Simple, accessible, effective: How to achieve inclusive design of digital health solutions for older adults

Although there are numerous digital health solutions for older people, many of them do not adequately address the actual needs of this target group. To better understand the reasons for this, the Institute for Patient-centred Digital Health at BFH School of Engineering and Computer Science has brought together findings from the literature, expert knowledge and the perspectives of older adults. The resulting guidelines for inclusive design were then validated in collaboration with experts. This article provides a concise overview of the guidelines, which go far beyond questions of usability and also take into account social and systemic factors influencing the use of digital health services by people aged 65 and over.

Why is inclusive design of digital health solutions important for older adults?

Due to demographic change, the number of older adults worldwide is continuously increasing (WHO, 2025). At the same time, the number of digital health interventions (DHIs) targeting older adults and providing additional health services is growing. These solutions include mobile apps for health monitoring, wearables, smartwatches and digital platforms that enable telemedicine applications such as online consultations with medical professionals. Although many of these solutions are marketed specifically for older adults, they do not always take into account their actual needs, abilities and contexts of use. This limits the usability and acceptance of DHIs. This is where the concept of inclusive design comes in, with the aim of making the design of products or services accessible to as broad a user group as possible, regardless of their abilities, limitations or social backgrounds. For this reason, the project “Inclusive Design of Digital Health Interventions for the Aging Population”, funded by the BFH thematic field Humane Digital Transformation, aimed to provide structured assistance for designers and developers. In future, this should support the development of user-centred and inclusive DHI for older adults aged 65 and over. Guidelines were developed to support the design and development process or the review of existing DHI and to take into account the specific requirements of this heterogenous user group in order to make DHI more inclusive.

Development process of the guidelines

The guidelines were developed in several methodical steps. First, a literature review was conducted to analyse existing DHIs and their design features (Denecke et al., 2025). This was followed by expert interviews (Kaufmann et al., 2025) and a focus group with people aged 65 and over to gather professional perspectives as well as user experiences and preferences. Based on these findings, an initial version of the guidelines was developed, which was then iteratively validated and further refined with experts in a workshop and an eDelphi study to ensure its relevance, clarity and practical applicability.

Figure 1: Overview of the methodological approach used to develop the guidelines

Rethinking inclusive design: People, healthcare systems and technology

During the project, it became clear that inclusive design for older adultsis not just about the design of the user interface, but also encompasses social and health-related system factors. These factors have a significant influence on the acceptance, use and sustainable integration of DHIs in the everyday lives of older adults. For this reason, the fourteen guidelines were divided into two central areas:

1. Guidelines addressing social and health system-related factors: This area focuses on embedding DHIs in existing care structures. Among other things, it addresses integration into clinical processes, the role of healthcare professionals as trusted authorities, transparent information about the benefits and limitations of the solutions, and support and training opportunities for older people. The aim is to create framework conditions that promote trust, provide guidance and to enable actual use in everyday care.
2. Guidelines that focus on the specific design and development of the digital health intervention itself: This area focuses on the user-centred design, development and evaluation of DHIs. It covers aspects such as participatory development processes, accessible and understandable design of content and interactions, personalisation options, motivation and social integration, as well as security and data protection requirements. The central question is how DHIs can be designed to take cognitive, sensory and linguistic diversity into account and to empower older people in their autonomy.

This structure enables a holistic view of inclusive design, taking into account both the context of use and technical implementation.

Figure 2: Overview of the guidelines for inclusive design of DHI for older adults developed in the project

From research to practice: the next steps

In the next step, we plan to provide a freely accessible website where the guidelines developed for designers and developers will be available. The aim is to ensure that the guidelines do not remain confined to the study, but can be actively used in practice. This should provide concrete support to professionals in developing user-centred and inclusive DHI for older people or in reviewing and specifically improving existing DHI.

In a follow-up project, we plan to develop an interactive tool that helps designers and developers to reflect on and evaluate their design concepts and ideas for DHI in terms of inclusivity for the target group. Based on our guidelines, they will receive specific tips and recommendations on how their solutions can be improved and which aspects should be given special consideration in the design and development process. In addition, a collection of best practice examples will illustrate how inclusive design for older adults can be successfully implemented in practice. This tool can help to systematically integrate inclusive design into the development process and sustainably improve the quality of digital health interventions for older adults.

References

World Health Organization. Ageing: Global population. World Health Organization, 21 February 2025;https://www.who.int/news-room/questions-and-answers/item/population-ageing(last accessed: 20 February 2026).

Denecke, K., Cvijic L., Petersen C. Toward Inclusive Design Heuristics for Digital Health Interventions for the Aging Population: Scoping Review. Journal of Medical Internet Research 2025, 27, doi:10.2196/79449.

Kaufmann, B., Cvijic, L., Denecke, K. Ensuring Inclusive Design in Digital Health Interventions for the Aging Population: Expert Perspectives. Blucher Design Proceedings 2025, 13(1), doi:10.5151/cidi2025-1085923.