Creating healthier futures for ill children

Stakeholder engagement, what does this mean to Triumf?

In order to help chronically ill children, we need to focus on many aspects. First and most importantly - their mental health - how they are coping, what are their strengths and difficulties. How we can support their strengths and help with their difficulties. But if they already have the disease then we need to monitor how their treatment is followed, we need to give information on their condition, their health and wellbeing, we need to support their general health behaviors so they could live healthier lives and at the same time empower and give a sense of success. These components that are necessary to induce behavioral change work only when these are delivered in a way that kids love. And don’t they enjoy playing games? In our mobile health game kids need to save the Triumfland city from the Disease Monster but how did we come up with that? How did we know about the needs of the users?

Involving stakeholders in the solution creation process

Even though we have three psychologists in the team who either have clinical or research background, we consider ill children to be the real experts. They are our expert partners not only from the perspective of the solution design but also from the perspective of their challenges. If you involve many stakeholders then you are able to pinpoint the universal issues that they are experiencing. And in our case, since we involved patients in various countries with different cultural backgrounds, then we saw the issues that were independent of the location. Same problems were described over and over again, problems that you might not be able to read from scientific articles. And then we knew how to proceed. Once we identified the unmet needs, we were able to utilize our own expert background in finding a way to support them. And once that was done, then we needed to define how we will do that. Again, together with patients, we started defining the best way to deliver this support to kids. So we did not start from the situation where we wanted to make a game to ill children. We started from defining the problems and brainstorming together. This collaborative process lead to designing the solution together. It all started in 2016 and today, we are still collaborating with patient organizations in order to constantly improve our solution because we are doing it for ill children. And they are the real experts who need additional support during their treatment process.

What happens when your solution solves the problems of different stakeholders?

It doesn’t have to be that your end users are the ones who are paying for the solution. And in our case, hospitals are our customers, they are paying for an annual license fee in order to prescribe the game for patients but at the same time we have created additional value for hospitals. They can use our visual dashboard for patient monitoring and the reason for our two-part solution came from the needs of care teams who needed more comprehensive data on their patients. Our visual dashboard helps with treatment monitoring, improves medical visit effectiveness and care team communication. So the key takeway here is that even if you are thinking that you are solving a problem for some group of people, you might realize that by doing what you do, you are also solving a problem for some other group of people. In our case, by collaborating so closely with patients, their families and care teams, we were able to create something for patients that really helps them. But at the same time, we were able to give additional value for hospitals. So currently, we are in the process of having our game listed as the first ever prescribable digital medicine in Estonia that is covered by the government.

Involving stakeholders is a difficult process

It is not easy to involve stakeholders. It takes a lot of time, a lot of resources and a lot of motivation. In our experience, however, this is also the most rewarding part of our social innovation. You are not creating additional value for youself, you are trying to help some group of people. Without taking their input into account, you might end up with potentially an absolutely awesome thing that unfortunately nobody gets additional value out of. It could be that there even wasn’t a problem in the first place but you are trying to solve something with a solution that could potentially be very expensive to create. Talk to your stakeholders and collaborate extensively. Not only with the users but with others in your field. For example we are part of several consortia that aim to either digitalize patient journey or co-create something with many partners. But I still want to point out that if you collaborate extensively with stakeholders then it takes time. Patience and persistance are something that you need. And you don’t always get positive feedback, people are different, their ideas, values and problems are different. So be prepared for all kinds of feedback. And take it seriously. Do you think you know better? If you think that way then you are doing it wrong. If you actively involve the right stakeholders in the process of creating your social innovation then this allows you to create something that is universally applicable. Then you are on the right track.


Dr. Kadri Haljas


Dr. Kadri Haljas

Being an expert in the mental burden of chronic disease, Kadri is the idea generator and Triumf team leader. She has a background in clinical psychology and research.