The goal of the WiECG project is to create a prototype device that makes it possible to perform a 12-lead ECG measurement on patients without wires from the patient to a monitor. The solution consists of a transmitter and receiver, one of which is close or on the patients body and the other is connected to a monitor. This thesis describes the design and implementation of a subsystem of the prototype device that performs digitization, digital processing and reconstruction of the measured 12-lead ECG signal. This concerns converting nine 0 to 3.3V analog signals to the digital domain by using Analog-to-Digital converters, real-time filtering of nine signals with multiple digital IIR filters and reconstructing nine digital signals to the analog domain using Digital-to-Analog converters. Furthermore, component selection, design decisions and the implementation process will be detailed in this document. The subsystem proposed in this paper is able to successfully sample, efficiently filter and reconstruct nine signals in real time. Recommendations on improving the implementation to better adhere to the lower power requirements for a longer battery life are provided as future research prospects.

Background & Objective: The unprecedented value and long­term uncertainties of gene therapies have challenged established health technology assessment (HTA) methods. Real-world data (RWD) and real-world evidence (RWE) may mitigate the encountered uncertainties. However, empirical evidence appears to be lacking in the literature. This research aimed to provide this evidence and identify implications for EU-wide gene therapy joint clinical assessments. Methods: An initial literature review laid the theoretical foundation for the research. A retrospective comparative analysis delivered empirical evidence on RWD/RWE usage in gene therapy HTAs. Preliminary findings were probed in three use cases and verified in semi­structured interviews. Results: Nineteen HTA reports published by the HTA bodies G­BA (Germany) and NICE (England) were identified for the ten in­scope gene therapies. Whereas NICE had an average inclusion of 14 sources per HTA report (with an acceptance rate of 56%), G­BA had 8 (with 32% acceptance rate). While RWD/RWE supporting evidence on an external comparator had the lowest acceptance rate, RWD/RWE on intervention effectiveness had the highest acceptance rate. Insufficient information to substantiate the choice of RWD/RWE and inappropriate RWE study design was the most common exclusion rationales for RWD/RWE. Conclusions: The presented empirical evidence adds to the current knowledge base in two ways; it provides empirical evidence on HTAs of gene therapies (1) and RWD/RWE usage in gene therapy HTAs (2). This work provides insights into how RWD/RWE usage differs between HTA bodies and explicates relevant considerations for gene therapy manufacturers when using RWD/RWE in future HTA submissions. It also proposes that alignment on evidentiary requirements and assessment elements will optimise the transferability of future joint clinical assessment outcomes to national HTA bodies. Knowledge transfer and knowledge sharing initiatives will play a pivotal role in achieving such a consensus.

Workflow orchestration in healthcare is a desirable field with massive opportunities. Healthcare providers are under pressure to deliver greater value and even faster than ever before. They have to deliver better care at lower cost while serving more patients. A number of integrated solutions are present in the field. However, the need for the medical staff to get the right information at the right time and the right place is prominent. In Cardiology, cardiovascular disease now heads the World Health Organisation list of biggest killers in the world and is rapidly increasing in prevalence. On the face of it, cardiovascular disease should be ideal for developing innovative models of care that will improve the well being of the population and the sustainability of their healthcare systems. Not connected and with multiple data entry points – the potential for human error is greater. One important step is the development of integrated solutions that streamline workflow and make procedures easier. We tackle these problems by addressing the unmet needs from research, and translate them into requirements. The requirements are the principles that lead to a strategic design solution – PULSE – Prompt User Liaison Service Experience system. The PULSE system is designed for the Cardiology domain. Further, the target users are in the categories of doctors, physicians and nurses. It helps the Cardiology staff to plan the right actions and make the best decisions. Moreover, it supports the Cardiology staff to collaborate with other professionals more effectively. Furthermore, PULSE is designed to hover above existing systems in hospitals that integrates information a professional needs. It is believed that PULSE can help in accomplishing effective planning, and ultimately leads to more time in better patient care. PULSE is not merely a digital product. It is a hybrid of product and service that brings workload efficiency and flexibility to the medical professionals. The vision we have for PULSE is connected well-being. It aligns to the mission of Philips: to improve the lives of billions of people in the near future.

An exhibition in a company museum, Océ museum, is designed in this graduation project. Océ is a global leader in digital imaging, industrial printing, and collaborative business services. The Océ museum was founded since 1983 to show the company history to its customers, fellow workers, and the interested public. In 2015, Océ opened the Customer Experience Center where visitors can experience the latest products and services of Océ. The assignment for this project is to design the presentation for Océ small format printing to connect the Customer Experience Center and to achieve a marketing effect. The research was done on the aspects of company, the market of small format printing, and museum in order to gather content about what can be presented for marketing and get inspired on how to present the content for a better museum experience. Through iterating from content to experience, a concept was proposed to let visitors experience the company’s growth in the changing world. The concept connects Océ museum with the Customer Experience Center by showing the evolvement of Océ’s positioning in the small format market, from office copying to production printing. The marketing effect is achieved by showing the evolvement of copying and printing facilitated by Océ’s remarkable products and unique technologies from diazo copying in the museum to inkjet printing in the Customer Experience Center. Visitors will experience the evolvement personally and have a time travelling from 1960, 1981, 1997 to the current. This experience enables visitors to have a comprehensive view on the company’s development and to witness its perseverance in technology developing and its tradition of innovation. To validate the concept, the experience of copying by Océ 155 and with diazo copying technology in 1960 is detailed. Tests are done to evaluate this experience and recommendations for further develop are put forward based on the test results.

WiECG aims to create a prototype device which enable ambulance personnel to perform a 12-lead ECG without wires connecting the patient to the monitor. The proposed solution consists of a transmitter and a receiver device. The transmitter transmits the measured signals, the receiver sends the measured signals to the monitor, which shows the measured signals. This thesis describes the design and implementation process for the hardware. This concerns the amplification and filtering of the signals produced by the heart of the patient as well as the reconstruction and attenuation at the output of the receiver module. These processes should be done for 9 signals. Furthermore, component selection, design decisions and the process of implementing this analog signal processing on a printed circuit board is described including the interfaces with the modules used by the other subgroups of this thesis. The prototype built during this project was able to filter the 9 signals and send it from transmitter to receiver while only adding 1.572 𝜇V RMS noise to the output ECG signal.

This project is an assignment commissioned by Houweling Interieur, a furniture retailer. They were seeking new business opportunities and therefore wanted to investigate the opportunities for a furniture lease service in the expatriate market. Introducing a lease service would have several consequences for the company as well as for the customer. The company would take on several responsibilities from the customer, and has to cover for the purchase costs, which are repaid in small monthly payments by the customer. In general the operation of the company would become more complex and the value for the customer would be closer to his or her needs. Houweling Interieur is able to handle this more complex operation. All the physical resources necessary are available to the company. However, some of these should be expended dependent on the size of the lease operation. If Houweling would introduce a lease service, it should position it at the high end of the market, where the company currently positions itself as well. This, because it matches the current suppliers, company vision and the Houweling Interieur brand name. However, in the expatriate market appears only to be a demand for lease furniture in the low end of the market. In the high end of the market, shipping in one’s own furniture is preferred. While the analyses show that targeting the expatriate market with a lease service is not advisable for now, furnishing house viewings and selling separate smaller pieces of furniture fitting the small houses in the Netherlands are opportunities that have presented itself in the different analyses. Furniture lease in other markets is still an option as well.

With healthcare systems being regarded as one of the critical infrastructure sectors, evaluated as a multi-trillion-dollar industry, and with 5 % to 10 % of total health expenditures allocated to medical devices, it is important to pay special attention to what and how technologies are brought into hospitals. This is heavily influenced by good procurement practices, but which are still inefficient in many countries across the world. This study aims to understand and analyse the current barriers and problems in Romanian healthcare procurement, in an attempt to determine what is needed to update the e-procurement of capital medical equipment. By combining a thorough literature review and semi-structured interviews, the research provides an in-depth understanding of the barriers faced by the Romanian acquisition system in public healthcare. The results indicate that an updated e-procurement platform would offer advantages to the relevant stakeholders, however this should not be seen as the go-to solution for the current context. Other human factors, as well as system-wide problems should be addressed before implementing technological solutions, such as a digital platform for procurement of capital medical equipment.