| 1. |
- Karnehed, Sara, 1979-, et al.
(författare)
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Kan samproduktion av framtidens teknik bidra till en hållbar arbetsmiljö för sjuksköterskor?
- 2023
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Konferensbidrag (refereegranskat)abstract
- Svensk primärvård står inför stora utmaningar med en åldrande befolkning och ett ökat antal personer som vårdas i hemmet (Landers et al., 2016). Digital teknik implementeras med förhoppning om att förbättra kommunikationen mellan vårdpersonal och underlätta möjligheterna till egenvård och tillgänglighet för patienter (Socialstyrelsen, 2021). Tidigare studier visar att användningen av digital teknik kan förändra det professionella landskapet (Petersson, 2020) och påverka arbetsmiljö och arbetets innehåll (Ertner, 2019). Trots att teknik som implementeras inom vården bör vara anpassad till hälso- och sjukvårdspersonalens arbete och värderingar (Palmer et al., 2019; Reed et al., 2019) är sjuksköterskor sällan involverade i beslut kring utformning eller implementering av ny teknik (von Gerich et al., 2022). Det behövs mer kunskap om hur digitaliseringen kan ske i samproduktion med sjuksköterskor och utformas så att en god arbetsmiljö bibehålls.Presentationen syftar till att beskriva sjuksköterskors arbete och arbetsmiljö inom hemsjukvården och hur dessa kunskaper kan användas vid utvecklingen och implementeringen av framtida digital teknik.Individuella semi-strukturerade intervjuer har genomförts med 20 sjuksköterskor som arbetar på vårdcentral och inom hemsjukvård i två halländska kommuner. Intervjuerna har analyserats genom kvalitativ innehållsanalys (Hsieh & Shannon, 2005). Implementeringsteoretiska ramverk används för att undersöka hur kunskapen kan inkorporeras vid innovation och implementering av digitala tekniker inom vårdverksamheter (Nilsen, 2015).Preliminära resultat kommer att presenteras vid konferensen.ReferenserErtner, S. M. (2019). Enchanting, evoking, and affecting: the invisible work of technology implementation in homecare. Nordic Journal of Working Life Studies, 9(S5), 33-47.Hsieh, H.-F., & Shannon, S. E. (2005). Three Approaches to Qualitative Content Analysis. Qualitative health research, 15(9), 1277-1288.Landers, S., Madigan, E., Leff, B., Rosati, R. J., McCann, B. A., Hornbake, R., MacMillan, R., Jones, K., Bowles, K., Dowding, D., Lee, T., Moorhead, T., Rodriguez, S., & Breese, E. (2016). The Future of Home Health Care: A Strategic Framework for Optimizing Value. Home Health Care Management & Practice, 28(4), 262-278.Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation science : IS, 10(1), 53-53.Palmer, V. J., Weavell, W., Callander, R., Piper, D., Richard, L., Maher, L., Boyd, H., Herrman, H., Furler, J., & Gunn, J. (2019). The Participatory Zeitgeist: an explanatory theoretical model of change in an era of coproduction and codesign in healthcare improvement. Medical humanities, 45(3), 247-257.Petersson, L. (2020). Paving the way for transparency: How eHealth technology can change boundaries in healthcare Lund University].Reed, J. E., Howe, C., Doyle, C., & Bell, D. (2019). Successful healthcare improvements from translating evidence in complex systems (SHIFT-Evidence): simple rules to guide practice and research. International journal for quality in health care, 31(3), 238-244.Socialstyrelsen. (2021). E-hälsa och välfärdsteknik i kommunerna 2021. Uppföljning av den digitala utvecklingen i socialtjänsten och den kommunala hälso-och sjukvården.von Gerich, H., Moen, H., Block, L. J., Chu, C. H., DeForest, H., Hobensack, M., Michalowski, M., Mitchell, J., Nibber, R., & Olalia, M. A. (2022). Artificial Intelligence-based technologies in nursing: A scoping literature review of the evidence. International Journal of Nursing Studies, 127, 104153.
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| 2. |
- Hagberg, Johan, 1973, et al.
(författare)
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Konsumtionsrapporten 2024
- 2024
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I Konsumtionsrapporten 2024 sammanfattas och analyseras konsumtionen i Sverige under 2023. I den första delen, ”Hushållens konsumtion” ges en översikt över den privata konsumtionen i Sverige och hur den förändrats. Här beskrivs även hållbarhetsaspekter på konsumtionen samt hushållens framtidsförväntningar på den egna ekonomin. I andra delen, ”Detaljhandeln” beskrivs försäljning och utveckling inom detaljhandeln under 2023 med fokus på olika delbranscher, kanaler och platser, inom e-handeln respektive den butiksbaserade detaljhandeln. Den andra delen avslutas med handelns framtidsförväntningar. Årets Konsumtionsrapport innehåller två fördjupningsdelar som var en och analyserar aktuella teman inom konsumtion. I den första av fördjupningsdelarna diskuterar Magdalena Petersson McIntyre och Emma Björner lyxkonsumtionens utveckling, status, hållbarhet och moral. I den andra fördjupningsdelen belyser Karin M. Ekström kulturkonsumtion med fokus på konstutställningar.
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| 3. |
- Hansson, Lena, 1968, et al.
(författare)
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Design, gender and competitiveness
- 2009
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Ingår i: I: John Bryson and Grete Rusten (eds.) Industrial Design and Competitiveness: Spatial and Organizational Dimensions. - : Palgrave Macmillan. - 9780230203495 ; , s. 169-194
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 4. |
- Karnehed, Sara, 1979-, et al.
(författare)
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Developers' beliefs and values – a discursive analysis of e-health technology in home healthcare
- 2023
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Konferensbidrag (refereegranskat)abstract
- BackgroundThe implementation of e-health is transforming healthcare. The acknowledged benefits of digitalization are quality improvement, patient empowerment, and increased efficiency. The mobility of e-health makes it especially suitable for home healthcare. eMar is a common e-health technology used in Swedish home healthcare. Decisions about technology design are governed by developers’ perceptions of intended users. These perceptions can be identified in the description and promotion of a specific product.PurposeThe purpose of the presentation is to contribute to increased knowledge about the values entailed in a specific eMar used in Swedish home healthcare, and furthermore to discuss how these values conform with existing national missions such as people-centered care.MethodInformation consisting of sales materials about a specific eMar used in several Swedish municipalities has been analyzed through critical discourse analysis to visualize values embedded in the eMar.FindingsPreliminary results show that the provider of the specific eMar describes care in terms borrowed from the industrial sector, such as shift changes and production of care. Good and safe care is defined as the right person receiving the right medicine at the right time. Furthermore, the app is advertised as a tool for monitoring assuming that the performance of tasks can be influenced through the remote control of the employee. The eMar is described as representing new and modern technologies that are expected to raise the status of healthcare professions and facilitate the recruitment of employees.
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| 5. |
- Karnehed, Sara, 1979-, et al.
(författare)
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Digital technologies in home healthcare – implications for job demands, job control, and support among healthcare professionals
- 2022
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Ingår i: Abstract Book of the 7th International Triennial Conference on Healthcare Systems Ergonomics and Patient Safety (HEPS) 2022. - Delft : Delft University of Technology. - 9789463666237 ; , s. 165-167
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Konferensbidrag (refereegranskat)abstract
- Increased use of digital technologies in healthcare offers healthcare professionals multiple ways to perform tasks and interact with patients and colleagues. We used the JDCS model to identify employee´s well-being in relation to the use of an eMar. The analysis indicated that the specific technology influenced the work environment for registered nurses and nursing assistants in different ways.
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| 6. |
- Karnehed, Sara, 1979-, et al.
(författare)
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Electronic medication administration record (eMAR) in Swedish home healthcare—Implications for Nurses' and nurse Assistants' Work environment : A qualitative study
- 2024
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Ingår i: Scandinavian Journal of Caring Sciences. - Chichester : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 38:2, s. 347-357
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Tidskriftsartikel (refereegranskat)abstract
- Background: The electronic medication administration record (eMAR) is an eHealth system that has replaced the traditional paper-based medication administration used in many healthcare settings. Research has highlighted that eHealth technologies can change working methods and professional roles in both expected and unexpected ways. To date, there is sparse research that has explored how nurses and nurse assistants (NA) in home healthcare experience eMAR in relation to their work environment. Aim: The aim was to explore how nurses and nurse assistants experienced their work environment, in terms of job-demand, control, and support in a Swedish home healthcare setting where an electronic medication administration record had been implemented to facilitate delegation of medical administration. Method: We took a qualitative approach, where focus groups were used as data collection method. The focus groups included 16 nurses and nine NAs employed in a Swedish municipality where an eMAR had been implemented 6 months before the first focus groups were performed. The analysis adapted the job-demand-control-support model, by condensing the professionals' experiences into the three categories of demand, control, and support, in alignment with the model. Results: NAs experienced high levels of job demand and low levels of job control. The use of the eMAR limited NAs' ability to control their work, in terms of priorities, content, and timing. In contrast, the nurses described demands as high but manageable, and described having a high level of control. Both professions found the eMar supportive. Conclusion: Nurses and NAs in home healthcare experienced changes in their work environment regarding demand, control, and support when an eMAR was implemented to facilitate delegation of medical administration. In general, nurses were satisfied with the eMAR. However, NAs felt that the eMAR did not cover all aspects of their daily work. Healthcare organisations should be aware of the changes that digitalisation processes entail in the work environment of nurses and NAs in home healthcare. © 2024 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.
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| 7. |
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| 8. |
- Neher, Margit, 1959-, et al.
(författare)
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Innovation in healthcare : leadership perceptions about the innovation characteristics of artificial intelligence—a qualitative interview study with healthcare leaders in Sweden
- 2023
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Ingår i: Implementation Science Communications. - London : BioMed Central (BMC). - 2662-2211. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite the extensive hopes and expectations for value creation resulting from the implementation of artificial intelligence (AI) applications in healthcare, research has predominantly been technology-centric rather than focused on the many changes that are required in clinical practice for the technology to be successfully implemented. The importance of leaders in the successful implementation of innovations in healthcare is well recognised, yet their perspectives on the specific innovation characteristics of AI are still unknown. The aim of this study was therefore to explore the perceptions of leaders in healthcare concerning the innovation characteristics of AI intended to be implemented into their organisation.Methods: The study had a deductive qualitative design, using constructs from the innovation domain in the Consolidated Framework for Implementation Research (CFIR). Interviews were conducted with 26 leaders in healthcare.Results: Participants perceived that AI could provide relative advantages when it came to care management, supporting clinical decisions, and the early detection of disease and risk of disease. The development of AI in the organisation itself was perceived as the main current innovation source. The evidence base behind AI technology was questioned, in relation to its transparency, potential quality improvement, and safety risks. Although the participants acknowledged AI to be superior to human action in terms of effectiveness and precision in some situations, they also expressed uncertainty about the adaptability and trialability of AI. Complexities such as the characteristics of the technology, the lack of conceptual consensus about AI, and the need for a variety of implementation strategies to accomplish transformative change in practice were identified, as were uncertainties about the costs involved in AI implementation.Conclusion: Healthcare leaders not only saw potential in the technology and its use in practice, but also felt that AI’s opacity limits its evidence strength and that complexities in relation to AI itself and its implementation influence its current use in healthcare practice. More research is needed based on actual experiences using AI applications in real-world situations and their impact on clinical practice. New theories, models, and frameworks may need to be developed to meet challenges related to the implementation of AI in healthcare. © 2023, The Author(s).
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| 9. |
- Nilsen, Per, 1960-, et al.
(författare)
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A Framework to Guide Implementation of AI in Health Care : Protocol for a Cocreation Research Project
- 2023
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Ingår i: JMIR Research Protocols. - Toronto : JMIR Publications. - 1929-0748. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Artificial intelligence (AI) has the potential in health care to transform patient care and administrative processes, yet health care has been slow to adopt AI due to many types of barriers. Implementation science has shown the importance of structured implementation processes to overcome implementation barriers. However, there is a lack of knowledge and tools to guide such processes when implementing AI-based applications in health care.Objective: The aim of this protocol is to describe the development, testing, and evaluation of a framework, “Artificial Intelligence-Quality Implementation Framework” (AI-QIF), intended to guide decisions and activities related to the implementation of various AI-based applications in health care.Methods: The paper outlines the development of an AI implementation framework for broad use in health care based on the Quality Implementation Framework (QIF). QIF is a process model developed in implementation science. The model guides the user to consider implementation-related issues in a step-by-step design and plan and perform activities that support implementation. This framework was chosen for its adaptability, usability, broad scope, and detailed guidance concerning important activities and considerations for successful implementation. The development will proceed in 5 phases with primarily qualitative methods being used. The process starts with phase I, in which an AI-adapted version of QIF is created (AI-QIF). Phase II will produce a digital mockup of the AI-QIF. Phase III will involve the development of a prototype of the AI-QIF with an intuitive user interface. Phase IV is dedicated to usability testing of the prototype in health care environments. Phase V will focus on evaluating the usability and effectiveness of the AI-QIF. Cocreation is a guiding principle for the project and is an important aspect in 4 of the 5 development phases. The cocreation process will enable the use of both on research-based and practice-based knowledge.Results: The project is being conducted within the frame of a larger research program, with the overall objective of developing theoretically and empirically informed frameworks to support AI implementation in routine health care. The program was launched in 2021 and has carried out numerous research activities. The development of AI-QIF as a tool to guide the implementation of AI-based applications in health care will draw on knowledge and experience acquired from these activities. The framework is being developed over 2 years, from January 2023 to December 2024. It is under continuous development and refinement.Conclusions: The development of the AI implementation framework, AI-QIF, described in this study protocol aims to facilitate the implementation of AI-based applications in health care based on the premise that implementation processes benefit from being well-prepared and structured. The framework will be coproduced to enhance its relevance, validity, usefulness, and potential value for application in practice. © 2023 The Author(s).
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| 10. |
- Petersson, Lena, 1968-, et al.
(författare)
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Challenges to implementing artificial intelligence in healthcare : a qualitative interview study with healthcare leaders in Sweden
- 2022
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Ingår i: BMC Health Services Research. - London : BioMed Central (BMC). - 1472-6963. ; 22
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Tidskriftsartikel (refereegranskat)abstract
- Background: Artificial intelligence (AI) for healthcare presents potential solutions to some of the challenges faced by health systems around the world. However, it is well established in implementation and innovation research that novel technologies are often resisted by healthcare leaders, which contributes to their slow and variable uptake. Although research on various stakeholders’ perspectives on AI implementation has been undertaken, very few studies have investigated leaders’ perspectives on the issue of AI implementation in healthcare. It is essential to understand the perspectives of healthcare leaders, because they have a key role in the implementation process of new technologies in healthcare. The aim of this study was to explore challenges perceived by leaders in a regional Swedish healthcare setting concerning the implementation of AI in healthcare.Methods: The study takes an explorative qualitative approach. Individual, semi-structured interviews were conducted from October 2020 to May 2021 with 26 healthcare leaders. The analysis was performed using qualitative content analysis, with an inductive approach.Results: The analysis yielded three categories, representing three types of challenge perceived to be linked with the implementation of AI in healthcare: 1) Conditions external to the healthcare system; 2) Capacity for strategic change management; 3) Transformation of healthcare professions and healthcare practice.Conclusions: In conclusion, healthcare leaders highlighted several implementation challenges in relation to AI within and beyond the healthcare system in general and their organisations in particular. The challenges comprised conditions external to the healthcare system, internal capacity for strategic change management, along with transformation of healthcare professions and healthcare practice. The results point to the need to develop implementation strategies across healthcare organisations to address challenges to AI-specific capacity building. Laws and policies are needed to regulate the design and execution of effective AI implementation strategies. There is a need to invest time and resources in implementation processes, with collaboration across healthcare, county councils, and industry partnerships. © The Author(s) 2022.
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| 11. |
- Petersson, Lena, 1968-, et al.
(författare)
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Developing an ethical model for guidance the implementation of AI in healthcare
- 2023
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Ingår i: 10th Nordic Health Promotion Research Conference 2023. Sustainability and the impact on health and well-being. - Halmstad : Halmstad University Press. - 9789189587410 ; , s. 84-84
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Konferensbidrag (refereegranskat)abstract
- Background: Artificial intelligence (AI) is predicted to improve healthcare, increase efficiency, save time and resources. However, research shows an urgent need to develop guidance to ensure that the use of AI in healthcare is ethically acceptable.Purpose: To develop an ethical model to support AI implementation in practice.Methods: The study used an explorative and empirically driven qualitative design. Individual interviews were conducted with 18 healthcare professionals from two emergency departments in Sweden where the county council has developed an AI application to predict the risk for unexpected mortality within 30 days after visiting an emergency department. A deductive analysis based on ethical theory i.e virtue, deontology and consequentialism, was used.Findings: The developed model shows how the healthcare professionals use ethical reasoning in relation to the implementation of AI. In relation to virtue ethics, moral considerations in relation to the use of AI were mentioned. In relation to deontology, considerations were mentioned on actions performed based on information acquired from the technology and adherence to specific duties, roles and responsibilities. In relation to consequentialism, considerations about how to provide better resources more rapidly in an equal way and how the technology can be adjusted to each patients’ individual needs and preferences in order to support decisions, self-determination, and actions that are in the patients best interest.Conclusions: Our findings provide an ethical model demonstrating the relevance of virtue, deontology and consequentialism when AI are to be implemented in practice.
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| 12. |
- Petersson, Lena, 1968-, et al.
(författare)
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Ethical considerations in implementing AI for mortality prediction in the emergency department : Linking theory and practice
- 2023
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Ingår i: Digital Health. - London : Sage Publications. - 2055-2076. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Artificial intelligence (AI) is predicted to be a solution for improving healthcare, increasing efficiency, and saving time and recourses. A lack of ethical principles for the use of AI in practice has been highlighted by several stakeholders due to the recent attention given to it. Research has shown an urgent need for more knowledge regarding the ethical implications of AI applications in healthcare. However, fundamental ethical principles may not be sufficient to describe ethical concerns associated with implementing AI applications.Objective: The aim of this study is twofold, (1) to use the implementation of AI applications to predict patient mortality in emergency departments as a setting to explore healthcare professionals’ perspectives on ethical issues in relation to ethical principles and (2) to develop a model to guide ethical considerations in AI implementation in healthcare based on ethical theory.Methods: Semi-structured interviews were conducted with 18 participants. The abductive approach used to analyze the empirical data consisted of four steps alternating between inductive and deductive analyses. Results: Our findings provide an ethical model demonstrating the need to address six ethical principles (autonomy, beneficence, non-maleficence, justice, explicability, and professional governance) in relation to ethical theories defined as virtue, deontology, and consequentialism when AI applications are to be implemented in clinical practice.Conclusions: Ethical aspects of AI applications are broader than the prima facie principles of medical ethics and the principle of explicability. Ethical aspects thus need to be viewed from a broader perspective to cover different situations that healthcare professionals, in general, and physicians, in particular, may face when using AI applications in clinical practice. © The Author(s) 2023.
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| 13. |
- Petersson, Lena, 1968-, et al.
(författare)
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Ethical Perspectives on Implementing AI to Predict Mortality Risk in Emergency Department Patients : A Qualitative Study
- 2023
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Ingår i: Caring is sharing - exploiting the value in data for health and innovation. - Amsterdam : IOS Press. - 9781643683881 - 9781643683898 ; , s. 676-677
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Konferensbidrag (refereegranskat)abstract
- Artificial intelligence (AI) is predicted to improve health care, increase efficiency and save time and recourses, especially in the context of emergency care where many critical decisions are made. Research shows the urgent need to develop principles and guidance to ensure ethical AI use in healthcare. This study aimed to explore healthcare professionals' perceptions of the ethical aspects of implementing an AI application to predict the mortality risk of patients in emergency departments. The analysis used an abductive qualitative content analysis based on the principles of medical ethics (autonomy, beneficence, non-maleficence, and justice), the principle of explicability, and the new principle of professional governance, that emerged from the analysis. In the analysis, two conflicts and/or considerations emerged tied to each ethical principle elucidating healthcare professionals' perceptions of the ethical aspects of implementing the AI application in emergency departments. The results were related to aspects of sharing information from the AI application, resources versus demands, providing equal care, using AI as a support system, trustworthiness to AI, AI-based knowledge, professional knowledge versus AI-based information, and conflict of interests in the healthcare system. © 2023 European Federation for Medical Informatics (EFMI) and IOS Press.
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| 14. |
- Petersson, Lena, 1968-, et al.
(författare)
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Expected values of implementing AI in healthcare – A Qualitative study
- 2023
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Ingår i: Nordic Health Promotion Research Conference 2023. - Halmstad.
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Konferensbidrag (refereegranskat)abstract
- Background: Artificial intelligence (AI) is often presented as a technology that will change healthcare and be useful inclinical work in disease prediction, diagnosis, and precision health. More knowledge is needed regarding the value of AI applications based on the perspectives of healthcare leaders to understand their roles as gatekeepers and facilitatorsfor successful implementation.The purpose of the study: To explore healthcare leaders’ perceptions of the value of AI applications in clinical work.Methods: The study had an explorative qualitative approach. Individual interviews were conducted from October2020 to May 2021 with 26 healthcare leaders with different experiences in implementing AI in clinical practice in acounty council in Sweden. Inductive qualitative content analysis was used, and eight sub-categories and threecategories emerged.Findings: The value of AI applications in clinical care was described in terms of expected benefits for patients as toolssupporting person-centered information and individualized self-management. The expected benefits for healthcareprofessionals included decision-support in diagnostics, risk assessments, and treatment recommendations but alsoproviding warning systems and second opinions in clinical work. On an organizational level, the benefits comprisedpatient safety and decision-support in prioritizing healthcare resources in and across healthcare organizations.Conclusions: The healthcare leaders perceived that AI applications would provide value on different levels inhealthcare for patients, healthcare professionals, and organizations. Across these levels, the implementation of AI cansupport person-centeredness, patient self-management, quality of care, patient safety, and resource optimization.
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| 15. |
- Petersson, Lena, 1968-, et al.
(författare)
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Healthcare Leaders' Perceptions of the Usefulness of AI Applications in Clinical Work : A Qualitative Study
- 2023
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Ingår i: Caring is sharing - exploiting the value in data for health and innovation. - Amsterdam : IOS Press. ; , s. 678-679
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Konferensbidrag (refereegranskat)abstract
- Artificial intelligence (AI) is often presented as a technology that changes healthcare and is useful in clinical work in disease prediction, diagnosis, treatment effectiveness, and precision health. This study aimed to explore healthcare leaders' perceptions of the usefulness of AI applications in clinical work. The study was based on qualitative content analysis. Individual interviews were conducted with 26 healthcare leaders. The usefulness of AI applications in clinical care was described in terms of expected benefits for 1) patients as supporting individualized self-management and person-centered information support tools 2) healthcare professionals in terms of providing decision-support in diagnostics, risk assessments, treatment recommendations, warning systems, and as a new colleague supporting the clinical work, and 3) organizations as providing patient safety and decision-support in prioritizing healthcare resources in organizing healthcare.
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| 16. |
- Petersson, Lena, 1968-, et al.
(författare)
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Implementering av AI i hälso- och sjukvården – ledares gränsarbete kan förändra professionella gränser
- 2023
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Konferensbidrag (refereegranskat)abstract
- Just nu pågår en digital transformation av svensk hälso- och sjukvård och artificiell intelligens (AI) är tänkt att vara lösningen på många av de utmaningar sjukvården står inför. I en kunskapssammanställning från Myndigheten för arbetsmiljökunskap (MYNAK) (2020) om digitalisering och arbetsmiljö påtalas att den snabba tekniska utvecklingen kommer att förändra arbetsmiljö och yrkesrollers karaktär. Professionellas arbete är traditionellt omgärdat av gränser och att upprätthålla gränserna kring det egna kunskapsområdet är en grundläggande del av professionens utveckling. Digitalisering och implementering av olika former av teknik kan förändra professionella gränser och därmed generera så kallat gränsarbete (Petersson, 2020) som kan indelas i tre former; konkurrenskraftigt gränsarbete, kollaborativt gränsarbete och konfigurativt gränsarbete (Langley et al. 2019). De tre formerna av gränsarbete är ofta sammanflätade i praktiken, men konfigurativt gränsarbete kan dock beskrivas som en kraft som driver de andra två kategorierna av gränsarbete, eftersom det riktar sig emot andras aktiviteter i syfte att utforma gränser för förändring mellan grupper (Langley et al., 2019). Denna studie fokuserar på hur gränserna kring vårdprofessionernas arbete kan förändras vid implementering av AI och på vilket konfigurativt gränsarbete som aktörer på ledningsnivån i ett sjukvårdssystem förutser kommer att ske när sjukvården blir mer datadriven genom användning av AI-analyser.Vi genomförde semistrukturerade intervjuer med 26 ledare som var i en position att potentiellt påverka implementeringen och användningen av AI i en svensk region. Intervjuerna analyserades med hjälp av kvalitativ innehållsanalys. Analysen i studien fokuserar på den konfigurativa formen av gränsarbete.Sammantaget visar resultatet att ledarna beskriver olika typer av konfigurativt gränsarbete. Ledarna har makten att bedriva gränsarbete som förändrar gränserna kring vårdpersonalens arbete och de beskriver att de, medvetet eller omedvetet, vill förändra gränserna kring i första hand läkarnas arbete vid implementeringen av AI i hälso- och sjukvården.ReferenserLangley, A., Lindberg, K., Mork, B. E., Nicolini, D., Raviola, E., Walter, L. (2019). Boundary work among groups, occupations, and organization: From Cartography to process. Academy of Management Annals, 13(2): 704–736.Mynak (2020). Framtidens arbetsmiljö – trender, digitalisering och anställningsformer. 2020:3. www.mynak.se.Petersson, L. (2020). Paving the way for transparency: How eHealth technology can change boundaries in healthcare. Lund: Department of Design Sciences, Faculty of Engineering, Lund University.
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| 17. |
- Petersson, Lena, 1968-, et al.
(författare)
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Implementering av artificiell intelligens (AI) : Ett projekt om hur AI förändrar information och kunskapspraktiker i hälso- och sjukvården
- 2023
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Ingår i: Program och abstrakt. - Lund : Lunds universitet. ; , s. 53-53
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Konferensbidrag (refereegranskat)abstract
- Vi kommer att presentera ett nytt forskningsprojekt vid Högskolan i Halmstad med finansiering från Vetenskapsrådet, som förväntas bidra med kunskap om hur arbetets gränser i hälso- och sjukvården förändras vid implementering av artificiell intelligens (AI). Hälso- och sjukvården i Sverige brottas idag med utmaningar kring att klara av att fördela resurser där de gör mest nytta, säkerställa kvalitet i den vård som ges och att ställa om till en mer digitaliserad vård som sker i mer samproduktion mellan vårdpersonal och patienter. Ett teknikområde som förväntas kunna bidra till att lösa dessa utmaningar är AI, men forskning har visat att det finns många hinder för att lyckas med att införa och använda AI-applikationer inom hälso- och sjukvården. Hälso- och sjukvårdspersonal har en viktig roll att spela i förändringsarbete inom vården och AI-applikationer kan komma att konkurrera med det monopol på kunskap i förhållande till hälsa och behandling av sjukdomar som vårdpersonalen erhållit genom lång akademisk utbildning, träning och praktisk erfarenhet. Det övergripande syftet med forskningsprojektet ImpAI är att generera ny kunskap om implementering och användning av AI-applikationer i rutinsjukvård och hur professionella roller kan fungera som barriärer under implementeringsprocessen. Det teoretiska ramverket består av professionsteori med fokus på tillit och arbetets gränser samt implementeringsteori. Projektet bygger på olika case i form av AI-applikationer som implementeras under 2023–2024 i Region Halland, Sverige och mixad metod används vid processutvärderingen av dessa case. Resultatet kommer både att främja förståelsen för hur processer kan etableras vid införande av AI applikationer i hälso- och sjukvården och bidra med information om hur sådana processer kan bygga på hälso- och sjukvårdspersonalens kompetens och roller.
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| 18. |
- Petersson, Lena, 1968-, et al.
(författare)
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The implementation of AI in healthcare – implications for professional boundaries and different forms of boundary work
- 2022
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Konferensbidrag (refereegranskat)abstract
- A digital transformation of Swedish healthcare is currently taking place, and artificial intelligence (AI) is meant to solve many of the healthcare sector's challenges. We conducted 26 semi-structured interviews with healthcare leaders and 18 with healthcare managers and professionals. The result shows that the leaders, healthcare managers, and healthcare professionals describe different types of boundary work in regard to the implementation of AI.
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| 19. |
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| 20. |
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| 21. |
- Arvidsson, Linnea, et al.
(författare)
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Virtual Follow up After Distal Radius Fracture Surgery — Patient Experiences During the COVID-19 Pandemic
- 2023
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Ingår i: Journal of Patient Experience. - Thousand Oaks, CA : Sage Publications. - 2374-3735 .- 2374-3743. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- The majority of patients with a distal radius fracture (DRF) are elderly, a group known to experience difficulties with new technology, partly due to a low level of digital literacy. At the beginning of the coronavirus disease 2019 pandemic, during the spring 2020, patients that underwent DRF surgery had regular follow-ups replaced by video calls from their surgeon and physiotherapist. Afterward, patients answered questionnaires regarding health and digital literacy and took part in semistructured interviews regarding the experience of the virtual follow-up. By systemic text condensation, 2 major categories were identified: (1) The video call—new, but surprisingly simple: All but 1 found it easier than expected, and (2) Video calls—the patient's choice: All but 1 patient preferred video calls to physical visits for follow-up. This is the first mixed methods study to assess patients’ experiences of digital follow-up after DRF surgery. This study indicates that digital follow-up was highly appreciated, even among patients with low levels of digital literacy. Digital technologies must be made suitable even for patients with inadequate levels of digital literacy. © The Author(s) 2023.
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| 22. |
- Barth, Henrik, 1971-, et al.
(författare)
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Towards a Mass Customised Healthcare - Healthcareprofessionals Experience of AI
- 2024
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Konferensbidrag (refereegranskat)abstract
- A growing and aging population provides challenges for the healthcare sector, generating higher healthcare costs, and ineffective work process that results in long patient queues and problems with recruiting and retaining healthcare professionals. Artificial intelligence (AI) is considered as one means to provide efficient processes for healthcare professionals, e.g. in diagnostics and treatment recommendations. However, research has shown that there are many obstacles to successfully introducing and using AI applications in healthcare, especially by focusing on the organizational level. However, individual healthcare professionals have an important role to play in the transition towards information driven healthcare. Therefore, we address the healthcare professionals' perception of the usefulness and value of AI applications, as well as challenges and considerations of this new technology. The study is based on an exploratory approach with more than 350 healthcare professionals in Sweden, carried out beginning of 2024. The questionnaire includes perceptions of the use of AI and identifies potential challenges that need to be addressed. The respondents include doctors (92%) and nurses (8%). The sample consists of answers from 221 (62%) male and 136 (38%) female respondents. Most of the respondents work in public hospitals (54%) and health centers (20% public and 14% private). Several AI applications are used by healthcare professionals, spanning from administrative work reduction to new insights in the analysis of complex cases.Thematic analysis is conducted to create a model of perception of usefulness, values and problems (barriers). The analysis includes a stepwise analysis to identify patterns and themes.The results from the project provide insights into how the introduction of AI applications in healthcare changes the work of healthcare professionals and the perceived challenges that need to be addressed to improve their work by using AI. To some extent, implementation and use is based on healthcare professionals’ interest in using new advanced technology but for others the decision to adopt AI is primarily based on formal decisions within the organization. Respondents that have been using AI for at least six months, indicate AI supports decision making, with the main benefit consisting of a more effective and faster work process, while other respondents do not perceive any changes. A surprising result is that healthcare professionals have identified the possibility to test and evaluate new ideas and more complex cases. One interpretation is that AI has made the workload easier, which may allow for more innovative work. Another interpretation is that their experience-based knowledge is augmented by AI, and this makes it possible for them to handle more complex cases. However, others experience a learning paradox – challenging to find time and learn how to use the technology, while at the same time adopting by testing AI applications.Conclusions drawn from the ongoing study provide insights on the transformation phase towards implementing and using AI applications in healthcare.
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| 23. |
- Erlingsdóttir, Gudbjörg, et al.
(författare)
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A Theoretical Twist on the Transparency of Open Notes : Qualitative Analysis of Health Care Professionals’ Free-Text Answers
- 2019
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Ingår i: Journal of Medical Internet Research. - Toronto : J M I R Publications, Inc.. - 1438-8871. ; 21:9
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Tidskriftsartikel (refereegranskat)abstract
- Background: The New Public Management movement strove for transparency so that policy makers and citizens could gain insight into the work and performance of health care. As the use of the electronic health record (EHR) started to diffuse, a foundation was laid for enhanced transparency within and between health care organizations. Now we appear to be experiencing a new kind of transparency in the health care sector. Many health care providers offer their patients online access to their EHRs (here referred to as Open Notes). The Open Notes system enables and strives for transparency between the health care organization and the patient. Hence, this study investigates health care professional (HCP) perceptions of Open Notes and deepens the understanding of the transparency that Open Notes implies.Objective: Based on two survey studies of HCP perceptions of Open Notes, this paper aims to deepen the academic writing on the type of transparency that is connected to Open Notes.Methods: HCPs in adult psychiatry in Region Skåne, Sweden, were surveyed before and after implementation of Open Notes. The empirical material presented consists of 1554 free-text answers from two Web surveys. A qualitative content analysis was performed.Results: The theoretically informed analysis pivots around the following factors connected to transparency: effectiveness; trust; accountability; autonomy and control; confidentiality, privacy, and anonymity; fairness; and legitimacy. The results show that free-text answers can be sorted under these factors as trade-offs with transparency. According to HCPs, trade-offs affect their work, their relationship with patients, and not least, their work tool, the EHR. However, since many HCPs also state that they have not met many patients, and in some cases none, who have read their EHRs, these effects seem to be more connected to the possibility (or threat) of transparency than to the actual effectuated transparency.Conclusions: The implementation (or reform) of Open Notes is policy driven while demanding real-time transparency on behalf of citizens/patients and not the authorities, which makes this particular form of transparency quite unique and interesting. We have chosen to call it governed individual real-time transparency. The effects of Open Notes may vary between different medical specialties relative to their sensitivity to both total and real-time transparency. When HCPs react by changing their ways of writing notes, Open Notes can affect the efficiency of the work of HCPs and the service itself in a negative manner. HCP reactions are aimed primarily at protecting patients and their relatives as well as their own relationship with the patients and secondly at protecting themselves. Thus, governed individual real-time transparency that provides full transparency of an actual practice in health care may have the intended positive effects but can also result in negative trade-offs between transparency and efficiency of the actual practice. This may imply that full transparency is not always most desirable but that other options can be considered on a scale between none and full transparency.© Gudbjörg Erlingsdóttir, Lena Petersson, Karin Jonnergård. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 25.09.2019.
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| 24. |
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| 25. |
- Erlingsdottir, Gudbjörg, et al.
(författare)
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Employees’ work environment and patients’ rights, conflicting responsibilities when implementing patient online access to their EHR
- 2016
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Konferensbidrag (refereegranskat)abstract
- This paper is based on an interview study examining the implementation of the eHealth service patient online access to electronic health records in two county councils in Sweden. Our aim is to present and discuss the two councils’ implementation processes and the differences between them, with particular focus on the implementers’ consideration of caregivers’ work environment. A theoretical aim is to shed light on the complicated situation that arises when a county council is responsible for both the implementation of an eHealth service and the effects it has on the work environment of the employees (professionals). The results from the total of 16 semi-structured indepth interviews show that the two county councils differ in the following areas: 1) whether the implementation is interpreted as a threat for the work environment; 2) who the interviewees consider as responsible for the work environment; and 3) if it was considered important to build trust between the implementers (the county councils) and the professionals – and how this trustbuilding was accomplished. It is concluded that the differences between the two implementation processes was due in part to the difference in how the service was framed and labelled in the two respective county councils, and that one of the county councils has encountered difficulties in taking dual responsibility towards both patients and the work environment of the employees. This implies, according to Bovens’ (1998) classification, that one of the county councils takes active responsibility for the work environment while the other takes passive responsibility for the work environment.
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