Elgar Fleisch

Last Name

Fleisch

First Name

Elgar

ORCID

0000-0002-4842-1117

Organisational unit

03681 - Fleisch, Elgar / Fleisch, Elgar

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Publications 1 - 10 of 331

Growth paths for overcoming the digitalization paradox
Gebauer, Heiko; Fleisch, Elgar; Lamprecht, Claudio (2020)
Business Horizons
Trust and Security in RFID-based Product Authentication Systems
Lehtonen, Mikko O.; Michahelles, Florian; Fleisch, Elgar (2007)
IEEE Systems Journal, Special Issue on RFID Technology : Opportunities and Challenges
Computer Mouse Movements as an Indicator of Work Stress: Longitudinal Observational Field Study
Banholzer, Nicolas; Feuerriegel, Stefan; Fleisch, Elgar; et al. (2021)
Journal of Medical Internet Research
Background: Work stress affects individual health and well-being. These negative effects could be mitigated through regular monitoring of employees’ stress. Such monitoring becomes even more important as the digital transformation of the economy implies profound changes in working conditions. Objective: The goal of this study was to investigate the association between computer mouse movements and work stress in the field. Methods: We hypothesized that stress is associated with a speed-accuracy trade-off in computer mouse movements. To test this hypothesis, we conducted a longitudinal field study at a large business organization, where computer mouse movements from regular work activities were monitored over 7 weeks; the study included 70 subjects and 1829 observations. A Bayesian regression model was used to estimate whether self-reported acute work stress was associated with a speed-accuracy trade-off in computer mouse movements. Results: There was a negative association between stress and the two-way interaction term of mouse speed and accuracy (mean −0.32, 95% highest posterior density interval −0.58 to −0.08), which means that stress was associated with a speed-accuracy trade-off. The estimated association was not sensitive to different processing of the data and remained negative after controlling for the demographics, health, and personality traits of subjects. Conclusions: Self-reported acute stress is associated with computer mouse movements, specifically in the form of a speed-accuracy trade-off. This finding suggests that the regular analysis of computer mouse movements could indicate work stress.
Nutrition Info and Other Front-of-Package Labels and Simulated Food and Beverage Purchases: A Randomized Clinical Trial
Grummon, Anna H.; O'Sullivan, Kevin; Petimar, Joshua; et al. (2025)
JAMA Network Open
Importance: In January 2025, the US Food and Drug Administration (FDA) released a proposed rule to require front-of-package nutrition information (Nutrition Info) labels that would signal when packaged foods contain low, medium, or high levels of saturated fat, sodium, or added sugars (ie, nutrients of concern). However, it is unknown whether this labeling system would encourage healthier food and beverage purchases. Objectives: To test whether Nutrition Info labels similar to those proposed by the FDA could lead to healthier food and beverage purchases compared with other existing or proposed labeling systems. Design, Setting, and Participants: This randomized clinical trial was conducted online from October 31 to November 21, 2024. Participants included a national sample of US adults who reported being their household's primary shopper. Data were analyzed from November 26, 2024, to August 27, 2025. Intervention: Participants were randomized to exposure to 1 of 6 front-of-package labeling systems: positive labels (ie, labels that communicate only the positive attributes of a food) only, Nutrition Info labels (similar to the FDA's proposal), positive plus Nutrition Info labels, "High In"labels (similar to designs the FDA tested to signal when products contain high levels of nutrients of concern), positive plus High In labels, or spectrum labels (similar to designs used internationally rating products from least to most healthy). Main Outcomes and Measures: Participants shopped for foods and beverages in a large, simulated online grocery store. The primary outcome was healthfulness of participants' food and beverage selections, assessed using the United Kingdom's Ofcom Nutrient Profiling Model scores (ranging from 0 to 100, with higher scores indicating healthier choices). Scores were compared between groups using the average differential effect (ADE). Results: A total of 5636 participants completed the trial (3400 [60%] women; mean [SD] age, 40.3 [12.6] years). The spectrum labels led to healthier purchases compared with both the positive labels only (ADE, 2.42; 95% CI, 1.66-3.17; P <.001) and all other labeling systems (range of ADEs, -1.87 [95% CI, -2.63 to -1.11] to -2.45 [95% CI, -3.21 to -1.69]; P <.001). By contrast, the Nutrition Info, positive plus Nutrition Info, High In, and positive plus High In labels did not lead to healthier purchases compared with the positive labels only (range of ADEs, -0.04 [95% CI, -0.80 to 0.72; P =.92] to 0.54 [95% CI, -0.22 to 1.30; P =.16]). Label effects did not differ by nutrition literacy, household income, or educational attainment. Conclusions and Relevance: In this randomized clinical trial of food labeling systems, spectrum labels that rate foods from least to most healthy led to healthier purchases than positive labels and Nutrition Info labels similar to those proposed by the FDA. These findings suggest that spectrum labels may be more promising than both existing positive labels and the FDA's proposed labels for promoting healthier food purchases. Trial Registration ClinicalTrials.gov Identifier: NCT06516627
Advancing Primary Care for Type 2 Diabetes Management: Stakeholder Perspectives on Digital Quality Monitoring in Switzerland
Giger, Odile-Florence; Ackermann, Lola; Principe, Marinja; et al. (2025)
Advancing Primary Care for Type-2 Diabetes Management: Stakeholder Perspectives on Digital Quality Monitoring in Switzerland: A Qualitative Interview Study
Odile-Florence Giger; Lola Jo Ackermann; Marinja Principe; et al. (2025)
Journal of Medical Internet Research
Background: Primary care physicians manage most type 2 diabetes (T2D) cases worldwide but face increasing workload pressures and limited infrastructure. To support consistent, guideline-based care, the Swiss Society of Endocrinology and Dia-betology (SSED) developed a quality monitoring tool known as the SSED score. The score evaluates whether essential care processes have been completed for each individual with T2D. These processes include HbA1c testing, blood pres-sure measurement, and screening for diabetes-related complications. By aggre-gating these elements, the SSED score provides a structured way to assess ad-herence to recommended standards of diabetes care. Although this approach shows promise for improving health outcomes, the score is currently mostly available in paper format and creates additional administrative burden for phy-sicians. Objective: This study explored challenges in T2D management in Swiss primary care, as-sessed the limitations of the SSED quality score, and identified strategies to ena-ble its adoption in routine practice. Methods: We conducted 38 semi-structured interviews following the COREQ guidelines with key stakeholders involved in T2D care in Switzerland: 12 healthcare pro-fessionals, 12 individuals with T2D, five health insurers, and nine healthcare software developers. Data were analyzed using thematic analysis. Results: Participants highlighted persistent challenges in T2D management, including time pressure for health care professionals, fragmented care, and lack of per-sonalized support. Barriers to digital quality monitoring included poor integra-tion with GP systems, misaligned incentives, and limited relevance to multi-morbidity. Suggested facilitators included embedding tools into workflows, en-abling task shifting for physicians, integrating patient-centered features and improving data sharing. Conclusions: A digital SSED score could support GPs by integrating patient-entered data, generating automated alerts, and enabling pharmacy-based follow-up. Success-ful adoption depends on GP workflow integration, system interoperability, and aligned incentives that promote engagement for individuals with T2D. Involv-ing stakeholders early is essential to ensure that new digital tools meet the needs of both individuals with T2D and GPs.
Barriers and facilitators of implementing value-based care: The case of SwissDiabeter
Giger, Odile-Florence; Fleisch, Elgar; Jovanova, Mia; et al. (2025)
Digital Health
Objective: Global spending on diabetes care soared to $966 billion in 2021, a 316% surge over the past 15 years. This sharp increase underscores a need for more efficient and cost-effective care strategies. Value-based care (VBC), which prioritizes patient outcomes while controlling expenses, presents a promising solution. However, its real-world implementation remains challenging, particularly in diabetes care. This study examines SwissDiabeter, a proposed diabetes clinic initiative in Switzerland inspired by a Dutch VBC-based Diabeter clinic. We examine key barriers and facilitators during Diabeter's implementation in the Netherlands and assess forthcoming challenges and enablers for SwissDiabeter in Switzerland. Methods: We employ a deep, extensive embedded single-case design conducting 27 interviews with healthcare professionals, insurers, and patient groups in Switzerland and the Netherlands. The main interview data were complemented by various secondary sources to enhance contextual comprehension, widen perspectives, and validate findings. Results: We identify four key factors for successful VBC adoption: leadership in driving change, financial restructuring, operational improvements, and enabling digital technologies. We next derive practical recommendations to guide the implementation of value-based diabetes care, redesigning financial incentives for healthcare providers, partnering up with key stakeholders such as insurers or policy makers, and measuring outcomes on a voluntary and anonymous basis. Conclusion: This study enhances the global discourse on VBC by analyzing key barriers and facilitators in implementing SwissDiabeter, drawing insights from the Diabeter model in the Netherlands. Our findings highlight the need for strong leadership, financial incentives, digital infrastructure, and interdisciplinary collaboration to drive outcome-driven care. Beyond diabetes, these insights provide a framework for scaling VBC across chronic disease management, promoting cost-effective, high-quality healthcare.
Understanding Products as Services
Wortmann, Felix; Gebauer, Heiko; Lamprecht, Claudio; et al. (2024)
Understanding Products as Services serves as an indispensable guide for navigating the hybrid economy, enabling you to leverage the integration of hardware and software, and propel your organization to the forefront of innovation and success.
Moving beyond the Simulator: Interaction-Based Drunk Driving Detection in a Real Vehicle Using Driver Monitoring Cameras and Real-Time Vehicle Data
Deuber, Robin; Langer, Patrick; Kraus, Mathias; et al. (2025)
CHI '25: Proceedings of the 2025 CHI Conference on Human Factors in Computing Systems
Alcohol consumption poses a significant public health challenge, presenting serious risks to individual health and contributing to over 700 daily road fatalities worldwide. Digital interventions can play a crucial role in reducing these risks. However, reliable drunk driving detection systems are vital to effectively deliver these interventions. To develop and evaluate such a system, we conducted an interventional study on a test track to collect real vehicle data from 54 participants. Our system reliably identifies non-sober driving with an area under the receiver operating characteristic curve (AUROC) of 0.84 ± 0.11 and driving above the WHO-recommended blood alcohol concentration limit of 0.05 g/dL with an AUROC of 0.80 ± 0.10. Our models rely on well-known physiological drunk driving patterns. To the best of our knowledge, we are the first to (1) rigorously evaluate the potential of (2) driver monitoring cameras and real-time vehicle data for detecting drunk driving in a (3) real vehicle.
Estimation of energy efficiency of heat pumps in residential buildings using real operation data
Brudermueller, Tobias; Potthoff, Ugne; Fleisch, Elgar; et al. (2025)
Nature Communications
As heat pumps become more prevalent in residential buildings, effective performance monitoring is essential. Design flaws, incorrect settings, and faults can escalate energy consumption and costs, leading to discrepancies in user expectations and hindering the widespread adoption of this technology crucial for the heating transition. However, field studies using large data sets to offer insights into real-world performance and methods for identifying low-performing systems in practical, scalable applications are lacking. In the largest field study to date, we analyze sensor data from 1023 heat pumps across Central Europe monitored over two years. Based on existing approaches for controlled laboratory conditions, we derive methods to evaluate and classify real-world performance using operational data. Applying these methods, we find that 17% of air-source and 2% of ground-source heat pumps do not meet existing efficiency standards. Additionally, around 10% of systems are oversized, while approximately 1% are undersized. This underscores the need for standardized post-installation performance evaluation procedures and digital tools to provide actionable feedback for users and installers to enhance operational efficiency and guide future installations.

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Elgar Fleisch

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