in ol ing hem in you p ocess migh make
i easie o hem o accep he solu ion.
I12: The ci cula ac ions and in en ions o an OEM
hold meaning o he buye . I an OEM emains he
owne o he p oduc , i demons a es hei ac i e
in ol emen in he p oduc 's ci cula i y, while i i
is sold ia a linea model you could ques ion hei
in en .
I13: No ed lags a e iden i ied o he Heal hdo ,
meaning i can be modi ied o wo k in a ci cula
sys em.
I14: You p oduc migh only need mino changes o
become ci cula .
C • Insigh o e iew
I15: Solu ions can be ound bo h in o he MWS and
in o he medical ca ego ies, bu also in comple ely
di e en p oduc ca ego ies, such as wi eless
cha ging om sma wa ches.
I16: The p oposed edesign shows ha i is possible
o educe he CO2 emissions and e-was e
om MWS using a simple solu ion ha allows
euse, wi hou complex machine y o expensi e
equipmen . I p oposes a uni e sal app oach o
ci cula i y, a sys em ha can be sha ed amongs
di e en OEMs o make i easy o euse a a ie y
o MWS.
I17: Fu he educ ions in he de ice’s impac will
yield mo e sho -use (1-5 uses) imp o emen s,
while changes in he sys em’s e iciency will yield
mo e long-use (6+) imp o emen s.
I18: Don’ look a you sys em and de ice in isola ion.
Take o he p oduc s ha exis in you con ex in o
conside a ion, as a combined solu ion migh be
bene icial o all.
I19: Ci cula S a egies and Business Models o m
he backbone o you sys em: hey de e mine he
low and he p oduc equi emen s ha ollow, and
hey a e linked oge he , as choosing one a ec s
you op ions o he o he .
I20: Ins ead o ocussing on only one s a egy, such
as euse, y o inco po a e mo e s a egies such
as epai and manu ac u ing and see i ha o e s
u he imp o emen s.
I21: The classic ‘who, wha , whe e, why, when, how’
ques ions can be use ul o ind challenges in you
sys ems ha you migh ha e missed.
I22: The sys em you design elies hea ily on you
scena io, wi h mino changes ha ing big e ec s.
Fo example, a change in he e u n me hod can
esul in comple ely di e en esul s. This is simila
o I6 om Chap e 5.
I23: LCA’s can gi e aluable insigh s when
compa ing concep s
I24: The de ice is an enable o he sys em. Iden i y
he challenges ha he sys em has and de e mine
which ones you de ice should sol e.
I25: The design p ocess o he de ice doesn’ di e
much om a egula design p ocess. I is based
on he equi emen s ha esul om he sys em
designed p e iously.
I26: The design o he sys em de e mines ci cula i y a
a high le el: How will you p oduc s ay in he loop
and ge used as much as possible? The design o
he p oduc de e mines he ci cula i y a a lowe
le el: How much impac is c ea ed when using he
p oduc , and how easily can i be ep ocessed o
emanu ac u ed?
D • Design S a egies and
Business Models
Adap ed om Bocken e .al. (2016) and Mo eno e .al. (2016)
Business Models
Design S a egies
Access and pe o mance
P o iding he capabili y o
se ices o sa is y use needs
wi hou needing o own
physical p oduc s
Ex ending p oduc alue
Exploi ing he esidual alue o
p oduc s - om manu ac u e
o consume s, and hen back
o manu ac u ing – o
collec ion o
p oduc s be ween dis inc
business en i ies
Encou age Su iciency
Solu ions ha ac i ely seek o
educe end-use consump ion
h ough p inciples such as
du abili y, upg adabili y,
se ice, wa an ies and
epa abili y and a non-con-
sume is app oach o
ma ke ing and sales
Classic long-li e model
Business models ocused on
deli e ing long-p oduc li e,
suppo ed by design o
du abili y and epai o
ins ance
• Ex ending esou ce alue
• Indus ial symbiosis
Slowing Loops Closing Loops
Slowing Loops Closing Loops
Design o p oduc -li e ex ension
• Design o ease o main enance and epai
• Design o upg adabili y and adap abili y
• Design o s anda diza ion and compa ibili y
• Design o dis- and eassembly
• Design o a echnological cycle
• Design o a biological cycle
• Design o dis- and eassembly
Designing long-li e p oduc s
• Design o a achmen and us
• Design o eliabili y and du abili y

Adap ed om Bocken e .al. (2016) and Mo eno e .al. (2016)
Business Models
Design S a egies
Access and pe o mance
P o iding he capabili y o
se ices o sa is y use needs
wi hou needing o own
physical p oduc s
Ex ending p oduc alue
Exploi ing he esidual alue o
p oduc s - om manu ac u e
o consume s, and hen back
o manu ac u ing – o
collec ion o
p oduc s be ween dis inc
business en i ies
Encou age Su iciency
Solu ions ha ac i ely seek o
educe end-use consump ion
h ough p inciples such as
du abili y, upg adabili y,
se ice, wa an ies and
epa abili y and a non-con-
sume is app oach o
ma ke ing and sales
Classic long-li e model
Business models ocused on
deli e ing long-p oduc li e,
suppo ed by design o
du abili y and epai o
ins ance
• Ex ending esou ce alue
• Indus ial symbiosis
Slowing Loops Closing Loops
Slowing Loops Closing Loops
Design o p oduc -li e ex ension
• Design o ease o main enance and epai
• Design o upg adabili y and adap abili y
• Design o s anda diza ion and compa ibili y
• Design o dis- and eassembly
• Design o a echnological cycle
• Design o a biological cycle
• Design o dis- and eassembly
Designing long-li e p oduc s
• Design o a achmen and us
• Design o eliabili y and du abili y
E • P oduc Jou ney
was e
Blis e packaging S icke backing Heal hdo +
gi en ma e ials
F • LCA Shee s
Heal hdo LCA
Manu
i em da abase name
Eco-in ensi y
(impac s pe
kg)
Mass pe i em
(kg)
I ems pe
unc.uni
(#)
Unce ain y
%No es Calcula ed
Impac
Housing
Idema 2023 ABS (Ac yloni ile bu adiene s y ene)
3,10
0,004 1,0 30%
(ABS + PA, unknown mix, A
12,4
Housing P oduc ion
Idema 2023 injec ion moulding, incl p oduc ion si e
1,20
0,004 1,0 30%
4,8
PCB
Idema 2023 PCB = P in ed Ci cui Boa d (including ICs)
475,02
0,003 1,0 30%
1425,0
Ba e y - Zinc PR44
Idema 2023 NiMH ba e y o lap ops (54 Wh pe kg)
61,02
0,002 2,0 30% NiMd used as eplacemen
205,0
Skin Adhesi e
Idema 2023 PET amo phous
1,01
0,001 1,0 30% Nylon used as es ima e
1,0
1648,3
T anspo
Eco-In ensi y
(impac s/
on-km)
Mass pe i em
( on)
Dis ance
pe i em
(km)
Unce ain y
%No es Calcula ed
Impac
Fac o y - Hospi al (Pos ) Idema 2023 T uck+ aile 24 ons ne (min weigh / olume a io 0,32 on/m3) ( km)
0,09
0,000013 120,00 30%
0,1
0,0
o al anspo
0
0,0
Use
Eco-In ensi y
(impac s/MJ
o o he )
Amoun pe
i em
(MJ o o he )
I ems pe
unc.uni
(#)
Unce ain y
%No es Calcula ed
Impac
0,0
End o Li e
Eco-In ensi y
(impac s/kg)
Mass pe i em
(kg)
I ems pe
unc.uni
(#)
Unce ain y
%No es Calcula ed
Impac
Incine a ion (Wo s case)
Idema 2023 ABS (Ac yloni ile bu adiene s y ene) was e incine a ion wi h el
1,39
0,012
1
100%
16,7
Incine a ion Pa ch (wo s case)
Idema 2023 PET (Polye hylene e eph hala e) was e incine a ion wi h elec i
0,158
0,001
1
30%
0,2
0,0
o al end-o -li e
17
0 500 1000 1500 2000
Housing
Housing P oduc ion
PCB
Ba e y - Zinc PR44
Skin Adhesi e
Fac o y - Hospi al (Pos )
Incine a ion (Wo s case)
Incine a ion Pa ch (wo s case)
Impac s by Componen
0 500 1000 1500 2000 2500
Ma e ials & M g.
T anspo
Use
End o Li e
To al
Impac s by Li e Cycle S age
G.2 Concep I e a ion 2
G.2.1 In e nal Reuse
In his concep , he Heal hdo is eused in e nally in he
hospi al. A e i s use cycle, and be o e he pa ien lea es
he hospi al, he Heal hdo is emo ed om he pa ien .
I is hen so ed in e nally in o a new depa men : he
Cen al Disin ec ion Se ice.
The CDS is a cen al place in he hospi al whe e eusable
de ices like he Heal hdo a e collec ed and p epa ed
o euse. When he Heal hdo comes in, i ge s scanned
by pe sonnel. A his momen , he compu e checks how
many imes he de ice has been used. Once i eaches
i s maximum amoun o uses, he de ice ge s blocked
and sen back o he OEM o euse. De ices ha a e s ill
good o go a e cleaned, cha ged and ge packaged
wi h new skin pa ches – acco ding o hospi al p o ocol.
De ices ha a e sen back o he OEM ge aken apa ,
he PCB goes h ough a check o see whe he i could
las ano he li e cycle and he casing ge s ecycled in o
new casings.
Business Model
The business model behind his concep is a pay-pe -
use model. Philips will s ay he owne o he p oduc ,
which means ha he longe hei p oduc las s he mo e
hey ea n on i – an incen i e o design sus ainable.
When he hospi al ac i a es a Heal hdo , hey will be
billed o he use. The hospi al can hen bill his on he
pa ien . Pe Heal hdo , he hospi al pays a deposi . I he
pa ien doesn’ e u n he Heal hdo hey would be in
cha ge o billing he pa ien o his.

P oduc Use
So ing
P epa a ion
Reuse Phase
In e nal euse low
Use Phase
Fac o y
Recycling
P oduc ion
Heal hdo is s o ed
un il i ’s needed Heal hdo is scanned
when placed o
ac i a e i
Heal hdo s ha don’
make he check a e sen
back o Philips
New pa ches
and packaging
is supplied
Re u ned
Heal hdo s a e
disman eld
The PCB’s a e
checked i hey
could go
h ough ano he
use cycle
Failed
Heal hdo s a e
eplaced wi h
new ones
Heal hdo is placed
on he pa ien
The Heal hdo is cha ged,
upda ed and pe sonal
da a is emo ed
The Heal hdo is
checked o hei
quali y and sa e y
The Heal hdo is
scanned so hei
a i al is documen ed
Heal hdo s ha ha e
eached hei maximum uses
a e sen back
A e XX days, he
Heal hdo is
emo ed
The Heal hdo is
sepe a ed om
i s s icke
The s icke is
disposed o
The Heal hdo is so ed
sepe a ely and b ough o
he Cen al Disin ec ion
Se ice
The heal hdo is cleaned
and inspec ed oge he
wi h o he senso s in a
uni e sal machine?
Heal hdo is
p epa ed wi h
packaging and
s icke s pe hospi al
p o ocol
Packaging
CDS
The Heal hdo is
eady o euse!
G.2.2 Ex e nal Reuse
In his concep , he Heal hdo is eused ex e nally. The
pa ien goes home wi h he de ice, and when i 's no
longe needed he pa ien sends i back o one o h ee
loca ions.
The i s op ion is he hospi al. In his scena io, he de ice
will come in and is sen o he CDS. I goes h ough he
same p ocess as he p e ious concep , bu i ge s he e
in a di e en way
The second and hi d op ions a e euse a ei he Philips
o a 3 d pa y. He e he de ice is sen o he ac o y,
whe e he de ice is scanned, cleaned and p epa ed.
A compu e checks how many imes he de ice has
been used and once i eaches i s maximum amoun o
uses, he de ice ge s blocked. I Philips is in cha ge o
euse, he de ice is al eady in a place whe e i could
be ecycled and he PCB could be eused. I i is a 3 d
pa y, ex a anspo mo emen s a e needed o he
ejec ed de ices and he new pa ches and packaging.
Business Model
The business model behind his concep is a pay-pe -
use model. Philips will s ay he owne o he p oduc ,
which means ha he longe hei p oduc las s he mo e
hey ea n on i – an incen i e o design sus ainable.
The hospi al buys Heal hdo s as no mal. They will pay
an ex a deposi , and i he pa ien doesn’ e u n he
Heal hdo hey would be in cha ge o billing he pa ien
o his.
A 3 d pa y would be ewa ded wi h a cleaning ee
e e y ime hey scan one o he de ices.
G.3 Concep E alua ion A and B
A e wo king on i o a bi , I spi he wo concep s in o
Hospi al Rep ocessing and Ex e nal Rep ocessing.
In he mee ing wi h he E asmus MC, he idea o a
Cen al Disin ec ion Se ice was ound unnecessa y, as
he Cen al S e ilisa ion Se ice al eady has disin ec ing
p ocedu es and could ake on his ask as well. Ano he
op ion ha was men ioned was cleaning he Heal hdo s
a he polyclinic we e hey a e used, which is cu en ly
done o Hol e de ices, o example. Bo h we e ine
as long as he cleaning p ocedu e is op imized o he
con ex .
Fac o y
New pa ches
and packaging
is supplied
Re u ned Heal hdo s
a e disman eld
The PCB’s a e
checked i hey
could go
h ough ano he
use cycle
Failed
Heal hdo s a e
eplaced wi h
new ones
Recycling
P oduc ion
P oduc Use
Re u ning
P epa a ion
Reuse Phase
Ex e nal euse low
Use Phase
Hosp ial
3 d Pa y / Philips
3 d Pa y
Philips
Heal hdo is s o ed
un il i ’s needed Heal hdo is scanned
when placed o
ac i a e i
Heal hdo s ha don’ make
he check a e aken apa
Heal hdo is placed
on he pa ien
The Heal hdo is
checked o hei
quali y and sa e y
The Heal hdo is
scanned so hei
a i al is documen ed
The Heal hdo is
sepe a ed om
i s s icke
The s icke is
disposed o
The heal hdo is cleaned and
inspec ed oge he wi h o he
senso s in a uni e sal machine?
The heal hdo is cleaned and
inspec ed acco ding o he
in e nal euse low diag am
Packaging
Pa ien goes home
wi h he applied
Heal hdo
A e 30 days, he
Heal hdo is
emo ed
The Heal hdo is
packaged and
shipped back
CDS
The Heal hdo is so ed
sepe a ely and b ough o he
Cen al Disin ec ion Se ice
The Heal hdo is cha ged,
upda ed and pe sonal
da a is emo ed
The Heal hdo is
eady o euse!
The Heal hdo is
packeged wi h new
pa ches and packaging
H • Challenges Map
Challenge C i icali y Reasoning
1 How do you gua an ee supply o de ices and supplemen s? N 1
2 How do you minimize down ime in s o age? N 1
3 How does he pa ien know he de ice is sa e? M 3
4 How do you know how o apply he senso ? Y 5 2
Cu en p oduc al eady has solu ions
o his, al hough he e is always
oom o imp o emen
5 Wha does he pa ien need when hey ake he de ice home? M 3
6 How do you know whe e you de ices a e (in use)? Y 5 2 T acking sys ems al eady exis in
hospi als
7 How does he de ice communica e ha i is unc ioning no mally? Y/M 4
8 How do you educe he impac o he used disposables? Y 5 4 Pa ches and packaging a e he leas
ci cula componen s o he sys e,
9 How do you make su e he pa ien e u ns he used de ice (quickly)? N 1
10 How do you ship he used de ice back? M 3
11 How do you so he used de ice in he hospi al? M/N 2
12 How o op imise he ep ocessing o he de ice? Y 5 4
Op imising he p ocess will
(assumed) esul in a mo e e icien
sys em
13 How do you know wha o do wi h he de ice? Y/M 4
14 How do you know i he de ice is s ill sa e o use? Y 5 5 T us is essen ial
15 How o sepa a e / collec he ejec ed de ices? M/N 2
16 How o (op imise) he cleaning p ocess o mul iple de ices? Y 5 4 Impo an , howe e he e a e
al eady some good op ions
17 How do you euse he cleaned de ice? Y 5 5 I he sys em becomes o demanding
i will ail
18 How do you p epa e he cleaned de ice? Y/M 4
19 How o make su e you ge ejec ed de ices back? M/N 2
20 How do you disassemble/ emanu ac u e ejec ed de ices? Y 5 3 The e is al eady a lo o knowledge
being done he e
21 Wha do you do wi h componen s ha can’ be emanu ac u ed (e.g. was e)? Y/M 4
22 How can you p oduce you de ice wi h he leas amoun o impac ? Y 5 2 A lo o knowledge al eady exis s
he e
23 How can you ins il us in emanu ac u ed componen s? M/N 2
Scope Check

A • chap e i le
second ow spacing
Pa ien Expe ience
How do you
know whe e o
send i ?
How do you
know wha o do
wi h i ?
How do you
know how o
package i ?
How do I know
i is sa e?
How do I know i 
i is s ill wo king
as i should?
Whe e can I find
in o ma ion as
he pa ien ?
How can I us
a eused PCB?
Especially wi h
he cpap
machines?
Pa ien
Pa ien Expe ience
How do you
know whe e o
send i ?
How do you
know wha o do
wi h i ?
How do you
know how o
package i ?
How do I know
i is sa e?
How do I know i 
i is s ill wo king
as i should?
Whe e can I find
in o ma ion as
he pa ien ?
How can I us
a eused PCB?
Especially wi h
he cpap
machines?
Pa ien
How do you
know how o
clean i ?
Doc o /Nu se expe ience
Nu se/Doc o
Doc o Nu se Pa ien
How do you
know i s ill sa e?
How do you
know i is no 
sa e anymo e?
How do you
know how i is
cha ged?
How do you
know i he da a
is emo ed?
How do you
know i is eady?
How do you
know wha you
need?
How do you
know whe e o
place i ?
How do you
know wha you
need?
How do you
know i is
ac i a ed?
How do you
know whe e o
so i ?
How do you
know whe e o
so i ?
How do you
know wha o do
wi h i ?
How do you
diffe en ia e
be ween senso s?
How do you know
i is wo king
p ope ly?
How do you
know i is placed
co ec ly?
How do you
know wha o do
wi h i ?
How do you know
how/whe e o
scan i ?
How do you
know eached
he max uses?
How do you
make su e you
ge hem back?
Whe e is
e e y hing?
Do I ha e i all?
How o deal wi h
mino diffe ences
be ween senso s?
Do I scan fi s
o place fi s ?
How do I know i 
is s ill ope a ing
as i should?
How do I know
wha o gi e o
he pa ien ?
Hospi al Expe ience
How o minimize
s o age ime?
How can you be
su e hey a e
clean?
How su e do
you ha e o be?
How do you
op imize he
ep ocessing s eps?
How do you
minimize he
cha ging ime? Whe e do you
so he b oken
p oduc s?
How long do you
ha e o s o e he
b oken p oduc s?
How do you connec
he Heal hdo o
you sys em?
How do you connec
he Heal hdo o
you sys em?
How do you
minimize his
down ime?
Wha do you gi e
he pa ien o ge 
he Heal hdo back?
Wha do you gi e
he pa ien 
home?
How will you p epa e
he Heal hdo s? To
wha le el?
How do you
gua an ee enough
Heal hdo s?
How do I
gua an ee p ope 
da a usage?
How do I know
whe e i goes?
Wha do I do
wi h he box?
How do I manage
he incoming
p oduc s?
How do I collec 
diffe en ypes o
senso s?
How do I make
su e I ha e enough
componen s?
How do I know
who has which
senso ? How can I mix
and ma ch
senso s?
Do I wan o
know abou 
eused PCBs?
How do I know
which pa ien is
billed wha ?
How do I know
whe e hey a e? Do I need a new
sys em o
connec i ?
How do you make
su e you ge i 
back (quickly)?
Wha i I wan o
so i o he
polyclinics
Wha i mul iple
polys use he
same de ice?
Wha i we make
a mis ake he e?
How much ime
does his
p ocess ake?
O e iew
How do you
minimize down ime
in s o age
How do you
gua an ee supply o 
de ices and
supplemen s
How does he
pa ine know he
de ice is sa e?
How do you know
how o apply he
senso ?
How do you know
how o apply he
senso ?
Wha does he pa ien 
need when hey ake
he de ice home?
How does he de ice
communica e ha i 
is unc ioning
no mally?
How do you educe he
impac o he used
disposables?
How do you educe
he impac o he
used disposables?
How do you make su e he
pa ien e u ns he used
de ice?
How do you ship he used
de ice back?
How do you so 
he used de ice in
he hospi al?
How can you
op imize he
ep ocessing?
How do you
know wha 
o do wi h
he de ice?
How do you know i 
he used de ice is
s ill sa e o use?
How o op imise
he cleaning
p ocess o 
mul iple
de ices?
How do you euse
he cleaned de ice?
How do you p epa e
he cleaned de ice?
How do you
make su e
you ge 
ejec ed
de ices back?
How do you
disassemble/
emanu ac u e
ejec ed de ices?
Wha do you
wi h
componen s ha 
can' be
emanu ac u ed?
How o collec he
ejec ed de ices?
How can
you p oduce
you de ice
wi h he
leas e
amoun o 
impac
How can you
ins il us in
emanu ac u ed
componen s?
How do you
gua an ee supply o 
de ices and
supplemen s
How do you p epa e
he used de ice?
When do you bill
he hospi al?
How do you know
whe e you de ices
a e?

I • Design B ains o m