| 1. |
- Ekstedt, Mirjam, Professor, et al.
(författare)
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Design and Development of an eHealth Service for Collaborative Self-Management among Older Adults with Chronic Diseases : A Theory-Driven User-Centered Approach
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- The increasing prevalence of chronic conditions and multimorbidity poses great challenges to healthcare systems. As patients' engagement in self-managing their chronic conditions becomes increasingly important, eHealth interventions are a promising resource for the provision of adequate and timely support. However, there is inconclusive evidence about how to design eHealth services to meet the complex needs of patients. This study applied an evidence-based and theory-informed user-centered design approach in three phases to identify the needs of older adults and healthcare professionals in the collaborative management of multimorbidity (phase 1), develop an eHealth service to address these needs (phase 2), and test the feasibility and acceptance of the eHealth service in a clinical setting (phase 3). Twenty-two user needs were identified and a web-based application-ePATH (electronic Patient Activation in Treatment at Home)-with separate user interfaces for patients and healthcare professionals was developed. The feasibility study with two nurses and five patients led to a redesign and highlighted the importance of adequately addressing not only varying user needs but also the complex nature of healthcare organizations when implementing new services and processes in chronic care management.
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| 2. |
- Frykholm, Oscar, 1975-
(författare)
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Case-based presentation in medical multidisciplinary team meetings : Applied research in CSCW and IxD
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Advanced medical technology is widely used in modern healthcare, as more and more specialised examinations and treatments are performed on patients. In the case of particularly complex diseases, a number of medical specialists, each an expert in their own field, must collaboratively make diagnoses and plan for treatment. In multidisciplinary team meetings (MDTM), the medical specialists present their pieces of the puzzle, stitch them together and in consensus make a decision. A large amount of information from several sources must be taken into account, but the digital tools to support this decision-making are lacking.This thesis describes research in which engineers and medical specialists have cooperatively developed such a tool. The main research question concerns improving patient information visualisation to support the collaborative work in MDTMs; a secondary question concerns the role of interaction design in medical work. Several design activities have been conducted together with the medical specialists by utilising research methods derived from computer- supported cooperative work (CSCW) and interaction design (IxD). The new tool has been evaluated in two simulated MDTMs and even though it was developed with the users, the results cut both ways.Case-based presentation of patients in MDTMs has a positive effect, as more information can be displayed during discussions. It helps the participants keep a shared focus on the patient, her medical history, results from examinations, and decisions made in the meeting. It is a new and aggregated view of the patient and an example of how patient information visualisation can be improved. On the other hand introducing new technology and new ways of interacting with information, in the meetings was not considered entirely positive. The participants have different roles and tasks in the meeting, and the tools should support these without distracting the shared focus.This practical way of working (conducting field studies, design activities and evaluations) together with ingenious medical specialists can make a difference. By exploring and concretising stakeholders’ needs and making long-term commitments, the interaction designer can take a central position in the deve- lopment of digital, collaborative tools for medical work.
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| 3. |
- Frykholm, Oscar, et al.
(författare)
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Interaction design in a complex context : medical multi-disciplinary team meetings
- 2012
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Ingår i: The 7th Nordic Conference on Human-Computer Interaction: Making Sense Through Design. - New York, NY, USA : ACM. - 9781450314824 ; , s. 341-350
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Konferensbidrag (refereegranskat)abstract
- In order to improve collaboration on, and visualisation of, patient information in medical multi-disciplinary team meetings, we have developed a system that presents information from different medical systems to be used as a support for the decision process. Based on field studies, we have implemented a high-fidelity prototype on tablet-sized displays, and tested it in a realistic setting. Our evaluation proved that more patient information can efficiently be displayed to all meeting participants, compared to the current situation. Interaction with the information, on the other hand, proved to be a complicated activity that needs careful design considerations; it should ultimately be based on what roles the meeting participants have, and what tasks they should complete. Medical decision-making is a complex area, and conducting interaction design in this area proved complex too. We foresee a great opportunity to improve medical work, by introducing collaborative tools and visualisation of medical data, but it requires that interaction design becomes a natural part of medical work.
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| 4. |
- Frykholm, Oscar, et al.
(författare)
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Medicine meets engineering in cooperative design of collaborative decision-supportive system
- 2010
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Ingår i: IEEE 23rd International Symposium on Computer-Based Medical Systems (CBMS). - Perth, WA : IEEE conference proceedings. ; , s. 116-121
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Konferensbidrag (refereegranskat)abstract
- Researchers in Human-Computer Interaction have worked together with physicians to specify and create prototypes of a system to be used primarily during multi-disciplinary team meetings. Physicians will use the system to aggregate and present relevant patient information during discussions on diagnosis and treatment, and also to coordinate the cases during the patient care pathway. In this paper we present the cooperative design process and activities conducted within the project. The results are two-fold; we report on the progress of creating the decision-supportive system, and describe how the physicians experience the design process. The design activities have made the physicians reflect on: the lack or loss of patient information, how patient information can be improved, break-downs in their work process, how they learn from each other, and the design methodology itself.
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| 5. |
- Frykholm, Oscar, et al.
(författare)
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References to personal experiences and scientific evidence during medical multi-disciplinary team meetings
- 2011
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Ingår i: Behavior and Information Technology. - 0144-929X .- 1362-3001. ; 30:4, s. 455-466
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Tidskriftsartikel (refereegranskat)abstract
- We present a field study of medical multi-disciplinary team meetings (MDTMs) where decisions are made concerning the diagnosis and treatment of patients suffering from diseases in the upper abdomen. The study shows how evidence is referred to during weekly team meetings; this evidence is related both to scientific studies and to personal experiences of similar cases. We focus on the conversations during the meetings, on the complicated nature of the cases and on the details in the discussions that led the meeting participants to refer to scientific evidence or previous cases. We identify possibilities for improving the use of already documented information from medical records, in order to identify clinically relevant similarities and to bring additional information into the treatment discussion.
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| 6. |
- Frykholm, Oscar, et al.
(författare)
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User-centered design of integrated eHealth to improve patients' activation in transitional care
- 2016
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156. ; 16:6, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The burden of chronic diseases is expected to escalate worldwide. Despite extensive use of emergency rooms and specialized care of persons with multiple or chronic diseases, the majority of the time care is managed in the patient’s home. For patients, living with chronic illnesses can be highly demanding, requiring them to manage their symptoms, disabilities and complex medical regimens at home. Effectively functioning in the role of self-manager requires a high level of knowledge, skill, and confidence. In order to handle these challenges, new models for care are required.eHealth solutions, successfully implemented in everyday clinical practice have shown significant effects on symptom management and self-efficacy, improving quality of care. Despite the wide proliferation and everyday use of consumer technology as well as eHealth solutions, the contribution of eHealth solutions in enhancing patients’ activation in self-management of their care is an underdeveloped field. Therefore, we undertake a long-term project of developing an eHealth solution where patients and care-givers are active stakeholders, and in parallel, paving the way for clinical ownership of the eHealth solution, in order to evaluate it in a randomized controlled study. The aim of this abstract is to describe the user-centered design in the development of an eHealth service.Theory and Method: We report process data from an ongoing study; aiming to improve transitional care by focusing on patient activation and participation during the critical post-hospitalization phase. We draw upon principals of the evidence-based Care Transition Intervention, which will be integrated into an eHealth solution, as a ‘digital coach’ to support patients’ self- management. We have identified four pillars that will form the foundation of the eHealth solution: care plan, medication self-management, symptom management, and contact information to relevant care-givers.In the first phase of the project, we have utilized a user-centered design process by engaging patients and care-givers in interviews, workshops and design activities. Results from these activities are documented in user-centered material such as patient journeys, effect maps, and prototypes of the eHealth solution. This material has been directly fed into the development of the technical solution, making us confident that the proposed solution will solve concrete user needs. At the same time, we make long-term collaborations with the care-givers and departments, from where the eHealth solution will be distributed to patients in the study.Progress report: A number of observational and design activities have been conducted with both patients and care-givers, at two different hospitals. User context has been documented in patient journeys, which describe a typical patient’s journey from first symptom through medical evaluation and treatment, up to living with the disease or complications of the treatment. The patient journey describes, in different stages, how the patient´s feels, their contact with health care, what information they receives and requires, and what examinations and treatments they undergoes. Visualizing health care from the patient’s perspective in this manner helps identifying gaps in e.g. information needs and to position the eHealth solution in situations where it can solve concrete needs. Furthermore, user needs have been captured in effect maps, which connect hands-on needs or functionality with high-level goals (e.g. ultimately enhanced patient activation and reduced re-hospitalization). As of now, in the second phase of the project, development of technical solution has commenced, and we are planning for pilot testing in the next couple of months.Discussion and conclusions: eHealth solutions play an important part in improving activation and awareness. However, it is not simply solved by the sheer introduction of eHealth solutions we have learned that it requires:- Successful implementation in the health care processes, as personnel should feel an ownership of the eHealth solution in order to perceive it as an effective tool in their communication with patients and collaboration with other care givers.- Presentation of relevant feedback to patients, in order for them to learn about their own disease and symptoms, and to be actively engaged in self-management at home Using motivational gamification in eHealth solutions will help to capture patients’ interest to take active role in their own care, and to motivate patients to learn and maintain self-management knowledge and skills.- Fitting it into the existing eco system of technical solutions for health care as well as patient- and lifestyle-centered applications.
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| 7. |
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| 8. |
- Groth, Kristina, et al.
(författare)
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Clinical journal: a collaborative shared medical workspace
- 2011
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Ingår i: CSCW '11 Proceedings of the ACM 2011 conference on Computer supported cooperative work. - NewYork, USA : ACM. ; , s. 633-636
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Konferensbidrag (refereegranskat)abstract
- We describe our findings from a cooperative design effort of a shared medical workspace used in multi-disciplinary team meetings, as well as during other activities in a patient care pathway for highly specialised care. In collaboration with surgeons, sketches of such a system have been developed and evaluated. Our findings point out the importance of overview and visualisation of the information
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| 9. |
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| 10. |
- Groth, Kristina, et al.
(författare)
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Efficiency in Treatment Discussions : A Field Study of Time Related Aspects in Multi-Disciplinary Team Meetings
- 2009
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Ingår i: 2009 22ND IEEE INTERNATIONAL SYMPOSIUM ON COMPUTER-BASED MEDICAL SYSTEMS. - 9781424448791 ; , s. 88-95
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Konferensbidrag (refereegranskat)abstract
- We present a field study of multi-disciplinary team meetings where decisions on treatment of patients with diseases in the upper part of the abdomen are made. These meetings are important for knowledge dissemination and learning. We have studied how different time related aspects affect the efficiency during these meetings. Time is relevant because several physicians attend these meetings, and they have tight schedules as it is. Our analysis focuses on the conversation during the team meetings, and on how aspects such as indistinct discussions, lack of relevant competence and information, and the structuring of medical information affect time efficiency.
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