| 1. |
- Ammenwerth, Elske, et al.
(författare)
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International Comparison of Six Basic eHealth Indicators Across 14 Countries: An eHealth Benchmarking Study
- 2020
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Ingår i: Methods of Information in Medicine. - : Georg Thieme Verlag KG. - 0026-1270 .- 2511-705X. ; 59:S2, s. e46-e63
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Tidskriftsartikel (refereegranskat)abstract
- Background Many countries adopt eHealth applications to support patient-centered care. Through information exchange, these eHealth applications may overcome institutional data silos and support holistic and ubiquitous (regional or national) information logistics. Available eHealth indicators mostly describe usage and acceptance of eHealth in a country. The eHealth indicators focusing on the cross-institutional availability of patient-related information for health care professionals, patients, and care givers are rare. Objectives This study aims to present eHealth indicators on cross-institutional availability of relevant patient data for health care professionals, as well as for patients and their caregivers across 14 countries (Argentina, Australia, Austria, Finland, Germany, Hong Kong as a special administrative region of China, Israel, Japan, Jordan, Kenya, South Korea, Sweden, Turkey, and the United States) to compare our indicators and the resulting data for the examined countries with other eHealth benchmarks and to extend and explore changes to a comparable survey in 2017. We defined "availability of patient data" as the ability to access data in and to add data to the patient record in the respective country. Methods The invited experts from each of the 14 countries provided the indicator data for their country to reflect the situation on August 1, 2019, as date of reference. Overall, 60 items were aggregated to six eHealth indicators. Results Availability of patient-related information varies strongly by country. Health care professionals can access patients most relevant cross-institutional health record data fully in only four countries. Patients and their caregivers can access their health record data fully in only two countries. Patients are able to fully add relevant data only in one country. Finland showed the best outcome of all eHealth indicators, followed by South Korea, Japan, and Sweden. Conclusion Advancement in eHealth depends on contextual factors such as health care organization, national health politics, privacy laws, and health care financing. Improvements in eHealth indicators are thus often slow. However, our survey shows that some countries were able to improve on at least some indicators between 2017 and 2019. We anticipate further improvements in the future.
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| 2. |
- Davoody, Nadia, et al.
(författare)
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Accessing and sharing health information for post-discharge stroke care through a national health information exchange platform : a case study
- 2019
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Ingår i: BMC Medical Informatics and Decision Making. - : Springer Science and Business Media LLC. - 1472-6947. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Patients and citizens need access to their health information to get a retrospective as well as a prospective view on their care and rehabilitation processes. However, patients' health information is stored in several health information systems and interoperability problems often hamper accessibility. In Sweden a national health information exchange (HIE) platform has been developed that enables information exchange between different health information systems. The aim of this study is to explore the opportunities and limitations of accessing and interacting with important health information through the Swedish national HIE platform.METHODS:A single case study approach was used for this study as an in-depth understanding of the subject was needed. A fictive patient case with a pseudo-name was created based on an interview with a stroke coordinator in Stockholm County. Information access through the national health information exchange platform and available service contracts and application programming interfaces were studied using different scenarios.RESULTS:Based on the scenarios created in this study, patients would be able to access some health related information from their electronic health records using the national health information exchange platform. However, there is necessary information which is not retrievable as it is either stored in electronic health records and eHealth services which are not connected to the national health information exchange platform or there is no service contract developed for these types of information. In addition, patients are not able to share information with healthcare professionals.CONCLUSION:The national Swedish HIE platform provides the building blocks needed to allow patients online access to their health information in a fragmented and distributed health system. However, more complex interaction scenarios allowing patients to communicate with their health care providers or to update their health related information are not yet supported. Therefore it is of great importance to involve patients throughout the design and evaluation of eHealth services on both national and local levels to ensure that their needs for interoperability and information exchange are met.
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| 3. |
- Davoody, Nadia, et al.
(författare)
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Collaborative interaction points in post-discharge stroke care.
- 2014
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156 .- 1568-4156. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Lack of appropriate electronic tools for supporting patient involvement and collaboration with care professionals is a problem in health care.METHODS: Care and rehabilitation processes of post-discharge stroke patients were analysed using the concept of interaction points where patients, next-of-kin and care professionals interact and exchange information. Thirteen interviews with care professionals and five non-participatory observations were performed. Data were analysed using content analysis and modelling of interaction points in the patient journey.RESULTS: Patient participation and interaction patterns vary; patients requiring home care have a passive role and next-of-kin or nurses become advocates by coordinating care on behalf of the patient, whereas patients who are able to visit primary care coordinate their own care by initiating interactions. Important categories of participation include the following: participation in care planning, in monitoring risk factors and in rehabilitation planning.CONCLUSIONS: Designing a supportive electronic tool requires understanding the interactions and patients' activity levels at each interaction point. A tool for patients with higher activity level should support them to coordinate their own care, whereas for a less-active patient group, the tool could focus on supporting next-of-kin and care professionals in motivating, guiding and including passive patients in their care and rehabilitation processes.
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| 4. |
- Davoody, Nadia, et al.
(författare)
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Evaluation of an Electronic Care and Rehabilitation Planning Tool With Stroke Survivors With Aphasia : Usability Study
- 2023
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Ingår i: JMIR Human Factors. - 2292-9495. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with chronic illnesses with physical and cognitive disabilities, particularly stroke survivors with aphasia, are often not involved in design and evaluation processes. As a consequence, existing eHealth services often do not meet the needs of this group of patients, which has resulted in a digital divide. Objective: The aim of this study was to examine the effectiveness and user satisfaction of an electronic care and rehabilitation planning tool from the perspective of stroke survivors with aphasia. This would help us gain knowledge on how such a tool would need to be adapted for these patients for further development. Methods: Usability tests were conducted with 9 postdischarge stroke survivors with aphasia. Effectiveness was measured using task-based tests, and user satisfaction was studied through qualitative interviews at the end of each test. All tests were audio recorded, and each test lasted approximately 1 hour. The data were analyzed using qualitative content analysis. As the tool can be used by stroke survivors either independently or with some support from their next of kin or care professionals, the research group decided to divide the participants into 2 groups. Group 1 did not receive any support during the tests, and group 2 received some minor support from the moderator. Results: The results showed that the care and rehabilitation planning tool was not effective for stroke survivors with aphasia, as many participants in group 1 did not accomplish the tasks successfully. Despite several usability problems and challenges in using the tool because of patients’ disabilities, the participants were positive toward using the tool and found it useful for their care and rehabilitation journey. Conclusions: There is a need to involve patients with chronic illnesses more in the design and evaluation processes of health information systems and eHealth services. eHealth services and health information systems designed for this group of patients should be more adaptable and flexible to provide them with appropriate functionalities and features, meet their needs, and be useful and easy to use. In addition, the design and evaluation processes should be adapted, considering the challenges of this patient group.
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| 5. |
- Davoody, Nadia, et al.
(författare)
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Post-discharge stroke patients' information needs as input to proposing patient-centred eHealth services.
- 2016
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Ingår i: BMC Medical Informatics and Decision Making. - : Springer Science and Business Media LLC. - 1472-6947. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite the potential of eHealth services to revolutionize the way healthcare and prevention is provided many applications developed for patients fail to deliver their promise. Therefore, the aim of this study is to use patient journey mapping to explore post-discharge stroke patients' information needs to propose eHealth services that meet their needs throughout their care and rehabilitation processes.METHODS: Three focus groups with younger (<65 years) and older (> = 65 years) stroke patients were performed. Content analysis was used to analyse the data. Stroke patients' information needs was explored using patient journey model.RESULTS: Four main events (discharge from hospital, discharge from rehab clinic, coming home, and clinical encounters) and two phases (at rehab clinic, at home) have been identified in patients' post-discharge journey. The main categories identified in this study indicate that patients not only need to have access to health related information about their care and rehabilitation processes but also practical guidance through healthcare and community services. Patients also have different information needs at different events and during different phases. Potential supportive eHealth services were suggested by the researchers considering different parts of the patients' journeys.CONCLUSIONS: Patient journey models and qualitative analysis of patients' information needs are powerful tools that can be used to improve healthcare from a patient perspective. As patients' understanding of their illness changes over time, their need of more flexible support throughout the care and rehabilitation processes increases. To design appropriate eHealth services that meet patients' information needs, it is imperative to understand the current care and rehabilitation processes and identify patients' information needs throughout their journey.
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| 6. |
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| 7. |
- Department of Computer and Information Science (IDA) Linköpings Universitet, SE - 581 83 Linköping, Sweden, Vivian, et al.
(författare)
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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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Ingår i: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 14:3, s. 195-209
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Tidskriftsartikel (refereegranskat)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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| 8. |
- Edman, Anneli, et al.
(författare)
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A Web-based User Adaptive Learning Environment
- 2000
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Ingår i: Proceedings in form of a CD. - : SSGRR 2000 computer and business conference.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- We present a design structure for constructing web based user adaptive learning environments. Currently the web offers huge amounts of unstructured information but no facilities for exploiting this in a problem solving situation. Our aim is to gather and
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| 9. |
- Engström, Maria, 1966-, et al.
(författare)
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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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Ingår i: Telemedicine journal and e-health. - : Mary Ann Liebert Inc. - 1530-5627 .- 1556-3669. ; 15:1, s. 53-61
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Tidskriftsartikel (refereegranskat)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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| 10. |
- Erlandson, Björn-Erik, et al.
(författare)
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eHälsa – Framtidsvision eller Verklighet?
- 2005
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Ingår i: Svenska Läkarsällskapets Riksstämma, 2005.
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Konferensbidrag (refereegranskat)abstract
- eHälsa – Framtidsvision eller Verklighet?Sabine Koch, Björn-Erik ErlandsonBakgrund:Sverige står, som de flesta länder i västvärlden, inför ett antal problem för framtidens hälso- och sjukvård/vård och omsorg:- ökning av antalet äldre och ökande incidens av kroniska sjukdomar beroende på förändrade livsstilar- alltmer decentraliserad sjukvård inkl. hemsjukvård i syfte att avlasta den slutna vården- krav på högre effektivitet och kvalitet i vård och omsorg trots begränsade ekonomiska resurser- problem med att rekrytera och behålla personal i framtiden.Inom hälso- och sjukvården har man sedan länge använt begreppen telemedicin. Enligt WHO definieras Telemedicin som ”Utövande av hälso- och sjukvård genom att använda interaktiv kommunikation av ljud, bild och data. Detta inkluderar diagnos, konsultation och behandling såväl som utbildning och överföring av medicinska data”. Under den senaste tiden har begreppet eHälsa eller eHealth etablerats samtidigt som begreppet får alltmera tyngd med tanke på europeiska satsningar som “e-Europe – An Information Society for All”. e-Europe är ett politiskt initiativ vars mål är att kommande generationer inom Europeiska unionen skall kunna dra nytta av de förändringar som informationssamhället för med sig. e-Hälsa är ett starkt interdisciplinärt område som knyta ihop olika kompetenser för att bli framgångsrikt bl. a: Medicin och vårdvetenskap, Medicinsk informatik och teknik, Kognitionspsykologi och beteendevetenskap, Sociologi, Ekonomi, Etik och Juridik.Metod:Områden för eHälsa omfattar både metoder och system för hälso- och sjukvårdspersonal och för patienter och anhöriga. En trend kan ses från att utveckla system för att stödja personalen i att utöva vård till att stödja patientens egenvård samt att använda eHälsa i sjukdomsförebyggande syfte.Resultat:Några eHälsa projekt har utvecklats i Uppsala och dessa syftar till att öka patientmedverkan, att förbättra informationsförsörjning mellan professionen och att stödja anhöriga. Ett projekt, Webtjänst för diabetespatienter, framtagen utifrån patientens behov och testad av patienter, läkare och sjuksköterskor under en 5 månaders testperiod (http://www.medsci.uu.se/mie/project/dino). Ett annat projekt handlar om webbaserade stödsystem som hjälper personer med kognitiva funktionshinder att sköta sin vardag på ett bättre sätt och ett tredje projekt syftar till att förbättra informationsöverföring mellan olika yrkesgrupper och informationsförsörjning för vårdtagare och anhöriga tekniker inom äldreomsorg och hemsjukvård (http://www.medsci.uu.se/mie/project/closecare).Sammanfattning:Många bra utvecklingar har gjorts inom områden som elektroniska patientjournaler, informationssystem, elektroniska kort, patientövervakning, telemedicin m fl. Nationella samordningsinitiativ är på gång på olika områden. Ändå finns det många relativt isolerade system och ännu fler utvecklingsprojekt vars spridning till fler verksamheter saknas. Huvudorsakerna till det är bristande interoperabilitet, otillräcklig acceptans samt legala, ekonomiska och organisatoriska hinder. Även om många tekniska problem är lösta idag, återstår dock konsekventa utvärderingar, effektstudier och nyttoanalyser ur olika perspektiv. Allt viktigare frågor blir också patientsäkerhet och etik. Även om eHälsa är inte en ren framtidsvision längre är frågan hur mycket av den teknologin som är möjligt vi vill ha?
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