| 1. |
- Andersson, Susanne, 1957-, et al.
(author)
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Experiences of a Novel Structured Foot Examination Form for Patients With Diabetes From the Perspective of Health Care Professionals : Qualitative Study
- 2023
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In: JMIR nursing. - : JMIR Publications. - 2562-7600. ; 6
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Journal article (peer-reviewed)abstract
- BACKGROUND: Diabetes is a growing threat to public health, and secondary diseases like foot complications are common. Foot ulcers affect the individual's quality of life and are a great cost to society. Regular foot examinations prevent foot ulcers and are a recommended approach both in Sweden and worldwide. Despite existing guidelines, there are differences in the execution of the foot examination, which results in care inequality. A structured foot examination form based on current guidelines was developed in this study as the first step toward digitalized support in the daily routine, and was validated by diabetes health care professionals.OBJECTIVE: The study aimed to validate a structured foot examination form by assessing health care professionals' experiences of working with it "foot side" when examining patients with diabetes.METHODS: Semistructured interviews were held in a focus group and individually with 8 informants from different diabetes professions, who were interviewed regarding their experiences of working with the form in clinical practice. The users' data were analyzed inductively using qualitative content analysis. The study is part of a larger project entitled "Optimised care of persons with diabetes and foot complications," with Västra Götaland Region as the responsible health care authority, where the results will be further developed.RESULTS: Experiences of working with the form were that it simplified the foot examination by giving it an overview and a clear structure. Using the form made differences in work routines between individuals apparent. It was believed that implementing the form routinely would contribute to a more uniform execution. When patients had foot ulcers, the risk categories (established in guidelines) were perceived as contradictory. For example, there was uncertainty about the definition of chronic ulcers and callosities. The expectations were that the future digital format would simplify documentation and elucidate the foot examination, as well as contribute to the accessibility of updated and relevant data for all individuals concerned.CONCLUSIONS: The foot examination form works well as a support tool during preventive foot examination, creates a basis for decision-making, and could contribute to a uniform and safer foot examination with more care equality in agreement with current guidelines.TRIAL REGISTRATION: ClinicalTrials.gov NCT05692778; https://clinicaltrials.gov/ct2/show/NCT05692778.
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| 2. |
- Barsaum, Peter, et al.
(author)
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Internet of Things Technology for Remote Healthcare : A Pilot Study
- 2016
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In: Proceedings from The 14th Scandinavian Conference on Health Informatics 2016. - Linköping : Linköping University Electronic Press. - 9789176857762 ; , s. 43-48
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Conference paper (other academic/artistic)abstract
- One of the latest trends in health informatics is Internet of Things (IoT). IoT consists of various types of technical objects connected to Internet and/or connected to each other, cooperating to reach a common goal. This pilot study explores how chronic patients, potential patients and healthcare personnel (n=100) perceive sensors and implanted sensors as two examples of IoT in remote healthcare. Data was collected through an acceptability questionnaire based on the Unified Theory of Acceptance and Use of Technology (UTAUT) framework using criteria as: performance expectancy; effort expectancy; attitude towards technology; and social influence. The pilot result indicated e.g. a strong acceptance of implants and that external sensors in a treatment requires further work. Differences between men and women were found: acceptance of sensors was preferred by women, and implants by men. In conclusion, IoT could be used to enhance person-centered healthcare, aiming to better engage patients in their treatment, rather than being a passive recipient of a medical intervention.
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| 3. |
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| 4. |
- Blusi, Madeleine, et al.
(author)
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Test av användbarheten hos innovationen TENA Identifi på Viktoriagården i Kramfors
- 2015
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Reports (other academic/artistic)abstract
- Norrlandicus är ett ”Living Lab” med syfte att i en verklig testmiljö inom äldreomsorgen testa innovationer i form av produkter, tjänster och arbetssätt för att se om de tillför ett ökat värde i en vård- och omsorgsprocess och om innovationen möter slutanvändarens faktiska behov. En utgångspunkt för Norrlandicus testmetod är Socialstyrelsens riktlinjer om värdegrunder i omsorgen av äldre, om äldres värdighet och välbefinnande.På ett äldreboende i Kramfors kommun har SCA Hygiene Products innovation för inkontinensutredning testats. Under tre dygn deltog ett antal utvalda äldre personer i en inkontinensutredning där man använde ny teknik med sensorer i inkontinensskyddet för att samla in information kring tidpunkt och ungefärlig urinmängd av läckage.I testet ingår först och främst att utvärdera innovationens användbarhet. Detta sker utifrån personalens användning och uppfattning kring verktyget. Det resultatet kan i viss mån även belysa nyttoeffekter av verktyget i en vård- och omsorgsprocess. Vilka effekter kan innovationen få för den äldre och vilken nytta kan den ge personalen? Enkäter och strukturerade intervjuer har utförts med personal och intervjuer har efter samtycke utförts med de berörda äldre. Användningen har även observerats och Norrlandicus-teamet har deltagit praktiskt i alla testets faser.Vårdpersonalens analys av data tillsammans med deras kännedom om personen underlättar för personalen att individanpassa de äldres inkontinensskydd bättre, och att bättre planera in assistans vid toalettbesök. Det ger i detta avseende möjligheter att öka de äldres välbefinnande och värdighet, vilket är i linje med äldreomsorgens nationella riktlinjer. Verktyget har även visat sig kunna förbättra inkontinensvården ur personalens synvinkel. Den information som verktyget ger är mer utförlig än den som fås från dagens utredningsmetod där inkontinensskydden vägs. Det ger stöd i besluten för vilka insatser som personen bör ha samt vilka typer av inkontinensskydd som bör användas. Dessutom slipper personalen momentet med vägning, vilket ökar de hygieniska aspekterna.Personalen som deltagit i testet är nöjda med utfallet och skulle gärna använda detta verktyg på rutinbasis vid inkontinensutredningar.
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| 5. |
- Bärkås, Annika, et al.
(author)
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Analysis of Voluntary User Feedback of the Swedish National PAEHR Service
- 2019
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In: MEDINFO 2019. - : IOS Press. - 9781643680033 - 9781643680026 ; 264, s. 1126-1130
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Conference paper (peer-reviewed)abstract
- "Journalen" is a patient accessible electronic health record (PAEHR) and the national eHealth service for Sweden's citizens to gain access to their EHR. The Swedish national eHealth organization Inera, responsible for Journalen, created an inbox to receive voluntary user feedback about Journalen in order to improve the service from the user perspective. Based on voluntary user feedback via email. This study explored patients' experiences of using the national eHealth service and identified pros and cons. A mixed method content analysis was performed. In total, 1084 emails from 2016-2017 have been analyzed. 9 categories were identified, the most frequent ones related to questions about why some information was not accessible (due to regional differencies), feedback (including only positive or negative comments as well as constructive improvement suggestions), and emails about errors that user found in their record. These data can be successfully used to continuously improve an already implemented eHealth service.
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| 6. |
- Bärkås, Annika, et al.
(author)
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Errors, Omissions, and Offenses in the Health Record of Mental Health Care Patients : Results from a Nationwide Survey in Sweden
- 2023
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In: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 25
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Journal article (peer-reviewed)abstract
- BACKGROUND: Previous research reports that patients with mental health conditions experience benefits, for example, increased empowerment and validation, from reading their patient-accessible electronic health records (PAEHRs). In mental health care (MHC), PAEHRs remain controversial, as health care professionals are concerned that patients may feel worried or offended by the content of the notes. Moreover, existing research has focused on specific mental health diagnoses, excluding the larger PAEHR userbase with experience in MHC. OBJECTIVE: The objective of this study is to establish if and how the experiences of patients with and those without MHC differ in using their PAEHRs by (1) comparing patient characteristics and differences in using the national patient portal between the 2 groups and (2) establishing group differences in the prevalence of negative experiences, for example, rates of errors, omissions, and offenses between the 2 groups. METHODS: Our analysis was performed on data from an online patient survey distributed through the Swedish national patient portal as part of our international research project, NORDeHEALTH. The respondents were patient users of the national patient portal 1177, aged 15 years or older, and categorized either as those with MHC experience or with any other health care experience (nonmental health care [non-MHC]). Patient characteristics such as gender, age, education, employment, and health status were gathered. Portal use characteristics included frequency of access, encouragement to read the record, and instances of positive and negative experiences. Negative experiences were further explored through rates of error, omission, and offense. The data were summarized through descriptive statistics. Group differences were analyzed through Pearson chi-square. RESULTS: Of the total sample (N=12,334), MHC respondents (n=3131) experienced errors (1586/3131, 50.65%, and non-MHC 3311/9203, 35.98%), omissions (1089/3131, 34.78%, and non-MHC 2427/9203, 26.37%) and offenses (1183/3131, 37.78%, and non-MHC 1616/9203, 17.56%) in the electronic health record at a higher rate than non-MHC respondents (n=9203). Respondents reported that the identified error (MHC 795/3131, 50.13%, and non-MHC 1366/9203, 41.26%) and omission (MHC 622/3131, 57.12%, and non-MHC 1329/9203, 54.76%) were "very important," but most did nothing to correct them (MHC 792/3131, 41.29%, and non-MHC 1838/9203, 42.17%). Most of the respondents identified as women in both groups. CONCLUSIONS: About 1 in 2 MHC patients identified an error in the record, and about 1 in 3 identified an omission, both at a much higher rate than in the non-MHC group. Patients with MHC also felt offended by the content of the notes more commonly (1 in 3 vs 1 in 6). These findings validate some of the worries expressed by health care professionals about providing patients with MHC with PAEHRs and highlight challenges with the documentation quality in the records.
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| 7. |
- Bärkås, Annika
(author)
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Patients’ Access to Their Mental Health Records : Understanding Policy, Access, and Patient Experiences
- 2024
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Doctoral thesis (other academic/artistic)abstract
- ORA is the concept of patients' access to clinical information, which has become more widespread worldwide. When patients are provided online record access (ORA) to their health records, concerns have been raised by healthcare professionals, especially when it comes to patients with mental health diagnoses. In the general population, positive aspects appear to outweigh the negative, yet limited research has so far explored the impact of ORA in mental healthcare. The overall aim of this thesis was to explore how patients experience ORA in mental healthcare through four studies: 1) a literature review aimed to explore the current literature on the experiences of ORA among mental healthcare patients, care partners, and healthcare professionals, 2) a document analysis combined with key stakeholder email interviews that aimed to explore to what extent ORA in mental healthcare has been implemented in Sweden including national and local policy regulations, 3) an online patient survey study aimed to understand mental healthcare patients' experiences with ORA in Sweden, Estonia, Finland, and Norway, and 4) an online patient survey study aimed to understand if and how patients with mental health conditions experiences of ORA differs from patients in other healthcare settings. More patients reported positive experiences with ORA in mental healthcare than negative experiences. Common benefits of ORA included, among others, a greater sense of control over their care, improved understanding of their mental health diagnosis, and better adherence to appointments. Despite patients' predominant positive experiences, only 17 out of 21 regions in Sweden offered ORA in mental healthcare in 2021. Additionally, many patients experienced errors and omissions and felt offended by the content of their health records. Mental healthcare patients experienced this at a higher rate than patients in other healthcare settings.In conclusion, mental healthcare patients have higher rates of negative experiences of ORA compared to patients in other healthcare settings. However, patients' experiences of ORA are still predominantly positive among both patient groups. Yet, in 2021, only 17 regions offered patients ORA in mental healthcare. Denying mental healthcare patients ORA to protect them from negative experiences could instead increase stigma in this patient group.
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| 8. |
- Bärkås, Annika, et al.
(author)
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Patients’ access to their psychiatric notes : Current policies and practices in Sweden
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:17
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Journal article (peer-reviewed)abstract
- Patients’ access to electronic health records (EHRs) is debated worldwide, and access to psychiatry records is even more criticized. There is a nationwide service in Sweden which offers all citizens the opportunity to read their EHR, including clinical notes. This study aims to explore Swedish national and local policy regulations regarding patients’ access to their psychiatric notes and describe to what extent patients currently are offered access to them. The rationale behind the study is that current policies and current practices may differ between the 21 self-governing regions, although there is a national regulation. We gathered web-based information from policy documents and regulations from each region’s website. We also conducted key stakeholder interviews with respondents from the regions and cross-regional private care providers, using a qualitative approach. The results show that 17 of 21 regions share psychiatric notes with patients, where forensic psychiatric care was the most excluded psychiatric care setting. All private care providers reported that they mainly follow the regions’ guidelines. Our findings show that regional differences concerning sharing psychiatric notes persist, despite Swedish regulations and a national policy that stipulates equal care for everyone. The differences, however, appear to have decreased over time, and we report evidence that the regions are moving toward increased transparency for psychiatry patients.
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| 9. |
- Bärkås, Annika, et al.
(author)
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Patients' Access to Their Psychiatric Records : A Comparison of Four Countries
- 2022
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In: Challenges of Trustable AI and Added-Value on Health. - Amsterdam; Berlin; Washington, DC : IOS Press. - 9781643682846 - 9781643682853 ; 294, s. 510-514
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Conference paper (peer-reviewed)abstract
- Several Nordic and Baltic countries are forerunners in the digitalization of patient ehealth services and have since long implemented psychiatric records as parts of the ehealth services. There are country-specific differences in what clinical information is offered to patients concerning their online patient accessible psychiatric records. This study explores national differences in Sweden, Norway, Finland, and Estonia in patient access to their psychiatric records. Data was collected through a socio-technical data collection template developed during a workshop series and then analyzed in a cross-country comparison focusing on items related to psychiatry records online. The results show that psychiatric records online are offered to patients in all four countries, and provide the same functionality and similar psychiatry information. Overall, the conclusion is that experiences of various functionalities should be scrutinized to promote transparency of psychiatric records as part of the national eHealth services to increase equality of care and patient empowerment.
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| 10. |
- Cajander, Åsa, et al.
(author)
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Designing eHealth Services for Patients and Relatives : Critical Incidents and Lessons to Learn
- 2016
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In: PROCEEDINGS OF THE NORDICHI '16. - New York, NY, USA : Association for Computing Machinery (ACM). - 9781450347631
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Conference paper (peer-reviewed)abstract
- The number of eHealth services for patients and relatives is rapidly increasing as many countries are launching such services as a means to manage an ageing population, to increase efficiency in healthcare, and to empower patients. However, design and deployment of eHealth services for patients is challenging due to the complex setting and the multitude of affected stakeholders, which in turn make the task of eliciting and managing the needs and requirements equally challenging. Hence, this workshop(1) aims to make use of critical incident analysis as a method for collecting and jointly reflecting on practices, assumptions, and experiences in relation to the design, deployment, and use of eHealth services for patients and relatives. The goal of the workshop is to engage in joint reflection, and to find potential ways forward in relation to critical incidents as well as supporting the shaping and reshaping of eHealth design and development. This full day workshop invites researchers and practitioners to apply/provide their critical reflection in order to derive changed practices and theories about practice. We also especially invite the patients' perspective as this is crucial to achieve successful eHealth services. This workshop provides a venue for challenging the process of eHealth service design and development and is built around a concept of active participation, where the workshop participants will analyse and discuss the critical incidents together.
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| 11. |
- Cajander, Åsa, Professor, 1971-, et al.
(author)
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Effects of patient accessible electronic health records on nurses' work environment : a survey study on expectations in Sweden
- 2022
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:11
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The introduction of information and communication technology influences the work environment of large groups of employees in healthcare. In Sweden, a national healthcare service providing patient accessible electronic health records (PAEHR) has been deployed, and this paper investigates nurses' expected effects of this implementation.SETTING: Nurses associated with the Swedish Association of Health Professionals working in healthcare such as primary care, hospitals and midwives in Sweden. Before a full-scale national implementation of PAEHR, a web survey study was distributed nationally. The respondents represented all 21 Swedish regions. Questions included five-point Likert scale questions and open questions.PARTICIPANTS: A survey link was distributed via email to 8460 registered nurses, midwives and union representatives in Sweden. The response rate was 35.4% (2867 respondents: registered nurses 84%; midwives 6%; chief position 5%; in projects 2% and other 3%). Three reminders were sent out, all of them increasing the response rate. A majority of the respondents were female (89.9%), 8.4% male, whereas 1.7% did not indicate their gender. 31.4% were under 40 years old, 53.8% 40-59 and 13.7% over 60.RESULTS: Data were analysed using exploratory factor analysis with principal component analysis as the extraction method. The analysis revealed three distinct factors related to nurses' expectations of PAEHR: (1) PAEHR improves the quality of care, (2) PAEHR improves the quality of the work environment and (3) risk and fears concerning patients' well-being. Some interesting results include that more experienced nurses are more favourable to PAEHR. Our analysis also shows that the view of the nurse-patient relationship is an essential underlying factor related to positive or negative expectations.CONCLUSIONS: Results show that the expectations and perceptions of PAEHR vary depending on the nurse's view of who the electronic record belongs to. Younger nurses are somewhat more negative towards PAEHR than older nurses.
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| 12. |
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| 13. |
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| 14. |
- Department of Computer and Information Science (IDA) Linköpings Universitet, SE - 581 83 Linköping, Sweden, Vivian, et al.
(author)
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Organizational effects of the use of information and communication technology (ICT) in elderly homecare : a case study
- 2008
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In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 14:3, s. 195-209
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Journal article (peer-reviewed)abstract
- The use of information and communication technology (ICT) to support integrated healthcare services in elderly homecare is becoming more established. In particular, ICT can enable information exchange, knowledge sharing and documentation at the point-of-care (POC). The aim of this study was to explore these effects using the Old@Home prototype. Old@Home was perceived to contribute in developing horizontal links for communication between individuals who work together, independent of geographical distance or organizational affiliation, and to contribute to increased work efficiency. The prototype was further seen to reduce professional isolation by providing a holistic overview of the care process. User centred design and implementation of Old@Home was considered key to facilitating acceptance of organizational changes. Participation of care professionals not only led to a better understanding of the needs of involved organizations, but also increased end-users' involvement and commitment, stimulating them to test and improve the prototype until the final version.
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| 15. |
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| 16. |
- Ekman, Björn, et al.
(author)
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Skala upp den befintliga digitala vården i Sverige
- 2020
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In: Dagens Medicin. - Stockholm : Bonnier. - 1104-7488.
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Journal article (pop. science, debate, etc.)abstract
- Ge Socialstyrelsen ett nationellt uppdrag att beställa och ersätta vårdgivare av digital vård, föreslår en grupp forskare med anledning av covid-19.
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| 17. |
- Engström, Maria, 1966-, et al.
(author)
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Evaluation of OLD@HOME virtual health record : staff opinions of the system and satisfaction with work
- 2009
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In: Telemedicine journal and e-health. - : Mary Ann Liebert Inc. - 1530-5627 .- 1556-3669. ; 15:1, s. 53-61
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Journal article (peer-reviewed)abstract
- The aim of the present research was to study outcomes of use of the OLD@HOME Virtual Health Record with regard to staff opinions about information, communication technology, and satisfaction with work. A quasi-experimental design was used. Staff opinions about the information and communication technology were assessed using a study-specific questionnaire at the test site (n =22) and at other settings in the municipality (n =172). Staff (n =22) job satisfaction, perceived quality of care, and psychosomatic health were assessed using the Satisfaction with Work Questionnaires before and after a 5-month period of testing the technology in an intervention and a comparison group. Staff opinions about the information and communication technology were significantly more positive at the test site compared to other settings in the municipality. For the total scale of quality of care and the factor documentation, there were significant differences in change scores between intervention and comparison groups, with improvements for the comparison group. For job satisfaction and psychosomatic health, there were no differences in change scores between the groups. Participatory design enhances staff opinions about information and communication technology. However, a 5-month test period showed no benefits regarding staff satisfaction with work when compared to a comparison group. On the contrary, the comparison group improved in documentation, and for the intervention group, there was a trend toward deterioration, which may be due to their knowing how to document, but not having time when using both paper-based and electronic systems.
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| 18. |
- Essén, Anna, et al.
(author)
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Patient access to electronic health records : Differences across ten countries
- 2018
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In: Health Policy and Technology. - : Elsevier. - 2211-8837 .- 2211-8845. ; 7:1, s. 44-56
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Journal article (peer-reviewed)abstract
- Abstract: Patient-accessible electronic health records (PAEHRs) are being implemented at international scale. Comparing policies and systems could allow countries to learn from each other to address global and nation-specific challenges. We compare national PAEHR policy (hard and soft regulation) and services in 10 countries.Methods: PAEHR policy and system documentation was gathered from Australia, Denmark, Estonia, Finland, France, the Netherlands, New Zealand, Norway, Sweden and the United States. A basic analytic model for policy analysis was used to delimit our focus to policy content, followed by an inductive thematic analysis across countries, in which we clustered initial themes into a set of categories of PAEHR service “approaches” related to three specific content areas.Results: Although all 10 countries ensured some patient rights to access medical records, policies and systems were highly variable, as were the technological processes arising from these. In particular, three policy areas showed great variability. Depending upon country of origin, a patient would encounter differences in: login procedures (security), access to own and other patients’ data during adolescence (user rights), and types of medical data made available to the patient (data sets).Conclusions: Individuals encounter very different access rights to their medical data depending on where they live. Countries may be able to develop improved policies by examining how other nations have solved common problems. Harmonizing policies is also an initial step likely to be needed before cross-national PAEHRs could be possible.
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| 19. |
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| 20. |
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| 21. |
- Fagerlund, A. J., et al.
(author)
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Experiences from patients in mental healthcare accessing their electronic health records : results from a cross-national survey in Estonia, Finland, Norway, and Sweden
- 2024
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In: BMC Psychiatry. - : BioMed Central (BMC). - 1471-244X. ; 24:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: Patients' online record access (ORA) enables patients to read and use their health data through online digital solutions. One such solution, patient-accessible electronic health records (PAEHRs) have been implemented in Estonia, Finland, Norway, and Sweden. While accumulated research has pointed to many potential benefits of ORA, its application in mental healthcare (MHC) continues to be contested. The present study aimed to describe MHC users' overall experiences with national PAEHR services.METHODS: The study analysed the MHC-part of the NORDeHEALTH 2022 Patient Survey, a large-scale multi-country survey. The survey consisted of 45 questions, including demographic variables and questions related to users' experiences with ORA. We focused on the questions concerning positive experiences (benefits), negative experiences (errors, omissions, offence), and breaches of security and privacy. Participants were included in this analysis if they reported receiving mental healthcare within the past two years. Descriptive statistics were used to summarise data, and percentages were calculated on available data.RESULTS: 6,157 respondents were included. In line with previous research, almost half (45%) reported very positive experiences with ORA. A majority in each country also reported improved trust (at least 69%) and communication (at least 71%) with healthcare providers. One-third (29.5%) reported very negative experiences with ORA. In total, half of the respondents (47.9%) found errors and a third (35.5%) found omissions in their medical documentation. One-third (34.8%) of all respondents also reported being offended by the content. When errors or omissions were identified, about half (46.5%) reported that they took no action. There seems to be differences in how patients experience errors, omissions, and missing information between the countries. A small proportion reported instances where family or others demanded access to their records (3.1%), and about one in ten (10.7%) noted that unauthorised individuals had seen their health information.CONCLUSIONS: Overall, MHC patients reported more positive experiences than negative, but a large portion of respondents reported problems with the content of the PAEHR. Further research on best practice in implementation of ORA in MHC is therefore needed, to ensure that all patients may reap the benefits while limiting potential negative consequences.
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| 22. |
- Fagerlund, Asbjørn Johansen, et al.
(author)
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Experiences from patients in mental healthcare accessing their electronic health records : results from a cross-national survey in Estonia, Finland, Norway, and Sweden
- 2024
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In: BMC Psychiatry. - : BioMed Central Ltd. - 1471-244X. ; 24:1
-
Journal article (peer-reviewed)abstract
- Background: Patients’ online record access (ORA) enables patients to read and use their health data through online digital solutions. One such solution, patient-accessible electronic health records (PAEHRs) have been implemented in Estonia, Finland, Norway, and Sweden. While accumulated research has pointed to many potential benefits of ORA, its application in mental healthcare (MHC) continues to be contested. The present study aimed to describe MHC users’ overall experiences with national PAEHR services. Methods: The study analysed the MHC-part of the NORDeHEALTH 2022 Patient Survey, a large-scale multi-country survey. The survey consisted of 45 questions, including demographic variables and questions related to users’ experiences with ORA. We focused on the questions concerning positive experiences (benefits), negative experiences (errors, omissions, offence), and breaches of security and privacy. Participants were included in this analysis if they reported receiving mental healthcare within the past two years. Descriptive statistics were used to summarise data, and percentages were calculated on available data. Results: 6,157 respondents were included. In line with previous research, almost half (45%) reported very positive experiences with ORA. A majority in each country also reported improved trust (at least 69%) and communication (at least 71%) with healthcare providers. One-third (29.5%) reported very negative experiences with ORA. In total, half of the respondents (47.9%) found errors and a third (35.5%) found omissions in their medical documentation. One-third (34.8%) of all respondents also reported being offended by the content. When errors or omissions were identified, about half (46.5%) reported that they took no action. There seems to be differences in how patients experience errors, omissions, and missing information between the countries. A small proportion reported instances where family or others demanded access to their records (3.1%), and about one in ten (10.7%) noted that unauthorised individuals had seen their health information. Conclusions: Overall, MHC patients reported more positive experiences than negative, but a large portion of respondents reported problems with the content of the PAEHR. Further research on best practice in implementation of ORA in MHC is therefore needed, to ensure that all patients may reap the benefits while limiting potential negative consequences.
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| 23. |
- Grünloh, Christiane, et al.
(author)
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Using Critical Incidents in Workshops to Inform eHealth Design
- 2017
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In: Human-Computer Interaction - INTERACT 2017. - Cham : Springer. - 9783319677439 - 9783319677446 ; , s. 364-373
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Conference paper (peer-reviewed)abstract
- Demands for technological solutions to address the variety of problems in healthcare have increased. The design of eHealth is challenging due to e.g. the complexity of the domain and the multitude of stakeholders involved. We describe a workshop method based on Critical Incidents that can be used to reflect on, and critically analyze, different experiences and practices in healthcare. We propose the workshop format, which was used during a conference and found very helpful by the participants to identify possible implications for eHealth design, that can be applied in future projects. This new format shows promise to evaluate eHealth designs, to learn from patients’ real stories and case studies through retrospective meta-analyses, and to inform design through joint reflection of understandings about users’ needs and issues for designers.
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| 24. |
- Hagström, Josefin, et al.
(author)
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Adolescents' and Young Adults' Experiences of Offense from Reading Their Health Records Online
- 2024
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In: Studies in Health Technology and Informatics. - : IOS Press. - 0926-9630 .- 1879-8365. ; 310, s. 1422-1423
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Journal article (peer-reviewed)abstract
- Patients feeling offended by reading records online is a concern among healthcare professionals, however previously published work has focused on adult patients. Here, a survey was used to explore and compare experiences of offense among adolescents (15-19 years old) and young adults (20-24 years old). Findings indicated that while the ratio of those offended did not differ between adolescents and young adults, reasons for feeling offended did.
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| 25. |
- Hagström, Josefin, et al.
(author)
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Adolescents Identifying Errors and Omissions in Their Electronic Health Records : A National Survey
- 2023
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In: Caring is Sharing. - : IOS Press. - 9781643683881 - 9781643683898 ; 302, s. 242-246
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Conference paper (peer-reviewed)abstract
- Patient accessible electronic health records (PAEHRs) have been proposed as a means to improve patient safety and documentation quality, as patients become an additional source to detect mistakes in the records. In pediatric care, healthcare professionals (HCP) have noted a benefit of parent proxy users correcting errors in their child's records. However, the potential of adolescents has so far been overlooked, despite reports of reading records to ensure accuracy. The present study examines errors and omissions identified by adolescents, and whether patients reported following up with HCPs. Survey data was collected during three weeks in January and February 2022 via the Swedish national PAEHR. Of 218 adolescent respondents, 60 reported having found an error (27.5%) and 44 (20.2%) had found missing information. Most adolescents did not take any action upon identifying an error or an omission (64.0%). Omissions were more often perceived as serious than errors. These findings call for development of policy and PAEHR design that facilitates reports of errors and omissions for adolescents, which could both improve trust and support the individual's transition into an involved and engaged adult patient.
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| 26. |
- Hagström, Josefin, et al.
(author)
-
Adolescents' reasons for accessing their health records online, perceived usefulness and experienced provider encouragement : a national survey in Sweden
- 2024
-
In: BMJ Paediatrics Open. - : BMJ Publishing Group Ltd. - 2399-9772. ; 8:1
-
Journal article (peer-reviewed)abstract
- Background Having online access to electronic health records (EHRs) may help patients become engaged in their care at an early age. However, little is known about adolescents using patient portals. A national survey conducted within the Nordic eHealth project NORDeHEALTH provided an important opportunity to advance our understanding of adolescent users of patient portals. The present study explored reasons for reading the EHRs, the perceived usefulness of information and functions in a patient portal and the association between frequency of use and encouragement to read the EHR. Methods Data were collected in a survey using convenience sampling, available through the Swedish online health portal during 3 weeks in January and February 2022. This study included a subset of items and only respondents aged 15-19. Demographic factors and frequencies on Likert-style questions were reported with descriptive statistics, while Fisher's exact test was used to explore differences in use frequency based on having been encouraged to read by a healthcare professional (HCP). Results Of 13 008 users who completed the survey, 218 (1.7%) were unique users aged 15-19 (females: 77.1%). One-fifth (47/218, 21.6%) had been encouraged by HCPs to read their records, and having been encouraged by HCPs was related to higher use frequency (p=0.018). All types of information were rated high on usefulness, while some functions were rated low, such as blocking specific clinical notes from HCPs and managing services for family members. The main reason for reading their health records online was out of curiosity. Conclusions Adolescents who read their records online perceive it to be useful. Encouragement by HCPs can lead to increased use of patient portals among adolescents. Findings should be considered in the future design of patient portals for adolescents.
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| 27. |
- Hagström, Josefin, et al.
(author)
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Minor and Parental Access to Electronic Health Records : Differences Across Four Countries
- 2022
-
In: Challenges of Trustable AI and Added-Value on Health. - : IOS Press. - 9781643682846 - 9781643682853 ; 294, s. 495-499
-
Conference paper (peer-reviewed)abstract
- An increasing number of countries are implementing patient access to electronic health records (EHR). However, EHR access for parents, children and adolescents presents ethical challenges of data integrity, and regulations vary across providers, regions, and countries. In the present study, we compare EHR access policy for parents, children and adolescents in four countries. Documentation from three areas: upper age limit of minors for which parents have access; age at which minors obtain access; and possibilities of access restriction and extension was collected from Sweden, Norway, Finland, and Estonia. Results showed that while all systems provided parents with automatic proxy access, age limits for its expiry differed. Furthermore, a lower minimum age than 18 for adolescent access was present in two of four countries. Differences between countries and potential implications for adolescents are discussed. We conclude that experiences of various approaches should be explored to promote the development of EHR regulations for parents, children and adolescents that increases safety, quality, and equality of care.
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| 28. |
- Hagström, Josefin, et al.
(author)
-
Security and Privacy of Online Record Access : A Survey of Adolescents' Views and Experiences in Sweden
- 2024
-
In: Journal of Adolescent Health. - : Elsevier. - 1054-139X .- 1879-1972.
-
Journal article (peer-reviewed)abstract
- Purpose: Ensuring security of online health records and patients' perceptions of security are concerns in adolescent healthcare. Little is known about adolescents' perceptions about healthcare's ability to protect online health records. This article explores adolescents' perspectives on security and privacy of their online health records, potential differences based on gender and health, attitudes to sharing information, and perceptions of what constitutes sensitive information. Methods: This study included a subset of items from a national online patient survey conducted in Sweden (January-February 2022), focusing on respondents aged 15–19 years. Gender and health status differences were calculated using the Kruskal-Wallis test. Results: Of 218 adolescent respondents (77.1% female), a minority had security and privacy concerns. A notable proportion (41.3%) wished to control who could see their records, and those who reported better perceived health were more likely to want to manage access to their electronic health record (H = 13.569, p = .009). Most had not experienced unauthorized access to their records (75.2%) and had never shared health information on other online applications (85.8%). More than half (56.0%) perceived some information as sensitive, where mental health was the most common (76.0%). Most felt that reading their notes improved their trust for their healthcare professional (65.6%) and supported better communication with healthcare professionals (66.5%). Discussion: In this national survey, adolescents generally reported few concerns about patient portals. Findings emphasize the need for security and privacy protection and to empower adolescents with greater control over access to their health information housed in electronic health record systems.
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| 29. |
- Hagström, Josefin, et al.
(author)
-
Use of and Experiences With Online Access to Electronic Health Records for Parents, Children, and Adolescents : Protocol for a Scoping Review
- 2022
-
In: JMIR Research Protocols. - : JMIR Publications Inc.. - 1929-0748. ; 11:6
-
Research review (peer-reviewed)abstract
- Background: As patient online access to electronic health records becomes the standard, implementation of access for adolescents and parents varies across providers, regions, and countries. There is currently no international compilation of evidence to guide policy decisions in matters such as age limit for access and the extent of parent proxy access.Objective: This paper presents the protocol for a scoping review of different stakeholders’ (including but not limited to end users) perspectives on use, opinions, and experiences pertaining to online access to electronic health records by parents, children, and adolescents.Methods: This scoping review will be conducted according to the Arksey and O’Malley framework. Several databases will be used to conduct a literature search (PubMed, CINAHL, and PsycInfo), in addition to literature found outside of these databases. All authors will participate in screening identified papers, following the research question: How do different stakeholders experience parents’, children’s, and adolescents’ online access to the electronic health records of children and adolescents? Data abstraction will include but will not be limited to publication type, publication year, country, sample characteristics, setting, study aim, research question, and conclusions. The data to be analyzed are from publicly available secondary sources, so this study does not require an ethics review.Results: The results from this scoping review will be presented in a narrative form, and additional data on study characteristics will be presented in diagrams or tabular format. This scoping review protocol was first initiated by Uppsala University in June 2021 as part of the NordForsk-funded research project NORDeHEALTH. The results are expected to be presented in a scoping review in June 2022. The results will be disseminated through stakeholder meetings, scientific conference presentations, oral presentations to the public, and publication in a peer-reviewed journal.Conclusions: This is, to our knowledge, the first study to map the literature on the use and experiences of parents’ and adolescents’ online access to the electronic health records of children and adolescents. The findings will describe what benefits and risks have been experienced by different stakeholders so far in different countries. A mapping of studies could inform the design and implementation of future regulations around access to patient-accessible electronic health records.
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| 30. |
- Hagström, Josefin, et al.
(author)
-
Views, Use, and Experiences of Web-Based Access to Pediatric Electronic Health Records for Children, Adolescents, and Parents : Scoping Review
- 2022
-
In: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 24:11
-
Research review (peer-reviewed)abstract
- Background: Ongoing efforts worldwide to provide patients with patient-accessible electronic health records (PAEHRs) have led to variability in adolescent and parental access across providers, regions, and countries. There is no compilation of evidence to guide policy decisions in matters such as access age and the extent of parent proxy access. In this paper, we outline our scoping review of different stakeholders’ (including but not limited to end users) views, use, and experiences pertaining to web-based access to electronic health records (EHRs) by children, adolescents, and parents. Objective: The aim of this study was to identify, categorize, and summarize knowledge about different stakeholders’ (eg, children and adolescents, parents, health care professionals [HCPs], policy makers, and designers of patient portals or PAEHRs) views, use, and experiences of EHR access for children, adolescents, and parents. Methods: A scoping review was conducted according to the Arksey and O’Malley framework. A literature search identified eligible papers that focused on EHR access for children, adolescents, and parents that were published between 2007 and 2021. A number of databases were used to search for literature (PubMed, CINAHL, and PsycINFO). Results: The approach resulted in 4817 identified articles and 74 (1.54%) included articles. The papers were predominantly viewpoints based in the United States, and the number of studies on parents was larger than that on adolescents and HCPs combined. First, adolescents and parents without access anticipated low literacy and confidentiality issues; however, adolescents and parents who had accessed their records did not report such concerns. Second, the main issue for HCPs was maintaining adolescent confidentiality. This remained an issue after using PAEHRs for parents, HCPs, and other stakeholders but was not an experienced issue for adolescents. Third, the viewpoints of other stakeholders provided a number of suggestions to mitigate issues. Finally, education is needed for adolescents, parents, and HCPs. Conclusions: There is limited research on pediatric PAEHRs, particularly outside the United States, and on adolescents’ experiences with web-based access to their records. These findings could inform the design and implementation of future regulations regarding access to PAEHRs. Further examination is warranted on the experiences of adolescents, parents, and HCPs to improve usability and utility, inform universal principles reducing the current arbitrariness in the child’s age for own and parental access to EHRs among providers worldwide, and ensure that portals are equipped to safely and appropriately manage a wide variety of patient circumstances. International Registered Report Identifier (IRRID): RR2-10.2196/36158
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| 31. |
- Hellstrand Tang, Ulla, 1956, et al.
(author)
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Patients’ Expectations of Evidence-Based Service at the Pharmacy Regarding Information on Self-Care of the Feet for Persons with Diabetes at Risk of Developing Foot Ulcers – A Cross-Sectional Observational Study in Sweden
- 2023
-
In: Patient Preference and Adherence. - : Dove Medical Press. - 1177-889X. ; 17
-
Journal article (peer-reviewed)abstract
- Purpose: Self-care of the feet is one of the cornerstones in the prevention of diabetic foot ulcers (DFU). Often, individuals with diabetes seek help at the pharmacy, but it is still unclear whether the service meets their expectations and needs. The aims were to explore patients’ expectations of support from the pharmacy regarding self-care of their feet and explore how patients with diabetes felt that they managed the self-care of their feet. Patients and Methods: The included participants (n = 17), aged 70 ± 9 years, answered surveys regarding their expectations of support from the pharmacy related to self-care of the feet and how they felt that they managed the self-care of their feet. By using software, MyFoot Diabetes, they assessed their risk of developing DFU (ranging from 1 = no risk to 4 = DFU). In addition, a healthcare professional assessed the risk grade. Results: Sixteen patients had not received any information from the pharmacy regarding how to take care of their feet. Several suggestions for ways the pharmacy could help patients with diabetes to take care of their feet were registered. They included having the necessary skills and competence, giving advice regarding self-care, giving information regarding the products they market and have for sale and giving advice on ointments/creams. The participants gave several examples of how they self-managed their feet: by wearing shoes indoors and outdoors, wearing socks and compression stockings as often as possible, being physically active, inspecting their feet, being aware of the fact that their feet have no problems, washing, moisturising their feet, cutting their nails and finally seeking help to prevent DFU. Conclusion: The participants thought that they should receive competent information from the personnel at the pharmacy to improve the self-care of their feet, eg, being given information about which ointments/creams to use. Clinical Trial: NCT05692778. Plain Language Summary: Persons living with diabetes have better opportunities to be physically active, keep on walking and participate in social activity if the feet are in good health. Besides getting support from healthcare, on how to promote good foot health, the pharmacies offer services and products aimed for self-care of the feet. Seventeen persons living with diabetes in the western region of Sweden answered a survey regarding their expectations of support from the pharmacy related to self-care of the feet and how they felt that they managed the self-care of their feet. The study found that persons living with diabetes self-managed their feet in different ways. The services being available from the pharmacies should be improved, promoting good foot health for persons living with diabetes, and in its prolongation prevent the development of diabetic foot ulcers.
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| 32. |
- Hellstrand Tang, Ulla, et al.
(author)
-
Patients’ Expectations of Evidence-Based Service at the Pharmacy Regarding Information on Self-Care of the Feet for Persons with Diabetes at Risk of Developing Foot Ulcers – A Cross-Sectional Observational Study in Sweden
- 2023
-
In: Patient Preference and Adherence. - : Dove Medical Press. - 1177-889X. ; 17, s. 3557-3576
-
Journal article (peer-reviewed)abstract
- Purpose: Self-care of the feet is one of the cornerstones in the prevention of diabetic foot ulcers (DFU). Often, individuals with diabetes seek help at the pharmacy, but it is still unclear whether the service meets their expectations and needs. The aims were to explore patients' expectations of support from the pharmacy regarding self-care of their feet and explore how patients with diabetes felt that they managed the self-care of their feet.Patients and methods: The included participants (n = 17), aged 70 ± 9 years, answered surveys regarding their expectations of support from the pharmacy related to self-care of the feet and how they felt that they managed the self-care of their feet. By using software, MyFoot Diabetes, they assessed their risk of developing DFU (ranging from 1 = no risk to 4 = DFU). In addition, a healthcare professional assessed the risk grade.Results: Sixteen patients had not received any information from the pharmacy regarding how to take care of their feet. Several suggestions for ways the pharmacy could help patients with diabetes to take care of their feet were registered. They included having the necessary skills and competence, giving advice regarding self-care, giving information regarding the products they market and have for sale and giving advice on ointments/creams. The participants gave several examples of how they self-managed their feet: by wearing shoes indoors and outdoors, wearing socks and compression stockings as often as possible, being physically active, inspecting their feet, being aware of the fact that their feet have no problems, washing, moisturising their feet, cutting their nails and finally seeking help to prevent DFU.Conclusion: The participants thought that they should receive competent information from the personnel at the pharmacy to improve the self-care of their feet, eg, being given information about which ointments/creams to use.
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| 33. |
- Hofflander, Malin
(author)
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Implementing video conferencing in discharge planning sessions : leadership and organizational culture when designing IT support for everyday work in nursing practice
- 2015
-
Doctoral thesis (other academic/artistic)abstract
- The overall aim of this thesis has been to study the implementation process concerning the use of video conferencing in discharge planning, during and after a development project in a region in southeast Sweden. The research approach has been developed within a new interdisciplinary research area, Applied Health Technology. The main focus of the research has been on how the new IT solution has affected everyday work, and in what ways management supported staff during the implementation process. The study design has a qualitative approach. Phenomenological hermeneutics, content analysis and Participatory Action Research (PAR) have been used in the analysis process. Study I aimed to describe primary healthcare nursing staff’s experiences of discharge planning, along with their concerns about using video conferencing in discharge planning sessions. It was found that there is need for improvement in communication and understanding between nursing staff working in hospitals and in primary healthcare, and need for nursing staff to obtain more information about how IT solutions could support their work. The aim of Study II was to examine the implementation process of using video conferencing in discharge planning, according to a theoretical framework composed from theories about implementation processes. It was found that implementation frameworks can be useful, and that framing the implementation process supports the exposure of factors and highlights relationships and states of dependency between those factors which may affect implementation. Study III set out to describe managers’ reflections about leading the implementation process of using video conferencing in the discharge planning session. The results indicate that managers experienced two leadership perspectives when they reflected on the implementation process. On one hand, they described a desired way of leading implementation, on the other hand they described an actual way of leading implementation. The aim of Study IV was to describe the reflections of professionals about what is needed in order to create what should become a new best practice using videoconferencing in the discharge planning sessions. The results indicate that the professionals experienced lack of knowledge and understanding about each other’s everyday work and that the absence of well-functioning common routines obstructed the process. The results also indicate that there is a lack of common arenas to enable discussions, negotiations and agreements about adopting new routines as the discharge planning process changes over time. This thesis contributes to the much-needed discussions about how to manage the many ongoing IT implementation processes in Swedish healthcare organizations, by highlighting challenges and difficulties that both healthcare professionals and managers have experienced during an implementation process. The results indicate that implementation frameworks can be useful when new IT solutions are introduced in healthcare, and that there is a need for dedicating time, space and support for involved professionals in designing their everyday work.
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| 34. |
- Huvila, Isto, Professor, 1976-, et al.
(author)
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Anticipating ageing : Older adults reading their medical records
- 2018
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In: Information Processing & Management. - : Elsevier. - 0306-4573 .- 1873-5371. ; 54:3, s. 394-407
-
Journal article (peer-reviewed)abstract
- In spite of the general interest in health information behaviour, there is little earlier research on how older adults, who are still active in working life but approaching retirement, differ from other age groups. A survey with Swedish patients who had ordered and read their medical record was conducted to map the preferences and motivations of older adults (born 1946-1960) ordering a copy of their medical record, and using medical records based e-health and information services in the future. The results do not indicate an obvious linear relationship between age and motivation to use online health information but show several differences between the age groups. Older adults were less interested in communication with their medical doctor by e-mail. Yet, they had searched health information in the Internet during the last week more likely than young. They were more inclined to read medical record to get an overview of their health than young, but less confident that they understood most of the content or turn to their family and friends to seek help than the elderly. When compared to younger adults and elderly people, older adults are the least confident and least motivated to use online health information. It is suggested that older adulthood can be seen as a transitory stage of life when the need of health information increases and engagement with health changes. The results agree with prior research on the potential usefulness of (online) medical records as a way to inform citizens. However, specific provision strategies may be necessary to match the needs and motivations of different age groups.
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| 35. |
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| 36. |
- Hägglund, Maria, Lektor, 1975-, et al.
(author)
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A Nordic Perspective on Patient Online Record Access and the European Health Data Space
- 2024
-
In: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 26:1
-
Journal article (peer-reviewed)abstract
- The Nordic countries are, together with the United States, forerunners in online record access (ORA), which has now become widespread. The importance of accessible and structured health data has also been highlighted by policy makers internationally. To ensure the full realization of ORA’s potential in the short and long term, there is a pressing need to study ORA from a cross-disciplinary, clinical, humanistic, and social sciences perspective that looks beyond strictly technical aspects. In this viewpoint paper, we explore the policy changes in the European Health Data Space (EHDS) proposal to advance ORA across the European Union, informed by our research in a Nordic-led project that carries out the first of its kind, large-scale international investigation of patients’ ORA—NORDeHEALTH (Nordic eHealth for Patients: Benchmarking and Developing for the Future). We argue that the EHDS proposal will pave the way for patients to access and control third-party access to their electronic health records. In our analysis of the proposal, we have identified five key principles for ORA: (1) the right to access, (2) proxy access, (3) patient input of their own data, (4) error and omission rectification, and (5) access control. ORA implementation today is fragmented throughout Europe, and the EHDS proposal aims to ensure all European citizens have equal online access to their health data. However, we argue that in order to implement the EHDS, we need more research evidence on the key ORA principles we have identified in our analysis. Results from the NORDeHEALTH project provide some of that evidence, but we have also identified important knowledge gaps that still need further exploration.
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| 37. |
- Hägglund, Maria, 1975-, et al.
(author)
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A Socio-Technical Analysis of Patient Accessible Electronic Health Records
- 2017
-
In: The Practice of Patient Centered Care. - : IOS Press. - 9781614998235 - 9781614998242 ; 244, s. 3-7
-
Conference paper (peer-reviewed)abstract
- In Sweden, and internationally, there is a movement towards increased transparency in healthcare including giving patients online access to their electronic health records (EHR). The purpose of this paper is to analyze the Swedish patient accessible EHR (PAEHR) service using a socio-technical framework, to increase the understanding of factors that influence the design, implementation, adoption and use of the service. Using the Sitting and Singh socio-technical framework as a basis for analyzing the Swedish PAEHR system and its context indicated that there are many stakeholders engaged in these types of services, with different driving forces and incentives that may influence the adoption and usefulness of PAEHR services. The analysis was useful in highlighting important areas that need to be further explored in evaluations of PAEHR services, and can act as a guide when planning evaluations of any PAEHR service.
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| 38. |
- Hägglund, Maria, et al.
(author)
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Bridging the gap : a virtual health record for integrated home care
- 2007
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In: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156 .- 1568-4156. ; 7:June, s. e26-
-
Journal article (peer-reviewed)abstract
- INTRODUCTION: The coexistence of different information systems that are unable to communicate is a persistent problem in healthcare and in integrated home care in particular. THEORY AND METHODS: Physically federated integration is used for design of the underlying technical architecture to implement a mobile virtual health record for integrated home care. A user centered system development approach is followed during design and development of the system. RESULTS: A technical platform based on a service-oriented approach where database functionality and services are separated has been developed. This guarantees flexibility with regard to changed functional demands and allows third party systems to interact with the platform in a standardized way. A physically federated integration enables point-of-care documentation, integrated presentation of information from different feeder systems, and offline access to data on handheld devices. Feeder systems deliver information in XML-files that are mapped against an ideal XML schema, published as an interface for integration with the information broker, and inserted into the mediator database. CONCLUSIONS: A seamless flow of information between both different care professionals involved in integrated home care and patients and relatives is provided through mobile information access and interaction with different feeder systems using the virtual health record.
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| 39. |
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| 40. |
- Hägglund, Maria, Lektor, 1975-, et al.
(author)
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Does user centred design work in homecare for elderly? : a retrospective on the OLD@HOME case
- 2011
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In: International Journal of Integrated Care. - Utrecht : Igitur. - 1568-4156 .- 1568-4156. ; 11
-
Journal article (peer-reviewed)abstract
- Introduction: Mobile information and communication technology (ICT) has been suggested to improve collaboration in integrated homecare, yet, few successful implementations are available. User centred design (UCD) can improve the usefulness of ICT, however, it is often claimed to be expensive and difficult to use in healthcare. In the action research project OLD@HOME (Sweden 2002–2005) a user centred approach was adapted to the specific context of integrated homecare for elderly.Aim: To revisit OLD@HOME and explore what methodological adjustments were needed to adapt UCD to integrated homecare of elderly, and what the long-term effects of using UCD were.Results: Our collaborative design method included all stakeholders and enabled development of both new work situations and new tools. Five years after implementation, the system is still used by home help service personnel, for both homecare- and office-based work, as it provides ubiquitous access to information and communication. Technical support is rarely needed; experienced users handle occurring problems, training and introduction of new users.Conclusions: We consider the development method a key factor for the OLD@HOME system’s success as it enabled the design of a homecare system that is not only easy to use, but adapted to the context of integrated homecare for elderly
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| 41. |
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| 42. |
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| 43. |
- Hägglund, Maria, et al.
(author)
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Integrated Care Plan for Shared Home Care : the technical architecture
- 2005
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In: Journal on Information Technology in Healthcare. - Wallington : Optimum. - 1479-649X. ; 3:5, s. 287-294
-
Journal article (peer-reviewed)abstract
- The move towards decentralising healthcare services from traditional care settings towards home care has produced new requirements for care planning and documentation of procedures performed in the home environment. To meet these requirements, a virtual care plan (VCP) has been developed that gives both district nurses and home help service personnel (HHS) access to their respective care plans in a mobile work situation. In this paper we present the technical architecture of this VCP, and describe how it integrates information from different feeder systems and allows for documentation at the point of care (POC) using mobile devices.
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| 44. |
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| 45. |
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| 46. |
- Hägglund, Maria, et al.
(author)
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Integration architecture of a mobile virtual health record for shared home care
- 2005
-
In: Connecting Medical Informatics and Bio-Informatics. - : IOS Press. - 9781586035495 - 9781607501350 ; , s. 340-345
-
Book chapter (peer-reviewed)abstract
- The coexistence of different information systems that are unable to communicate with each other is a persistent problem in health care in general, and in shared care in particular. This is especially critical when it comes to information access needed at the point of care, e.g. in the patients home. The purpose of this paper is to present the technical architecture of a virtual health record (VHR) that both integrates information from different electronic health records (EHRs) and allows for documenting at the point of care using mobile devices. The VHR supports a seamless information and communication flow between different care providers giving them mobile access to selected patient-oriented information. A service oriented system architecture where database functionality and services are separated has been implemented. This guarantees flexibility with regard to changed functional demands and allows third party systems to interact with the platform in a standardised way. Major requirements for the VHR have been documentation support at the point of care, integrated presentation of the information from different feeder systems, and the possibility of offline access to the data on handheld devices. Therefore, publishing was chosen for the integration design. A patient centred XML schema is published as an interface for integration with the information broker. The feeder systems deliver their information in XML.-files that are mapped against the ideal schema and inserted into the mediator database. The paper describes both an online web application and an offline solution that was implemented on personal digital assistants (PDAs). The system has been introduced in a Swedish home care district with an established fiber-optical network infrastructure connecting all the locations forming the study site.
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| 47. |
- Hägglund, Maria, Lektor, 1975-, et al.
(author)
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Mobile Access and Adoption of the Swedish National Patient Portal
- 2020
-
In: Integrated Citizen Centered Digital Health and Social Care. - : IOS Press. - 9781643681443 - 9781643681450 ; 275, s. 82-86
-
Conference paper (peer-reviewed)abstract
- Patient portals are used as a means to facilitate communication, performing administrative tasks, or accessing one's health record. In a retrospective analysis of real-world data from the Swedish National Patient Portal 1177.se, we describe the rate of adoption over time, as well as how patterns of device usage have changed over time. In Jan 2013, 53% of all visits were made from a computer, and 38% from a mobile phone. By June 2020, 77% of all visits were made from a mobile phone and only 20% from a computer. These results underline the importance of designing responsive patient portals that allow patients to use any device without losing functionality or usability.
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| 48. |
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| 49. |
- Hägglund, Maria, et al.
(author)
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NORDeHEALTH – Learning from the Nordic Experiences of Patient Online Record Access
- 2023
-
In: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871.
-
Journal article (other academic/artistic)abstract
- The Nordic countries are forerunners in online record access (ORA) which has now become widespread. The importance of accessible and structured health data has also been highlighted by policymakers internationally. To ensure the full realization of ORA’spotential in the short and long term, there is a pressing need to study ORA from a cross-disciplinary, technical, clinical, humanistic, and social sciences perspective that looks beyond strictly technical aspects. In this viewpoint paper, we explore the policy changes in the European Health Data Space (EHDS) proposal to advance ORA across the European Union, and introduce a Nordic-led research project that carries out the first of its kind, large-scale international investigation of patients’ ORA; NORDeHEALTH. We argue that the EHDS proposal will pave the way for patients to access and control third-party access to their electronic health records (EHRs). This will have implications within Europe and globally as it will further extend the boundaries for accessing and using EHRs for primary and secondary data use. Research such as that led by the NORDeHEALTH project is essential in guiding the design and implementation of solutions to meet the requirements of the EHDS proposal. Further international collaboration and research are needed to ensure that socio-technical and contextual factors are considered to ensure successful and secure implementation.
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| 50. |
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