This study aims to explore the design of technological service system of long-term care institutes. The design is based on the integrated framework of activity theory and customer value perspective to suggest the critical considerations of system design. This study collected a total of 351 service events of 17 long-term care institutions located in Japan, Singapore, and China and a total of 75 equipment or facilities. In addition, this study conducted in-depth interviews with experts. The findings are described as follows. First, in the aspect of the services, provided by the subject for the objects, the study shows long-term care institutes place more emphasis on hedonic value and then functional value and contextual value of the objects. Moreover, ethical value and relationship value are neglected. Second, in the aspect of tool, the equipment or facilities of long-term care mostly emphasize functional value and contextual value. Third, in the aspect of community, the system design should consider sharing platform, sharing information and network between the focal institute and other institutes. Finally, in the initial stage of system design, related policies, rules, and operation procedures should be considered. Moreover, long-term care institutes can improve the service quality based on the five-dimension framework of customer value. Furthermore, the focal long-term care institute should collaborate with external institutes to reach a clear division of labor through the sharing platform to build a complete care ecosystem.