**6. Value-Based Healthcare System and Personalized Healthcare**

The legacy health care system is staff-centric. Driven by the need to transform the healthcare system to be patient- and personnel-centric, numerous governments have proposed a transformation strategy. For instance, in Saudi Arabia, the government has identified eight challenges that the current health care system should cope with. Those challenges are: (1) the continued growth and aging of the population, (2) the prevalence of avoidable injuries and non-communicable diseases beyond the international standard, (3) the inadequacy and inconsistency of primary care, (4) wide-scale disparity in the quality of care, (5) a significant deficiency in value and quality, (6) the system is resource-, staff-, and institution-centric, (7) insufficient use of digital integrated systems, and (8) the growing need to decrease government spending in health care systems [113].

The value-based healthcare system is a new framework adopted by many governments to improve healthcare services and user experience through the improvement of patient healthcare outcomes at the lowest possible cost, i.e., the value is determined as the ratio of outcomes to cost [114]. Preventive medicine and early intervention lowers the cost associated with the hospitalization of patients. Healthcare 4.0, a new paradigm shift in the health industry, has transformed healthcare from an institution-centered to a patientcentered system [115].

Wearables are cornerstone technologies in Healthcare 4.0. The design of patientcentered care mandates the inclusion of the user requirements to identify functional and non-functional requirements [35]. Surveys, focus groups, and interviews are common ways to capture user requirements. In [116], the authors devised a cost-efficient system for the monitoring of the sedentary level of senior citizens. The system requirements and guidelines have been gathered from a literature review. The system is then evaluated using a mixed approach: focus group, interview, and observations. The system is refined through the feedback provided by the end-user. The authors reported that: (1) the majority of the respondents are interested in receiving a feedback on the level of their physical activity at the end of the day, (2) nearly 58% of participants showed interest in a system that integrates games with physical activity, and (3) virtually 83% of the participants showed interest in profiling their daily activities and receiving alerts when their physical activities are low.

The user requirements for the wearables targeting Chinese seniors are the focus of the work described in [117]. Those requirements have been classified under the following three categories: healthcare requirements, privacy and security requirements, and commodity requirements.
