| 1. |
- Berg, Marie, 1955, et al.
(författare)
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Web-Based Intervention for Women With Type 1 Diabetes inPregnancy and Early Motherhood : Critical Analysis of Adherenceto Technological Elements and Study Design
- 2018
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 20:5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Numerous Web-based interventions have been implemented to promote health and health-related behaviors inpersons with chronic conditions. Using randomized controlled trials to evaluate such interventions creates a range of challenges, which in turn can influence the study outcome. Applying a critical perspective when evaluating Web-based health interventions is important.Objective: The objective of this study was to critically analyze and discuss the challenges of conducting a Web-based health intervention as a randomized controlled trial.Method: The MODIAB-Web study was critically examined using an exploratory case study methodology and the framework for analysis offered through the Persuasive Systems Design model. Focus was on technology, study design, and Web-based support usage, with special focus on the forum for peer support. Descriptive statistics and qualitative content analysis were used.Results: The persuasive content and technological elements in the design of the randomized controlled trial included all four categories of the Persuasive Systems Design model, but not all design principles were implemented. The study duration was extended to a period of four and a half years. Of 81 active participants in the intervention group, a maximum of 36 women were simultaneously active. User adherence varied greatly with a median of 91 individual log-ins. The forum for peer support was used by 63 participants. Although only about one-third of the participants interacted in the forum, there was a fairly rich exchange of experiences and advice between them. Thus, adherence in terms of social interactions was negatively affected by limited active participation due to prolonged recruitment process and randomization effects. Lessons learned from this critical analysis are that technology and study design matter and might mutually influence each other. In Web-based interventions, the use of design theories enables utilization of the full potential of technology and promotes adherence. The randomization element in a randomized controlled trial design can become a barrier to achieving a critical mass of user interactions in Web-based interventions, especially when social support is included. For extended study periods, the technology used may need to be adapted in line with newly available technical options to avoid the risk of becoming outdated in the user realm, which in turn might jeopardize study validity in terms of randomized controlled trial designs.Conclusions: On the basis of lessons learned in this randomized controlled trial, we give recommendations to consider when designing and evaluating Web-based health interventions.
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| 2. |
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| 3. |
- Midlöv, Patrik, et al.
(författare)
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PERson-centredness in hypertension management using information technology (PERHIT): a protocol for a randomised controlled trial in primary health care
- 2020
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Ingår i: Blood Pressure. - : TAYLOR & FRANCIS LTD. - 0803-7051 .- 1651-1999. ; 29:3, s. 149-156
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: For primary health care (PHC), hypertension is the number one diagnosis for planned health care visits. The treatment of high blood pressure (BP) and its consequences constitutes a substantial economic burden. In spite of efficient antihypertensive medications, a low percentage of patients reach a well-controlled BP. The PERson-centredness in Hypertension management using Information Technology (PERHIT) Study is a multicentre randomised controlled trial. PERHIT is designed to evaluate the effect of supporting self-management on systolic blood pressure by the use of information technology in Swedish primary health care. Materials and Methods: After inclusion, 900 patients from 36 PHC centres are randomised to two groups. In the intervention group, patients are provided with a self-management support system including a home-BP monitor and further requested to perform self-reports and measure BP every evening for eight consecutive weeks. In the control group, patients receive treatment as usual. Results: The primary outcome will be the change in systolic blood pressure in patients with hypertension. In addition, person-centredness, daily life activities, awareness of risk and health care costs will also be evaluated. Conclusion: The results of this randomised controlled trial with assessment of blood pressure and same-day self-reports will provide patients a tool to understand the interplay between blood pressure and lifestyle applicable to primary health care. The self-management support system may be of importance for improved adherence to treatment and persistence to treatment recommendations.
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| 4. |
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| 5. |
- Nilsson, Agneta, 1968, et al.
(författare)
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Improvisational Change Management in the Public Sector
- 2001
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Ingår i: In Proceedings of the 34th Annual Hawaii International Conference on Systems Science HICSS'34, IEEE CS Press, Maui, Hawaii..
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Konferensbidrag (refereegranskat)
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| 6. |
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| 7. |
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| 8. |
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| 9. |
- Andersson, Ulrika, et al.
(författare)
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Patients and Professionals as Partners in Hypertension Care: Qualitative Substudy of a Randomized Controlled Trial Using an Interactive Web-Based System Via Mobile Phone
- 2021
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 23:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: The use of technology has the potential to support the patient´s active participation regarding treatment of hypertension. This might lead to changes in the roles of the patient and health care professional and affect the partnership between them. Objective: The aim of this qualitative study was to explore the partnership between patients and health care professionals and the roles of patients and professionals in hypertension management when using an interactive web-based system for self-management of hypertension via the patient’s own mobile phone. Methods: Focus group interviews were conducted with 22 patients and 15 professionals participating in a randomized controlled trial in Sweden aimed at lowering blood pressure (BP) using an interactive web-based system via mobile phones. The interviews were audiorecorded and transcribed and analyzed using thematic analysis. Results: Three themes were identified: the technology, the patient, and the professional. The technology enabled documentation of BP treatment, mainly for sharing knowledge between the patient and the professional. The patients gained increased knowledge of BP values and their relation to daily activities and treatment. They were able to narrate about their BP treatment and take a greater responsibility, inspired by new insights and motivation for lifestyle changes. Based on the patient’s understanding of hypertension, professionals could use the system as an educational tool and some found new ways of communicating BP treatment with patients. Some reservations were raised about using the system, that it might be too time-consuming to function in clinical practice and that too much measuring could result in stress for the patient and an increased workload for the professionals. In addition, not all professionals and patients had adopted the instructions regarding the use of the system, resulting in less realization of its potential. Conclusions: The use of the system led to the patients taking on a more active role in their BP treatment, becoming more of an expert of their BP. When using the system as intended, the professionals experienced it as a useful resource for communication regarding BP and lifestyle. Patients and professionals described a consultation on more equal grounds. The use of technology in hypertension management can promote a constructive and person-centered partnership between patient and professional. However, implementation of a new way of working should bring benefits and not be considered a burden for the professionals. To establish a successful partnership, both the patient and the professional need to be motivated toward a new way of working.
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| 10. |
- Berg, Marie, 1955, et al.
(författare)
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Person-centered web support to women with type 1 diabetes in pregnancy early motherhood : the development process
- 2013
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Ingår i: Diabetes Technology & Therapeutics. - : Mary Ann Liebert. - 1520-9156 .- 1557-8593. ; 15:1, s. 20-25
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pregnancy and early motherhood are extraordinarily demanding periods for women with type 1 diabetes, who therefore need optimal support. This article describes the process of developing person-centered Web-based support for women with type 1 diabetes during the period of pregnancy through early motherhood. Important aspects of perrsoncenteredness are a broader scope of medicine, viewing the patient as a person, shared decision-making to accomplish a therapeutic alliance, and the role of documentation.Materials and Methods: A participatory design was used in the development process to capture the target group’s knowledge, experiences, and needs, and a systematic process map for Web-based support was used to describe the process.Results: Content and layout in the Web support were developed collaboratively by project managers, advisory and scientific reference groups, technical producers, and representatives for the target group. Based on needs assessment and evidence synthesis, three main components of complementary Web-based support were identified: (1) specific information about pregnancy, childbirth, and early motherhood in relation to type 1 diabetes; (2) a self-care diary, including a device for documenting and evaluating blood glucose levels, insulin doses, food intake, physical activities, and overall well-being; and (3) a forum for communication between women with type 1 diabetes in the childbearing period.Conclusions: Using a perspective of person-centered care, a participatory design and the process map were fruitful for developing person-centered Web support for self-care and self-learning. The developed Web support product will be evaluated in a randomized controlled trial and further developed based on this result.
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| 11. |
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| 12. |
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| 13. |
- Hallberg, Inger, 1956, et al.
(författare)
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Experiences, expectations and challenges of an interactive mobile phone-based system to support self-management of hypertension: patients’ and professionals’ perspectives
- 2018
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Ingår i: Patient Preference and Adherence. - : DOVE MEDICAL PRESS LTD. - 1177-889X. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: A well-controlled blood pressure (BP) reduces cardiovascular complications. Patient participation in care using technology may improve the current situation of only 13.8% of adults diagnosed with hypertension worldwide having their BP under control. Objective: The objective of this study was to explore patients’ and professionals’ experiences of and expectations for an interactive mobile phone-based system to support self-management of hypertension. Methods: The self-management system consists of: 1) a mobile phone platform for self-reports, motivational messages and reminders; 2) a device for measuring BP and 3) graphical feedback of self-reports. Patients diagnosed with high BP (n=20) and their treating professionals (n=7) participated in semi-structured interviews, after 8 weeks use of the system in clinical practice. Data were analyzed thematically. Results: The self-reporting of BP, symptoms, medication use, medication side effects, lifestyle and well-being was perceived to offer insight into how daily life activities influenced BP and helped motivate a healthy lifestyle. Taking increased responsibility as a patient, by understanding factors affecting one’s well-being, was reported as an enabling factor for a more effective care. Based on the experiences, some challenges were mentioned: for adoption of the system into clinical practice, professionals’ educational role should be extended and there should be a reorganization of care to fully benefit from technology. The patients and professionals gave examples of further improvements to the system, for example, related to the visualization of graphs from self-reports and an integration of the system into the general technical infrastructure. These challenges are important on the path to accomplishing adoption. Conclusion: The potential of a more autonomous, knowledgeable and active patient, through use of the interactive mobile system would improve outcomes of hypertension treatment, which has been desired for decades. Documentation and visualization of patients’ self-reports and the possibilities to communicate these with professionals may be a significant resource for person-centered care.
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| 14. |
- Hallberg, Inger, 1956, et al.
(författare)
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Phases in development of an interactive mobile phone-based system to support self-management of hypertension
- 2014
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Ingår i: Integrated blood pressure control. - : Dove Medical Press. - 1178-7104. ; 7, s. 19-28
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Tidskriftsartikel (refereegranskat)abstract
- Hypertension is a significant risk factor for heart disease and stroke worldwide. Effective treatment regimens exist; however, treatment adherence rates are poor (30%–50%). Improving self-management may be a way to increase adherence to treatment. The purpose of this paper is to describe the phases in the development and preliminary evaluation of an interactive mobile phone-based system aimed at supporting patients in self-managing their hypertension. A person-centered and participatory framework emphasizing patient involvement was used. An interdisciplinary group of researchers, patients with hypertension, and health care professionals who were specialized in hypertension care designed and developed a set of questions and motivational messages for use in an interactive mobile phone-based system. Guided by the US Food and Drug Administration framework for the development of patient-reported outcome measures, the development and evaluation process comprised three major development phases (1, defining; 2, adjusting; 3, confirming the conceptual framework and delivery system) and two evaluation and refinement phases (4, collecting, analyzing, interpreting data; 5, evaluating the self-management system in clinical practice). Evaluation of new mobile health systems in a structured manner is important to understand how various factors affect the development process from both a technical and human perspective. Forthcoming analyses will evaluate the effectiveness and utility of the mobile phone-based system in supporting the self-management of hypertension.
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| 15. |
- Hallberg, Inger, 1956, et al.
(författare)
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Supporting the self-management of hypertension: Patients’ experiences of using a mobile phone-based system
- 2016
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Ingår i: Journal of Human Hypertension. - : Springer Science and Business Media LLC. - 0950-9240 .- 1476-5527. ; 30, s. 141-146
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Tidskriftsartikel (refereegranskat)abstract
- Globally, hypertension is poorly controlled and its treatment consists mainly of preventive behavior, adherence to treatment and risk-factor management. The aim of this study was to explore patients’ experiences of an interactive mobile phone-based system designed to support the self-management of hypertension. Forty-nine patients were interviewed about their experiences of using the self-management system for 8 weeks regarding: (i) daily answers on self-report questions concerning lifestyle, well-being, symptoms, medication intake and side effects; (ii) results of home blood-pressure measurements; (iii) reminders and motivational messages; and (iv) access to a web-based platform for visualization of the self-reports. The audio-recorded interviews were analyzed using qualitative thematic analysis. The patients considered the self-management system relevant for the follow-up of hypertension and found it easy to use, but some provided insight into issues for improvement. They felt that using the system offered benefits, for example, increasing their participation during follow-up consultations; they further perceived that it helped them gain understanding of the interplay between blood pressure and daily life, which resulted in increased motivation to follow treatment. Increased awareness of the importance of adhering to prescribed treatment may be a way to minimize the cardiovascular risks of hypertension.
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| 16. |
- Josefsson, Ulrika, 1965, et al.
(författare)
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Person-centred web-based support - development through a Swedish multi-case study.
- 2013
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Ingår i: BMC medical informatics and decision making. - : Springer Science and Business Media LLC. - 1472-6947. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons' needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care.Methods/designThe research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described.
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| 17. |
- Lindén, Karolina, et al.
(författare)
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Ongoing research : a social and learning community to support self-management in childbearing women with type 1 diabetes
- 2013
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Ingår i: Medicine 2.0.. - London, United Kingdom. ; , s. 226-227
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Konferensbidrag (refereegranskat)abstract
- Background: Women with type 1 diabetes have a demanding life situation during the period of pregnancy and early motherhood. There is a need to develop person-centered models of care for women with type 1 diabetes in relation to pregnancy and early motherhood. People, who share a concern for something, learn together as they regularly interact. For example, people learn from each other as they discuss experiences, treatment and self-management issues in daily life. To empower women during with type 1 diabetes during pregnancy and in early motherhood, a website promoting self-management through a social and learning community has been developed.Objectives: To describe the design and content of a specially designed person-centered web support for women with type 1 diabetes during the period of pregnancy through early motherhood. This web-based support aims at improving the women’s self-management of diabetes and overall well-being.Methods: The web-based support has been developed through a participatory design involving different stakeholders such as health care professionals, mothers with type 1 diabetes, web designers and researchers. The project is under evaluation in a randomized controlled trial. Women with type 1 diabetes are randomized in early pregnancy to either usual care or web-based support in addition to usual care. All study participants are followed from baseline in early pregnancy to six months after childbirth.Results: The developed person-centered web-basedsupport consists of three complementary parts: 1) specific information about pregnancy, childbirth and early motherhood in relation to type 1 diabetes; 2) a self-care diary including a device for documenting and evaluating blood glucose levels, insulin doses, food intake, physical activities and overall well-being; and 3) a forum for communication between women with type 1 diabetes in the childbearing period. The support is developed for computer and mobile use.Conclusions: This website for self-care, self-learning and peer support is a person-centered and easy accessible service. Taking a person-centered approach means that the pregnant women with diabetes must be treated and supported in ways that allow them to be people rather than objectified as individuals with a chronic illness. The website can complement usual health care organizational arrangements and provides possibilities for documenting health and related issues. This social and learning community may strengthen self-care ability by empowering women with type 1 diabetes during a vulnerable period.
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| 18. |
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| 19. |
- Norén, Lars, 1955, et al.
(författare)
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Guides and an overflow of choices
- 2019
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Ingår i: Overwhelmed by overflows? How people and organizations create and manage excess (Eds. Barbara Czarniawska and Orvar Löfgren). - : Manchester University Press. - 9789198469813 ; , s. 151-169
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 20. |
- Norén, Lars, 1955, et al.
(författare)
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Promoting competition in Swedish primary care
- 2015
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Ingår i: Journal of Health Organization and Management. - 1477-7266. ; 29:1, s. 25-38
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Tidskriftsartikel (refereegranskat)abstract
- Purpose - This paper examines the role of accreditation documents in the competition based on provider quality in a quasi-market for primary healthcare. Design/methodology/approach - The paper uses a mixed-method research methodology to analyse two primary healthcare accreditation documents in two Swedish regions. Nineteen interviews were conducted with actors involved in the creation and use of such documents. Findings - This paper points to the crucial role of accreditation documents in the identification of quality differences that influence the competition in primary healthcare. This finding contrasts with the commonly held laissez-faire idea that competition causes providers to develop their own service concepts and where the invisible hand creates quality differences. The paper adds to the discussion with its detailed description of how accreditation documents create competition among primary healthcare providers through selection processes, quality differentiation, and ranking. Research limitations/implications - The paper does not explore quality differences in the medical treatment of patients in primary healthcare centres. Practical implications - The paper provides insights for politicians on how to use accreditation documents to control competition and regulate choice. Originality/value ¬- The paper takes an innovative approach to the examination of how accreditation documents increase the competition in primary healthcare choice.
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| 21. |
- Norén, Lars, 1955, et al.
(författare)
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The Internet web portal as an enrolment device
- 2005
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Ingår i: Czarniawska, Barbara & Hernes, Tor (eds.) Actor-Network theory and organizing. - : Liber & Copenhagen Business School Press, Malmö. - 9147074817 ; , s. 188-207
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 22. |
- Ranerup, Agneta, 1960, et al.
(författare)
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Actors and intentions in the development process of a mobile phone platform for self-management of hypertension
- 2015
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Ingår i: Informatics for Health and Social Care. - : Taylor & Francis. - 1753-8157 .- 1753-8165. ; 40:4, s. 299-318
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to enhance the knowledge regarding actors and intentions in the development process of a mobile phone platform for self-management of hypertension. Methods: Our research approach was a 14-month longitudinal “real-time ethnography” method of description and analysis. Data were collected through focus groups with patients and providers, patient interviews, and design meetings with researchers and experts. The analysis was informed by the concepts of actors and inscriptions in actor-network theory (ANT). Results: Our study showed that laypersons, scientific actors, as well as technology itself, might influence development processes of support for self-management of hypertension. The intentions were inscribed into the technology design as well as the models of learning and treatment. Conclusions: The study highlighted important aspects of how actors and intentions feature in the development of the mobile phone platform to support self-management of hypertension. The study indicated the multifacetedness of the participating actors, including the prominent role of technology. The concrete results of such processes included questions in the self-report system, learning and treatment models.
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| 23. |
- Ranerup, Agneta, 1960, et al.
(författare)
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Actors and Intentions in the Dissemination of Robotic Process Automation in Social Work.
- 2022
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Ingår i: Juell-Skielse, G., Lindgren, I., Åkesson, M. (eds): Service Automation in the Public Sector. Progress in IS.. - Cham : Springer. ; , s. 129-146, s. 129-146
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Bokkapitel (refereegranskat)abstract
- Automated decision-making is prevalent in numerous areas of the public sector. Based on the results of a qualitative, event-based study of how robotic process automation (RPA) is discussed and implemented in social work in Sweden, two questions are answered in this paper: What actors, intentions and network formations appear in the dissemination of RPA in the management of applications for social assistance in Sweden? What are the key, sometimes conflicting, intentions from a social work and a general public sector perspective? A spectrum of national, municipal and local actors—including technologies such as e-applications and RPA—are actively involved in the dissemination. A few important intentions are, for example, promoting the use of RPA, saving time and resources and answering the issue of ‘why’ RPA should be implemented. From a social work perspective, a key consideration and conflict relates to the core of social work, especially regarding the intention of helping people to become self-supporting. The more general considerations are related to intentions about implementing RPA to improve efficiency and effectiveness, as well as caseworkers’ discretion in view of laws regulating automated decision-making. Future research should focus on the actual effects of RPA on efficiency and effectiveness and caseworkers’ discretion in view of new laws and longer experiences with RPA
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| 24. |
- Ranerup, Agneta, 1960, et al.
(författare)
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An analysis of business models in Public Service Platforms
- 2016
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Ingår i: Government Information Quarterly. - 0740-624X. ; 33:1, s. 6-14
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Tidskriftsartikel (refereegranskat)abstract
- Public Service Platforms (PSPs) are a new type of technology platform. They are based in the philosophy of New Public Management (NPM) and support public services for citizens in quasi-markets. This article increases our understanding of the business models behind these PSPs in terms of their Value Propositions, structures, networks, and financing. We interviewed representatives from 14 PSP providers in four public sectors in Sweden: education, healthcare, elder care, and public pensions. We identified a “Traditional view” with its focus on public agencies and neutral information and an “Emerging view” that includes dialogues, user evaluations, long-term perspectives on choice, promotion of the ideal of choice, and self-promotion by public agencies. The article contributes to research with its empirical example of the digitalization of NPM and the underlying business logic of PSPs.
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| 25. |
- Ranerup, Agneta, 1960, et al.
(författare)
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Automated decision-making, discretion and public values: a case study of two municipalities and their case management of social assistance
- 2023
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Ingår i: European Journal of Social Work. - : Informa UK Limited. - 1369-1457 .- 1468-2664. ; 26:5, s. 948-962
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Tidskriftsartikel (refereegranskat)abstract
- Our aim is to increase knowledge about discretion and automated decision-making (ADM) in social work based on an approach that brings forward the role of humans and technologies and the resulting public values. This approach is applied to a case study of two Swedish municipalities and their social assistance case management. Our research questions are twofold: (1) How do humans and technologies appear in decisions about social assistance? and (2) How do they influence digital discretion and the resulting public values? A case management process with human actors (caseworkers and clients) and non-human actors (case management systems, e-applications, robotic process automation and algorithms) is used, influencing the digital discretion of caseworkers and the resulting ethical, democratic and professional values. Digital discretion is not dichotomous but, rather, related to a repertoire of technologies, their design and their use in a routine that ADM is a part of. The interaction with clients may be considered an important rationale for ADM itself. There is a necessary difference in weight between public values related to more straightforward (an ‘improved’ process enabling professional values) and complicating factors (distrust between caseworkers and the unwanted use of information technology).
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| 26. |
- Ranerup, Agneta, 1960
(författare)
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Can Internet Improve Democracy in Local Government?
- 1998
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Ingår i: PDC 98 Proceedings of the Participatory Design Conference Seattle, Washington, USA Nov 1998, eds. R. Henderson Chatfield, S. Kuhn & M. Muller.
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Konferensbidrag (refereegranskat)
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| 27. |
- Ranerup, Agneta, 1960, et al.
(författare)
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Can Portals Calculate? A Study of Public e-Services in Educational Markets
- 2007
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Ingår i: International Journal of Public Information Systems. - Sundsvall : Mittuniversitetet. ; 3:3, s. 117-134
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Tidskriftsartikel (refereegranskat)abstract
- The relationship between the individual and the state is more often than previously mediated by public e-services. An emergent phenomenon in this respect is the various forms of devices supporting choice of education that are provided through portals. The question dealt with in this article is: How do portals containing different devices support choice in educational markets? Two portals run by national public authorities in Sweden concerned with educational issues have been chosen as material for the analysis. A first conclusion is that the devices integrate a sequence of advanced calculations, which aim to contribute to a choice of education. Secondly, we can distinguish between a mechanical and a pedagogical character of integration. A third conclusion is that the devices connect the objectives of government authorities with choices in educational markets and are therefore part of public policy implementation. Finally, it is argued that the seemingly simple procedures for calculation might affect people’s entire lives, a fact which adds an ethical dimension to the design of this kind of public e-services.
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| 28. |
- Ranerup, Agneta, 1960
(författare)
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Constructing Consumers in Healthcare: A Comparative Study of National Public Portals in Scandinavia and the UK
- 2008
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Ingår i: ECIS 2008. ; Galway, Irland, June 9-11 2008
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Konferensbidrag (refereegranskat)abstract
- The patients of today are more often than previously said to act as consumers towards healthcare. However, the definition of the concept of consumer is often unclear and not based on theory. The present paper applies a theoretical framework that emphasizes the role of technological devices for the construction of calculating consumers as outlined by Michel Callon. The focus is on to what extent technological devices on national public healthcare portals in the UK and in three Scandinavian countries equip patients to act as consumers towards healthcare. It is concluded that Norway’s technological devices to some extent and the UK and Danish devices to a greater extent equip patients to act as consumers. Sweden’s technological repertoire when it comes to public national healthcare portals is to date much more limited. The Danish and UK devices showing quality indicators stand out as cutting edge facilities. The UK device Choose and Book offering connections between selected hospitals and a device for booking appointments is a further example. The applied theoretical perspective enhances the understanding of fundamental design issues related to the role of technology for the individual in forming his or her relationship towards healthcare.
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| 29. |
- Ranerup, Agneta, 1960, et al.
(författare)
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Consumerism Revisited: The Emergent Roles of New Electronic Intermediaries between Citizens and the Public Sector
- 2003
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Ingår i: Information Polity. - 1570-1255. ; 8:3/4, s. 167-180
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Tidskriftsartikel (refereegranskat)abstract
- An important transformation of the welfare state of today is the marketisation reforms many times strengtening the role of citizens preferences in the choice of public services. Another important transformation is the new electronic interm iaries between citizens and the public sector that have emerged during the last few years. This paper focuses on intermediaries between citizens and the public sector when viewed in a quasi-market perspective. Our object of study are Swedish patients online communities and public portals for educational opportunities representing different forms of ownership. The aim of the paper is to problematize the capacities to act that citizens are provided with by means of the new electronic intermediaries. We argue that the forms of citizns influence induced by th marketisation reforms and the new electronic intermediaries provide capacities to act that previously only to a limited extent have been discussed in a systematic manner. In this paper the supplemnetary role of consumerist activities compared with e.g. representative and deliberative democracy is acknowledged.
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| 30. |
- Ranerup, Agneta, 1960, et al.
(författare)
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Decision Support Systems for Choosing a Primary Health Care Provider in Sweden
- 2012
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991. ; 86:3, s. 342-347
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate how patients are supported with information and other forms of Web-based decision support for making an informed choice of a primary health care provider. Methods: The article is based on a comparative case study of recently developed tools provided by Web portals in Sweden (one national, three regional). The theoretical framework for analysis is the general calculation model, including the steps of isolating, examining, and ranking available options. Results: The provision of information and other forms of support is reasonable when it comes to isolating a particular alternative or presenting a general view of alternatives. As for examining and ranking, one regional system and one national system offer support based on information from patient surveys and waiting times, and one regional system offers support based on provider competencies. Conclusion: One design alternative is to represent the opinions of patients about care centers, another is to represent the characteristics of care centers, and a third is to combine the two. The general calculation model is relevant as a framework for analysis from a practical as well as a theoretical viewpoint. Practical implications: The study provides practical examples of decision support for patient choice in primary health care.
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| 31. |
- Ranerup, Agneta, 1960
(författare)
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Decision Support Systems for Public Policy Implementation The Case of Pension Reform
- 2008
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Ingår i: Social Science Computer Review. - : SAGE Publications. - 0894-4393 .- 1552-8286. ; 26:4, s. 428-445
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Tidskriftsartikel (refereegranskat)abstract
- This article argues that the Internet not only serves as a basis for public service delivery but features in public policy implementation, with the specific aim of supporting the individual's decisions in educational policy, labor market policy, and pension policy. The present study is based on the actor-network theory and illustrates the process during which a decision support system (DSS), provided via the Internet, is part of public policy implementation, with a focus on pension policy and the choice of premium pension funds. The idea of supporting choice via a DSS was supported by many actors-albeit to a lesser degree by citizens'-active use. Technology has developed from providing information and facilities for changing funds online into offering a DSS for advanced financial decisions. A final conclusion is that there are two ways of supporting citizens in choosing funds: the provision of a DSS and simplifying the available options.
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| 32. |
- Ranerup, Agneta, 1960
(författare)
-
Designing Judgement Devices: Information Needs in the Choice of Primary Healthcare Provider
- 2012
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Ingår i: 9th Scandinavian Workshop on E-Government, Feb 9-10, Copenhagen.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Choice of provider in public healthcare is introduced in many countries. The context of study was primary care in Sweden. The aims with the study were: 1) To investigate patients’ needs of information as an input to the design of technology for supporting the choice of healthcare provider in primary care. 2) To apply a theoretical framework with a focus on the activity of examining qualities of healthcare providers and the role of technical devices herein. The research method used was an e-panel (n=990). Information about access, reception and doctors’ competence were seen as most important. The women expressed a higher need of information than men, whereas the differences among age groups were less clear-cut. The result and the applied theoretical framework contribute to the design of technology to support choice in primary care.
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| 33. |
- Ranerup, Agneta, 1960, et al.
(författare)
-
Digital Discretion: Unpacking Human and Technological Agency in Automated Decision Making in Sweden's Social Services
- 2020
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Ingår i: Social Science Computer Review. - : SAGE Publications. - 0894-4393 .- 1552-8286. ; 40:2
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Tidskriftsartikel (refereegranskat)abstract
- The introduction of robotic process automation (RPA) into the public sector has changed civil servants' daily life and practices. One of these central practices in the public sector is discretion. The shift to a digital mode of discretion calls for an understanding of the new situation. This article presents an empirical case where automated decision making driven by RPA has been implemented in social services in Sweden. It focuses on the aspirational values and effects of the RPA in social services. Context, task, and activities are captured by a detailed analysis of humans and technology. This research finds that digitalization in social services has a positive effect on civil servants' discretionary practices mainly in terms of their ethical, democratic, and professional values. The long-term effects and the influence on fair and uniform decision making also merit future research. In addition, the article finds that a human-technology hybrid actor redefines social assistance practices. Simplifications are needed to unpack the automated decision-making process because of the technological and theoretical complexities.
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| 34. |
- Ranerup, Agneta, 1960, et al.
(författare)
-
Discretion, Automated Decision-Making and Public Values. : Background and Test of an Approach for Unpacking Human and Technological Agency
- 2022
-
Ingår i: Electronic Government. EGOV 2022. Lecture Notes in Computer Science. - Cham : Springer International Publishing. - 9783031150869 - 9783031150852 ; 13391, s. 291-306
-
Bokkapitel (refereegranskat)abstract
- This study aims to develop a theoretical and analytical approach for studying discretion, automated decision-making (ADM) and the consequential public values. This is achieved through our proposed approach, an overview of literature and an empirical test. The context of our empirical test is decisions made about economic support in social work. The research questions are as follows: 1) What are the relevant components in a theoretical and analytical approach with this specific aim? 2) How does human, non-human and joint, ‘hybrid’, agency influence digital discretion and the consequential public values in social work? 3) What are the usefulness and prospective problems with the approach? Our approach enhances the understanding of the ground for discretion in ADM, which is seen as an emergent routine in the form of knowledge about process, and the details of human and non-human actors involved in relation to consequential public values. To develop its usefulness, the approach should primarily be applied in multiple case studies of ‘ín-between’ contexts, such as social work, to generate a theory of the role of human and non-human agency in the consequential public values of ADM.
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| 35. |
- Ranerup, Agneta, 1960, et al.
(författare)
-
Discretion, automated decision-making and their influence on public values: Background and test of unpacking human and technological agency
- 2022
-
Ingår i: 19th Scandinavian Workshop on E-government January 26-27. - University of Agder.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this paper is to further develop a theoretical and analytical approach for studying discretion, automated decision-making and public values. We do this through an overview of literature and an empirical test of the usefulness of our approach of unpacking human and non-human actors. The context of study is decisions about economic support in social work. The research questions that express the core of our approach are: How does human, non-human and joint, ´hybrid´ agency appear as well as influence digital discretion in social work? And; what are their specific influence on a selection of Ethical, Democratic and Professional public service values and associated IT-use and purposes? Our approach served to enhance the understanding of the ground for discretion in automated decision-making seen as an emergent routine in form of detailed attention to the process, involved technologies and humans, and resulting public values. The approach should be applied in research in form of multiple case studies in order to further develop its usefulness in studies that demand rich empirical accounts as well as a theoretical focus on multiple forms of agency and public values.
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| 36. |
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| 37. |
- Ranerup, Agneta, 1960
(författare)
-
Electronic Government as a combination of human and technological agency:Testing the principle of symmetry
- 2007
-
Ingår i: Information Polity. ; 12
-
Tidskriftsartikel (refereegranskat)abstract
- It is argued here that Electronic Government (E-Gov) research to date has misconceived humans and technology, tending to give primacy to one or the other, but failing to grapple with their interaction. The present paper tries to remedy this by introducing an Actor-Network Theory (ANT) inspired approach in which the principle of symmetry is applied to an empirical case. This perspective emphasizes agency as a combination of actions of humans and technology, both separately and in conjunction (a “hybrid”). The research context is a computerized decision support (DSS) for portfolio management in the premium pension system in Sweden. The study shows that a system incorporating humans in conjunction with the DSS (a “hybrid”) is able to make advanced economic decisions in line with pension policy by incorporating the preferences and characteristics of humans as well as the capabilities of technology. From a more general perspective, E-Gov is discussed today as a way of extending the hybridization of society, which is becoming an increasingly important component of the state’s relationship with its citizens. The paper also discusses methodological implications, most importantly how to represent technology in a symmetrical analysis and how to avoid excessive detail in reporting.
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| 38. |
- Ranerup, Agneta, 1960
(författare)
-
Electronic Markets Connecting Citizens to Pension Reform
- 2006
-
Ingår i: Electronic Markets. - 1019-6781. ; 16:4, s. 282-291
-
Tidskriftsartikel (refereegranskat)abstract
- This study argues that Electronic Markets (EM) are not only used by public agencies for service delivery, but also feature in attempts to influence citizens to behave in line with public objectives like pension reform. The purpose of this paper is to contribute to e-government research by providing experiences and perspectives that go beyond the dominant paradigm of transactions. The aim is to study attempts to connect citizens to pension reform through electronic markets. The study applies the theoretical concept of enrolment, which emanates from Actor-Network Theory. This concept refers to a situation where some actors use technological devices to try and make other actors to behave according to certain objectives. Based on a case study of pension reform in Sweden, which includes two different EMs, a broad analysis is made of the existing objectives and technological devices. The conclusion is that there are several important objectives: to provide services in line with the 24/7 ideal for self-service; to accomplish an active choice of premium pension funds; to improve knowledge about all pension sources; and to improve the quality of the individual’s choice of funds. Different devices incorporated into the EMs were identified that had the intention of enrolling or connecting citizens to all of these objectives, thus demonstrating an important element in public policy implementation in pension reform.
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| 39. |
- Ranerup, Agneta, 1960, et al.
(författare)
-
Enrolling citizens as informed consumers in quasi-markets
- 2019
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Ingår i: Information Technology and People. - 0959-3845. ; 32:6, s. 1517-1535
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Many countries today, especially in Europe, provide publicly funded public services in quasi-markets. As these markets commercialize, agencies of various types are providing technologies that support citizens’ choice of services. Citizens’ use of technologies for service provision is studied as e-government under labels of channel management, e-service uptake or adoption. In contrast, by using actor–network theory (ANT), the purpose of this paper is to focus on the marketing devices that are used to enroll citizens to choose technologies in a context with large penetration of quasi-market arrangements. Design/methodology/approach Based on a Swedish case study, this paper uses qualitative data from 11 occurrences of technologies to support citizens’ choice (“market devices”) in education, healthcare and public pension in an analysis of the means taken (“marketing devices”) to increase their use. The study formulates a tentative typology of these devices. Findings The marketing devices are intended to attract citizens’ attention to the possibility of choice (e.g. catalogs, postcards and commercials), invite interaction (e.g. various social media platforms), improve the technological support in line with user needs (e.g. user participation in development), increase visibility of technological support (e.g. search optimization) or directly connect citizens to technological support (e.g. via links). Originality/value The paper contributes to e-government research through a typology of means taken to increase citizens’ technology use based on selected concepts from ANT, and to a discussion of technologies and humans.
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| 40. |
- Ranerup, Agneta, 1960
(författare)
-
Enrolling Local Strategic Actors in Public Portal Development
- 2011
-
Ingår i: Jannssen, M., Scholl, H., Wimmer, M., Tan, Y-H (Ed.) Electronic Government. 10th IFIP WG 8.5 International Conference, EGOV 2011, Delft, The Netherlands, August/September 2011, Proceedings.
-
Konferensbidrag (refereegranskat)abstract
- This paper focuses on the seemingly routine but essential aspects of network formation by actors in an E-government context. A qualitative case study is used to explore portal development in public healthcare. The theoretical framework applied is Actor-Network Theory (ANT). The research question is: What factors contribute to the enrolment of strategic local actors in technology development in E-government? The results of the study show that the basic functionalities are of strategic importance for the enrolment of local actors in the portal development and its use. These functionalities act as enrolment devices. In complex environments, critical success factors for network formation require local support based on present usefulness of the functionalities and on long-term project organization that safeguards their future development.
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| 41. |
- Ranerup, Agneta, 1960, et al.
(författare)
-
How are citizens’ public service choices supported in quasi-markets?
- 2015
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Ingår i: 12th Scandinavian Workshop on E-government (SWEG 2015), Copenhagen, Denmark, 3-4 February 2015..
-
Konferensbidrag (refereegranskat)abstract
- Many countries have introduced quasi-market reforms that enable citizens’ choice in education, healthcare, and other public services. The research question in this paper is the following: How can Web-based decision support enhance citizens’ ability to make informed/calculated public service choices in quasi-markets? In the theory section, the paper focuses on how decision support design contributes to citizens’ ability to make informed/calculated choices. A case study, set in Sweden, explores 14 cases of decision support in education, healthcare, elder care, and the public pension system. Decision support is most evident in the area of education, but decision support is found in the other areas as well. In most cases, the support consists of information on the right of choice and instructions on how to search among alternatives. Many areas permit direct comparisons, but some areas only permit more indirect comparisons. All 14 cases explain how to make a choice, but only a few cases offer a ranking device. The decision support for choice is inconsistent with the theoretical model of informed/calculated choice in some aspects despite the trend toward greater consistency with the model. Our results call for a critical discussion of citizens as consumers or customers in their relationship with public services.
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| 42. |
- Ranerup, Agneta, 1960, et al.
(författare)
-
How are citizens´public service choices supported in quasi-markets?
- 2015
-
Ingår i: International Journal of Information Management. - : Elsevier BV. - 0268-4012. ; 35:5, s. 527-537
-
Tidskriftsartikel (refereegranskat)abstract
- Many countries have introduced quasi-market reforms that enable citizens’ choice in education, healthcare, and other public services. The research question in this paper is the following: How can Web-based decision support help citizens to make calculated public service choices in quasi-markets? In the theory section, the paper focuses on how decision support design helps citizens make such choices as they isolate, examine, and rank alternatives. A case study, set in Sweden, explores 14 cases of decision support in education, healthcare, elder care, and the public pension system. Decision support is most evident in the area of education, but decision support is found in the other areas as well. In most cases, the support consists of information on the right of choice and instructions on how to search among alternatives. Many areas permit direct comparisons, but some areas only permit more indirect comparisons. All 14 cases explain how to make a choice, but only a few cases offer a ranking device. The decision support for choice is inconsistent with the theoretical model of calculated choice in all aspects despite the trend toward greater consistency with the model. Our results call for a critical discussion of technology design that aids citizens as consumers or customers in their relationship with public services.
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| 43. |
- Ranerup, Agneta, 1960
(författare)
-
ICT and discretion: An “up-to-date” view of what we want to know and how it can be studied
- 2023
-
Ingår i: Presented at 20th Scandinavian Workshop on E-Government (SWEG): From Government automation to AI, 1-2 February, 2023, Örebro University..
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The discretion of street-level bureaucrats is increasingly affected by public sector digitalisation. The aim of this study was to provide a scoping review with “state of the art” of research about information and communication technology (ICT) and discretion for the period January 2017–October 2022. The specific emphasis was on the methodologies used in research targeting ICT and discretion to provide ideas for future research. Street-level bureaucrats’ managing and copying, surveys of their attitudes and the more direct influence of ICT on discretion and literature reviews in various contexts often related to public values were common themes in research. A repertoire of research approaches was used: case studies with or without empirical data, more and less structured literature reviews, surveys with or without experiments and document analyses. In contrast to an oft-cited literature review of digital discretion from 2018, the far most common types of technology were artificial intelligence. A number of approaches for describing technology were often based on sociotechnical theories or similar. Few studies provided detailed descriptions of the more specific role of technology. However, inspiring examples were found of how to bring forward aspects of the full decision process or the infrastructure with all the appearing technologies. This result could serve as an inspiration for reflections about what we should describe and what we should want to understand in studies about ICT and discretion, as well as to highlight gaps in research. Important examples are the ´design dimension´ of discretion both in terms of the being specific about the full repertoire of the appearing technologies and the humans that influence the design. A critical mass of studies with more detailed descriptions of technologies is needed to generate a theoretical understanding.
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| 44. |
- Ranerup, Agneta, 1960
(författare)
-
In What Ways does Web Technology Support the Individual in Choice Reforms in Healthcare?
- 2008
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Ingår i: International Journal of Healthcare Information Systems and Informatics. ; 3:2, s. 48-68
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this paper is to evaluate the provision of Web support in choice reforms in health care in Norway, Denmark, and Sweden. Two main issues are investigated: (1) What institutional frameworks for choice in health care exist, and how is the exercise of choice supported by Web technology in these countries? (2) As a consequence of this, what roles of the individual are mediated by this technology? The present study provides a critical analysis of current technologies for providing information about health care. It is concluded that in Norway the individual is equipped to be a reasonably informed consumer, customer, and citizen. A similar situation exists in Denmark, but here the consumer role is even more prominent. In Sweden, there has been little technological support for these roles, but recently national actors have initiated a project aimed at creating a national portal for public health care.
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| 45. |
- Ranerup, Agneta, 1960
(författare)
-
Internet-Based Guidance in Quasi-Markets for Education in Sweden
- 2004
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Ingår i: International Journal for Educational and Vocational Guidance. ; 4:1, s. 43-60
-
Tidskriftsartikel (refereegranskat)abstract
- This paper presents some recent Swedish experiences of how publicly financed Internet portals are used as a means of providing guidance on educational issues. The paper analyses the role of technology, information and further support to guidance seekers, with special reference to their role in the development of quais-markets in education in Sweden. The author concludes that in quasi-markets Internet-based guidance can assume a twofold role: first as a tool for providing guidance according to traditional views; and secondly, as an electronic intermediary and market-maker. The quasi-market arrengements in Sweden cover primary, lower and upper secondary forms of education, which gives the Swedsih experiences particular values as a basis for discussing the role of Internet-based guidance in quasi-markets.
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| 46. |
- Ranerup, Agneta, 1960
(författare)
-
Internet-enabled applications for local government democratisation: contradictions of the Swedish experience
- 1999
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Ingår i: Reinventing government in the information age, ed. R. Heeks. - London : Routledge. ; , s. 177-193
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- This chapter evaluates a Swedsih example of using Internet-enabled applications - especially the World Wide Web - as a link between citizens and local government and, henve, as a component of democratisation processes in public sector reform. After reviewing more general experiences, the chapter describes a project in which the Web was used bly local government in three districts of Göteborg. In evaluating this project, a set of contradictions are found that represent tensions or conflicts or opposing views related to the use of Internet-enabaled applications in government. Recommendations are made that address the contradictions. However, while the contradictions remain, they are likely to constrain the contribution of the Internet to public sector reform.
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| 47. |
- Ranerup, Agneta, 1960, et al.
(författare)
-
Mastery and Autonomy in Medication with a Mobile Self-report System: A Project in Action.
- 2012
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Ingår i: Persuasive 2012. Linköping June 6-8..
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Konferensbidrag (refereegranskat)abstract
- The overall aim of this research program is to design and examine if a mobile phone-based self-report system can be used to a) mediate knowledge about hypertension b) improve adherence to antihypertensive treatment and c) increase patient participation and autonomy
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| 48. |
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| 49. |
- Ranerup, Agneta, 1960
(författare)
-
On-line discussion forums in a Swedish local government context
- 2000
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Ingår i: Community informatics: enabling communities with information and communicationns technologies, ed. M. Gurstein. - Hershey : idea Group Publishing. - 1878289691 ; , s. 359-379
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- This text decsribes experiences of four on-line discussion forums that are used in a Swedish local government context. The main issue is how aspects such as the implementation of the forums, functional features of the forums, and activities to increase access to Internet affect the on-line debate. Furthermore, the debate in the on-line forums is evaluated against the ideal of deliberative democracy. Lastly, three strategies for how the amount of of debate in the on-line forums might be incrased are outlined. One strategy would be to provide citizen groups with access to technology in order to involve them in the forum and the local government network as such. Another strategy would be to welcome a completely open debate in the forums, in the hope of getting a discussion that also includes issues that are of relevance to local government. Yet another strategy would be to more seriously involve local politicians in the discussion. This group seems to be of stsrategic importance when aiming at democractic effects of on-line forums.
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| 50. |
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