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Sökning: WFRF:(Rexhepi Hanife 1984 )

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1.
  • Cajander, Åsa, et al. (författare)
  • Worlds Apart - Doctors’ Technological Frames and Online Medical Records
  • 2015
  • Ingår i: INTERACT 2015 adjunct proceedings : 15th IFIP TC.13 International Conference on Human-Computer Interaction 14 to 18 September 2015, Bamberg, Germany. - Bamberg : University of Bamberg Press. - 978-3-86309-352-5 - 978-3-86309-353-2 ; s. 357-367
  • Konferensbidrag (refereegranskat)abstract
    • <p>The ability of individuals to access and use their online medical records serves as one of the cornerstones of national efforts to increase patient empowerment and improve health outcomes. However, the launch of online medical records in Uppsala County, Sweden, has been criticized by the medical profession and the local doctors’ union. The aim of this paper is therefore to present the results from an exploratory study where interviews with two oncologists are analysed and discussed based on the theory of Technological Frames and Patient Empowerment. The results indicate that medical doctors have different assumptions and perspectives that affect their use of technology and how they view patient empowerment in everyday clinical work.</p>
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2.
  • Gruenloh, Christiane, et al. (författare)
  • Using Critical Incidents in Workshops to Inform eHealth Design
  • 2017
  • Ingår i: Human-Computer Interaction – INTERACT 2017 : 16th IFIP TC 13 International Conference Mumbai, India, September 25–29, 2017 Proceedings, Part I. - Cham : Springer. - 978-3-319-67744-6 - 978-3-319-67743-9 ; s. 364-373
  • Konferensbidrag (refereegranskat)abstract
    • <p>Demands for technological solutions to address the variety of problems in healthcare have increased. The design of eHealth is challenging due to e.g. the complexity of the domain and the multitude of stakeholders involved. We describe a workshop method based on Critical Incidents that can be used to reflect on, and critically analyze, different experiences and practices in healthcare. We propose the workshop format, which was used during a conference and found very helpful by the participants to identify possible implications for eHealth design, that can be applied in future projects. This new format shows promise to evaluate eHealth designs, to learn from patients' real stories and case studies through retrospective meta-analyses, and to inform design through joint reflection of understandings about users' needs and issues for designers.</p>
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3.
  • Grünloh, Christiane, et al. (författare)
  • "why do they need to check me?" patient participation through ehealth and the doctor-patient relationship : Qualitative study
  • 2018
  • Ingår i: Journal of Medical Internet Research. - J M I R Publications, Inc.. - 1438-8871 .- 1438-8871. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background: Roles in the doctor-patient relationship are changing and patient participation in health care is increasingly emphasized. Electronic health (eHealth) services such as patient accessible electronic health records (PAEHRs) have been implemented to support patient participation. Little is known about practical use of PAEHR and its effect on roles of doctors and patients. Objective: This qualitative study aimed to investigate how physicians view the idea of patient participation, in particular in relation to the PAEHR system. Hereby, the paper aims to contribute to a deeper understanding of physicians' constructions of PAEHR, roles in the doctor-patient relationship, and levels and limits of involvement. Methods: A total of 12 semistructured interviews were conducted with physicians in different fields. Interviews were transcribed, translated, and a theoretically informed thematic analysis was performed. Results: Two important aspects were identified that are related to the doctor-patient relationship: roles and involvement. The physicians viewed their role as being the ones to take on the responsibility, determining treatment options, and to be someone who should be trusted. In relation to the patient's role, lack of skills (technical or regarding medical jargon), motives to read, and patients' characteristics were aspects identified in the interviews. Patients were often referred to as static entities disregarding their potential to develop skills and knowledge over time. Involvement captures aspects that support or hinder patients to take an active role in their care. Conclusions: Literature of at least two decades suggests an overall agreement that the paternalistic approach in health care is inappropriate, and a collaborative process with patients should be adopted. Although the physicians in this study stated that they, in principle, were in favor of patient participation, the analysis found little support in their descriptions of their daily practice that participation is actualized. As seen from the results, paternalistic practices are still present, even if professionals might not be aware of this. This can create a conflict between patients who strive to become more informed and their questions being interpreted as signs of critique and mistrust toward the physician. We thus believe that the full potential of PAEHRs is not reached yet and argue that the concept of patient empowerment is problematic as it triggers an interpretation of "power" in health care as a zero-sum, which is not helpful for the maintenance of the relationship between the actors. Patient involvement is often discussed merely in relation to decision making; however, this study emphasizes the need to include also sensemaking and learning activities. This would provide an alternative understanding of patients asking questions, not in terms of "monitoring the doctor" but to make sense of the situation.</p>
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4.
  • Moll, Jonas, et al. (författare)
  • Patients’ Experiences of Accessing Their Electronic HealthRecords National Patient Survey in Sweden
  • 2018
  • Ingår i: DOME. - J M I R Publications, Inc..
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background: Internationally, there is a movement toward providing patients a Web-based access to their electronic health records (EHRs). In Sweden, Region Uppsala was the first to introduce patient-accessible EHRs (PAEHRs) in 2012. By the summer of 2016, 17 of 21 county councils had given citizens Web-based access to their medical information. Studies on the effect of PAEHRs on the work environment of health care professionals have been conducted, but up until now, few extensive studies have been conducted regarding patients’ experiences of using PAEHRs in Sweden or Europe, more generally.</p><p>Objective: The objective of our study was to investigate patients’ experiences of accessing their EHRs through the Swedish national patient portal. In this study, we have focused on describing user characteristics, usage, and attitudes toward the system.</p><p>Methods: A national patient survey was designed, based on previous interview and survey studies with patients and health care professionals. Data were collected during a 5-month period in 2016. The survey was made available through the PAEHR system, called <em>Journalen</em>, in Sweden. The total number of patients that logged in and could access the survey during the study period was 423,141. In addition to descriptive statistics reporting response frequencies on Likert scale questions, Mann-Whitney tests, Kruskal-Wallis tests, and chi-square tests were used to compare answers between different county councils as well as between respondents working in health care and all other respondents.</p><p>Results: Overall, 2587 users completed the survey with a response rate of 0.61% (2587/423,141). Two participants were excluded from the analysis because they had only received care in a county council that did not yet show any information in <em>Journalen</em>. The results showed that 62.97% (1629/2587) of respondents were women and 39.81% (1030/2587) were working or had been working in health care. In addition, 72.08% (1794/2489) of respondents used <em>Journalen</em> about once a month, and the main reason for use was to gain an overview of one’s health status. Furthermore, respondents reported that lab results were the most important information for them to access; 68.41% (1737/2539) of respondents wanted access to new information within a day, and 96.58% (2454/2541) of users reported that they are positive toward <em>Journalen</em>.</p><p>Conclusions: In this study, respondents provided several important reasons for why they use <em>Journalen</em> and why it is important for them to be able to access information in this way—several related to patient empowerment, involvement, and security. Considering the overall positive attitude, PAEHRs seem to fill important needs for patients.</p>
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5.
  • Moll, Jonas, et al. (författare)
  • The Effect of Patient Accessible Electronic Health Records on Communication and Involvement in Care A National Patient Survey in Sweden
  • 2020
  • Ingår i: Studies in Health Technology and Informatics. - IOS Press. - 0926-9630 .- 1879-8365. ; 270, s. 1056-1060
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>During recent years, patient accessible electronic health records (PAEHRs) have been implemented nationally in Sweden, as well as internationally, as a means of supporting patient engagement and shared decision making. Few studies have, however, investigated the long-term effects of PAEHRs on communicaiton with care professionals and involvement in care. The national survey study presented here, answered by 2587 patients in Sweden, focuses on these aspects specifically. The results show that the Swedish PAEHR system Journalen has had a positive impact on communication with care overall (84% agree or strongly agree with that communication with medical staff has improved), but only 31% agree or strongly agree with that the content of the PAEHR is discussed with care professionals. Journalen also seems to have a positive impact on involvement in care, but the results are mixed when it comes to effects on shared decision making.</p>
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6.
  • Rexhepi, Hanife, 1984- (författare)
  • BRIDGING THE INFORMATION GAP Supporting Evidence-Based Medicine and Shared Decision-Making through Information Systems
  • 2018
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p>Practicing evidence-based medicine (EBM) and shared decision-making (SDM)along the patient process is important in today's healthcare environment, as thesemodels of care offer a way to improve quality and safety of care, patient satisfaction,and reduce costs. EBM is the conscientious and judicious use of current best medicalevidence in conjunction with clinical expertise. It also includes taking into accountpatient values and preferences to guide decisions about the care of individual patients.SDM offers a process that guides how a healthcare professional (e.g., a physicianor a nurse) and a patient jointly can participate in a decision after incorporatingthe body of evidence (the options, benefits and harms) and considering the patient'svalues and preferences.</p><p>The degree to which healthcare professionals can practice EBM and SDM is dependentupon the availability of information about the patient (e.g., medical diagnosis,therapies as well as laboratory and administrative information) and medical evidence(such as medical guidelines). Patient information is a prerequisite for making decisionsabout the care of individual patients and it is evidence-based medicalknowledge, clinical expertise as well as patient values and preferences that guidethese decisions. Moreover, for patients to be able to communicate values and preferencesas well as participate effectively in their own care, they need to have a basicunderstanding of their condition and treatment options, and the consequences ofeach. Hence, they need access to the same information streams—in "patientaccessible"form—as their physician(s) and care team throughout their journey (process)in healthcare. However, making the right decisions about the care of individualpatients at the right time and place is a challenge for healthcare professionals. Due tointeroperability issues, existing information systems do not support a seamless flowof patient information along the patient process. Healthcare professionals are thereforeunable to easily access up-to-date information about the patient at the right timeand place. The situation is complicated further by the fragmentation of medical evidencein different repositories and its presentation by diverse providers, each withunique ideas about how information should be organized and how search enginesshould function. Limited or no access to relevant patient information and the bestmedical evidence about the benefits and risks of treatment options can result inflawed decisions and, more seriously, the suffering of patients. The situation also affectsSDM. If patients are not informed about their health condition, treatment options,benefits and risks or not given high quality information, e.g., becausehealthcare professionals do not have access to the best evidence, patients will be unIIable to assess 'what it is important to them', or they will make inadequate decisionsabout key issues. Consequently, it is almost impossible to practice EBM and SDM ineveryday clinical care.</p><p>For EBM and SDM to serve their purpose, healthcare professionals and patients needinformation systems that provide quick and trouble-free access to all-round information.They also need information systems that can influence the patient/physicianrelationship and facilitate their pursuance of shared goals in the healthcare process,taking into account both illness and personal experience. Hence, based on a qualitativeapproach, this thesis proposes recommendations regarding the redesign of futurehealthcare information systems in ways that will facilitate, rather than hinder,the access to relevant information. One important recommendation identified is thatfuture healthcare information systems must support the core characteristics of EBMand SDM, in an integrated manner, and using the one without the other is notenough. However, such support requires the adoption of a process view on informationsystem development based on the patient's process. A process-oriented approachwith supporting information systems is thus vital for the support of an evidence-based practice where the patient is an important and active collaborator.Moreover, the challenges identified with regard to information system support arenot exclusively technical. Organizational culture, and the attitudes of healthcare professionalsto patient involvement are some of the biggest challenges facing healthcareorganizations.</p>
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7.
  • Rexhepi, Hanife, 1984-, et al. (författare)
  • Cancer Patients’ Attitudes and Experiences of Online Access to their Electronic Medical Records : A Qualitative Study
  • 2018
  • Ingår i: Health Informatics Journal. - Sage Publications. - 1460-4582 .- 1741-2811. ; 24:2, s. 115-124
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Patients’ access to their online medical records serves as one of the cornerstones in the efforts to increase patient engagement and improve healthcare outcomes. The aim of this paper is to provide in-depth understanding of cancer patients’ attitudes and experiences of online medical records, as well as an increased understanding of the complexities of developing and launching e-Health services. The study result confirms that online access can help patients prepare for doctor visits and to understand their medical issues. In contrast to the fears of many physicians the study shows that online access to medical records did not generate substantial anxiety, concerns or increased phone calls to the hospital</p>
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8.
  • Rexhepi, Hanife, 1984-, et al. (författare)
  • Cancer Patients’ Attitudes and Experiences of Online Medical Records
  • 2015
  • Ingår i: Proceedings of the 17<sup>th</sup> International Symposium on Health Information Management Research – ISHIMR 2015. ; s. 19-25
  • Konferensbidrag (refereegranskat)abstract
    • <p><em>Patients’ access to their online medical records serves as one of the cornerstones in the efforts to increase patient engagement and improve healthcare outcomes. The aim of this paper is therefore to provide in-depth understanding of cancer patients’ attitudes and experiences of online medical records, as well as an increased understanding of the complexities of developing and launching eHealth services. The study result confirms that online access can help patients prepare for doctor visits and to understand their medical issues. In contrast to the fears of many physicians the study shows that online access to medical records did not generate substantial anxiety, concerns or increased phone calls to the hospital. </em></p>
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9.
  • Rexhepi, Hanife, 1984-, et al. (författare)
  • Challenges to Implementing IT Support for Evidence Based Practice Among Nurses and Assistant Nurses : A Qualitative Study
  • 2017
  • Ingår i: Journal of Electronic Commerce in Organizations. - I G I Global. - 1539-2937 .- 1539-2929. ; 15:2, s. 61-76
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>When practitioners make decisions as well as treat and care for patients they interpret patient specific information according to evidence based medical knowledge. This process is complex as evidence is infrequently available in a form that can be acted upon at the time decisions must be made. The aim of this paper is to (1) explore how primary, secondary and municipality care in Sweden work with the process of managing knowledge, (2) explore how nurses and assistant nurses experience availability of medical knowledge when and where they need it and (3) conditions for developing a coherent IT-based knowledge portal for different areas of knowledge bases in healthcare. The results show significant deficiencies in the knowledge management process of the participating organizations. The knowledge management processes are not embedded in business processes, activities and relationships, which cause major difficulties for practitioners to keep up with the latest medical evidence.</p>
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10.
  • Rexhepi, Hanife, 1984- (författare)
  • Improving healthcare information systems A key to evidence based medicine
  • 2015
  • Licentiatavhandling (övrigt vetenskapligt)abstract
    • <p>Delivering good quality care is a complex endeavor that is highly dependent on patient information and medical knowledge. When decisions about the care of a patient are made, they must, as far as possible, be based on research-derived evidence rather than on clinical skills and experience alone. Evidence based medicine (EBM) is the conscientious and judicious use of current best evidence in conjunction with clinical expertise as well as patient values and preferences to guide healthcare decisions. Following the principles of EBM, healthcare practitioners are required to formulate questions based on patients’ current clinical status, medical history, values and preferences, search the literature for answers, evaluate the evidence for its validity and usefulness, and finally apply the information to the patient. Information systems play a crucial role in the practice of evidence based medicine, by allowing healthcare practitioners to access clinical evidence and information about the patients’ health as they formulate their patient-care strategies. However, current information systems solutions are far from this perspective for various reasons. One of these reasons is that existing information systems do not support a seamless flow of patient information along the patient process. Due to interoperability issues, healthcare practitioners cannot easily exchange patient information from one information system to another and from one healthcare practitioner to another. Consequently, vital information that is stored in separate information systems and which could present a clear and complete picture of the patient cannot be easily accessed. All too often, units have to operate without knowledge of the problems addressed by other healthcare practitioners from other units, the services provided, medications prescribed, or preferences expressed in those previous situations. The practice of EBM is further complicated by current information systems that do not support practitioners in their search and evaluation of current evidence in everyday clinical care.</p><p>Based on a qualitative approach, this work aims to find solutions for how future healthcare information systems can support the practice of EBM. By combining existing research on process orientation, knowledge management and evidence based medicine with empirical data, a number of recommendations have been initiated. These recommendations aim to support healthcare managers, IT–managers and system developers in the development of future healthcare information systems, from a process-oriented and knowledge management perspective. By following these recommendations, it is possible to develop information systems that facilitate the practice of evidence based medicine, and improve patient engagement.</p>
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