| 1. |
- Andrenucci, Andrea, et al.
(author)
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Knowledge patterns for online health portal development
- 2019
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In: Health Informatics Journal. - : SAGE Publications. - 1460-4582 .- 1741-2811. ; 25:4, s. 1779-1799
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Journal article (peer-reviewed)abstract
- This article describes the development and evaluation of a set of knowledge patterns that provide guidelines and implications of design for developers of mental health portals. The knowledge patterns were based on three foundations: 1) Knowledge integration of language technology approaches; 2) Experiments with language technology applications and 3) User studies of portal interaction. A mixed-methods approach was employed for the evaluation of the knowledge patterns: formative workshops with knowledge pattern experts and summative surveys with experts in specific domains. The formative evaluation improved the cohesion of the patterns. The results of the summative evaluation showed that the problems discussed in the patterns were relevant for the domain and that the knowledge embedded was useful to solve them. Ten patterns out of thirteen achieved an average score above 4.0, which is a positive result that leads us to conclude that they can be used as guidelines for developing health portals.
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| 2. |
- Baig, Mirza Mansoor, et al.
(author)
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Clinical decision support systems in hospital care using ubiquitous devices : Current issues and challenges
- 2019
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In: Health Informatics Journal. - : SAGE PUBLICATIONS INC. - 1460-4582 .- 1741-2811. ; 25:3, s. 1091-1104
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Journal article (peer-reviewed)abstract
- Supporting clinicians in decision making using advanced technologies has been an active research area in biomedical engineering during the past years. Among a wide range of ubiquitous systems, smartphone applications have been increasingly developed in healthcare settings to help clinicians as well as patients. Today, many smartphone applications, from basic data analysis to advanced patient monitoring, are available to clinicians and patients. Such applications are now increasingly integrating into healthcare for clinical decision support, and therefore, concerns around accuracy, stability, and dependency of these applications are rising. In addition, lack of attention to the clinicians' acceptability, as well as the low impact on the medical professionals' decision making, are posing more serious issues on the acceptability of smartphone applications. This article reviews smartphone-based decision support applications, focusing on hospital care settings and their overall impact of these applications on the wider clinical workflow. Additionally, key challenges and barriers of the current ubiquitous device-based healthcare applications are identified. Finally, this article addresses current challenges, future directions, and the adoption of mobile healthcare applications.
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| 3. |
- Berner, Jessica, et al.
(author)
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Factors influencing Internet usage in older adults (65 years and above) living in rural and urban Sweden
- 2015
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In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 21:3, s. 237-249
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Journal article (peer-reviewed)abstract
- Older adults living in rural and urban areas have shown to distinguish themselves in technology adoption; a clearer profile of their Internet use is important in order to provide better technological and health-care solutions. Older adults' Internet use was investigated across large to midsize cities and rural Sweden. The sample consisted of 7181 older adults ranging from 59 to 100 years old. Internet use was investigated with age, education, gender, household economy, cognition, living alone/or with someone and rural/urban living. Logistic regression was used. Those living in rural areas used the Internet less than their urban counterparts. Being younger and higher educated influenced Internet use; for older urban adults, these factors as well as living with someone and having good cognitive functioning were influential. Solutions are needed to avoid the exclusion of some older adults by a society that is today being shaped by the Internet.
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| 4. |
- Ehrentraut, Claudia, et al.
(author)
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Detecting hospital-acquired infections : A document classification approach using support vector machines and gradient tree boosting
- 2018
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In: Health Informatics Journal. - : SAGE Publications. - 1460-4582 .- 1741-2811. ; 24:1, s. 24-42
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Journal article (peer-reviewed)abstract
- Hospital-acquired infections pose a significant risk to patient health, while their surveillance is an additional workload for hospital staff. Our overall aim is to build a surveillance system that reliably detects all patient records that potentially include hospital-acquired infections. This is to reduce the burden of having the hospital staff manually check patient records. This study focuses on the application of text classification using support vector machines and gradient tree boosting to the problem. Support vector machines and gradient tree boosting have never been applied to the problem of detecting hospital-acquired infections in Swedish patient records, and according to our experiments, they lead to encouraging results. The best result is yielded by gradient tree boosting, at 93.7percent recall, 79.7percent precision and 85.7percent F1 score when using stemming. We can show that simple preprocessing techniques and parameter tuning can lead to high recall (which we aim for in screening patient records) with appropriate precision for this task.
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| 5. |
- Holmberg, Christopher, 1984, et al.
(author)
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Health literacy in a complex digital media landscape: Pediatric obesity patients’ experiences with online weight, food, and health information
- 2019
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In: Health Informatics Journal. - : SAGE Publications. - 1460-4582 .- 1741-2811. ; 25:4, s. 1343-1357
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Journal article (peer-reviewed)abstract
- This study aimed to explore experiences with online information regarding food, weight management, and health in a group of adolescents in treatment for obesity. Individual semi-structured interviews with 20 adolescents were conducted. Participants used a screen-recorded laptop to demonstrate their search procedures and online information sources. The transcribed interviews were categorized using qualitative content analysis. The adolescents described both encouraging and discouraging experiences. On one hand, they said that online forums could provide nutritious meal ideas and inspiration as well as social support for behavior change. On the other hand, they mentioned that there was a confusing amount of misleading commercial content online and also experiences of peer-facilitated food marketing in online networks. An overarching theme was generated: social media might be a resource for health inspiration, health information, and social support, but requires awareness and competencies. Implications for clinical practice are discussed in light of these findings.
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| 6. |
- Islind, Anna Sigridur, 1985-, et al.
(author)
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Shift in translations : Data work with patient-generated health data in clinical practice
- 2019
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In: Health Informatics Journal. - : SAGE Publications. - 1460-4582 .- 1741-2811. ; 25:3, s. 577-586
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Journal article (peer-reviewed)abstract
- This article reports on how the introduction of patient-generated health data affects the nurses’ and patients’ data work and unpacks how new forms of data collection trigger shifts in the work with data through translation work. The article is based on a 2.5-year case study examining data work of nurses and patients at a cancer rehabilitation clinic at a Swedish Hospital in which patient-generated health data are gathered by patients and then used outside and within clinical practice for decision-making. The article reports on how data are prepared and translated, that is, made useful by the nurses and patients. Using patient-generated health data alters the data work and how the translation of data is performed. The shift in work has three components: (1) a shift in question tactics, (2) a shift in decision-making, and (3) a shift in distribution. The data become mobile, and the data work becomes distributed when using patient-generated health data as an active part of care
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| 7. |
- Jørgensen, Lene Bastrup, et al.
(author)
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The psychosocial effect of web-based information in fast-track surgery
- 2017
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In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 23:4, s. 304-318
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Journal article (peer-reviewed)abstract
- The psychosocial effects of web-based information have yet to be tested for patients joining a fast-track total hip arthroplasty programme. This study compared and evaluated the psychosocial impact of standard total hip arthroplasty programme, with and without supplementation with a web-based information platform (E-total hip arthroplasty programme). Totally, 299 patients were enrolled in an un-controlled, before-and-after study, 117 in the S-total hip arthroplasty programme group and 182 in the E-total hip arthroplasty programme group. Psychosocial outcomes before and during admission and then 3 months post-surgery were evaluated, with analyses conducted between and within groups. All outcomes improved significantly from pre-admission to 3 months post-surgery, with no between-group differences. In all, 112 of the 182 E-total hip arthroplasty programme patients accessed the learning platform. A subgroup analysis showed no significant differences between users and non-users, either at baseline or in terms of outcome. This study found no positive psychosocial effect between groups, but a significant effect within groups.
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| 8. |
- Karlsson, David, et al.
(author)
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Electronic data capture on athletes pre-participation health and in-competition injury and illness at major sports championships : An extended usability study in Athletics
- 2018
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In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 24:2, s. 136-145
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Journal article (peer-reviewed)abstract
- This study set out to identify factors critical for the usability of electronic data collection in association with championships in individual sports. A qualitative analysis of electronic data collection system usability for collection of data on pre-participation health from athletes and in-competition injury and illness from team physicians was performed during the 2013 European Athletics Indoor Championships. A total of 15 athletes and team physicians participated. Athletes were found to experience few problems interacting with the electronic data collection system, but reported concerns about having to reflect on injury and illness before competitions and the medical terminology used. Team physicians encountered problems when first navigating through the module for clinical reporting, but they were not subjected to motivational problems. We conclude that athletes motivation to self-report health data and the design of the human-computer interface for team physicians are key issues for the usability of electronic data collection systems in association with championships in individual sports.
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| 9. |
- Li, SS, et al.
(author)
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Setting priorities for EU healthcare workforce IT skills competence improvement
- 2019
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In: Health informatics journal. - : SAGE Publications. - 1741-2811 .- 1460-4582. ; 25:1, s. 174-185
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Journal article (peer-reviewed)abstract
- A major challenge for healthcare quality improvement is the lack of IT skills and knowledge of healthcare workforce, as well as their ambivalent attitudes toward IT. This article identifies and prioritizes actions needed to improve the IT skills of healthcare workforce across the EU. A total of 46 experts, representing different fields of expertise in healthcare and geolocations, systematically listed and scored actions that would improve IT skills among healthcare workforce. The Child Health and Nutrition Research Initiative methodology was used for research priority-setting. The participants evaluated the actions using the following criteria: feasibility, effectiveness, deliverability, and maximum impact on IT skills improvement. The leading priority actions were related to appropriate training, integrating eHealth in curricula, involving healthcare workforce in the eHealth solution development, improving awareness of eHealth, and learning arrangement. As the different professionals’ needs are prioritized, healthcare workforce should be actively and continuously included in the development of eHealth solutions.
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| 10. |
- Rexhepi, Hanife, 1984-, et al.
(author)
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Cancer Patients’ Attitudes and Experiences of Online Access to their Electronic Medical Records : A Qualitative Study
- 2018
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In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 24:2, s. 115-124
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Journal article (peer-reviewed)abstract
- Patients’ access to their online medical records serves as one of the cornerstones in the efforts to increase patient engagement and improve healthcare outcomes. The aim of this paper is to provide in-depth understanding of cancer patients’ attitudes and experiences of online medical records, as well as an increased understanding of the complexities of developing and launching e-Health services. The study result confirms that online access can help patients prepare for doctor visits and to understand their medical issues. In contrast to the fears of many physicians the study shows that online access to medical records did not generate substantial anxiety, concerns or increased phone calls to the hospital
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| 11. |
- Riggare, Sara, et al.
(author)
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Patients are doing it for themselves : A survey on disease-specific knowledge acquisition among people with Parkinson's disease in Sweden.
- 2017
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In: Health Informatics Journal. - : SAGE Publications. - 1460-4582 .- 1741-2811.
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Journal article (peer-reviewed)abstract
- Effective self-management is key to living well with Parkinson's disease and one important aspect is disease-specific knowledge. This article explores how people with Parkinson's disease in Sweden (1) acquire disease-specific knowledge and (2) use Parkinson's disease-related healthcare. Data were collected through an online survey, which had 346 respondents (16-87 years old, median age: 68 years, 51% male; time since diagnosis: 0-31 years, median time: 7 years). Our results show that disease-specific knowledge is mainly found online, especially for women with Parkinson's disease and people with Parkinson's disease of working age, that most people with Parkinson's disease in Sweden see their neurologist for 1 h or less per year and only one in two people with Parkinson's disease has regular contact with other Parkinson's disease-related healthcare professionals. We also find that people with Parkinson's disease reporting higher levels of specific knowledge also are more likely to be satisfied with the amount of time they get with their neurologist, regardless of the amount of time.
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| 12. |
- Robinson, Stephen Cory, 1982-
(author)
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No exchange, same pain, no gain : Risk–reward of wearable healthcare disclosure of health personally identifiable information for enhanced pain treatment
- 2019
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In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 25:4, s. 1675-1691
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Journal article (peer-reviewed)abstract
- Wearable technologies have created fascinating opportunities for patients to treat chronic pain in a discreet, mobile fashion. However, many of these health wearables require patients to disclose sensitive information, including health information (e.g., heart rate, glucose levels) and personal information (location, email, name, etc.). Individuals using wearables for treatment of chronic pain may sacrifice social health elements, including their privacy, in exchange for better physical and mental health. Utilizing communication privacy management, a popular disclosure theory, this article explores the policy and ethical ramifications of patients disclosing sensitive health information in exchange for better health treatment and relief of chronic pain. The article identifies scenarios where a user must disclose information, and what factors motivate or dissuade disclosure, and ultimately the use of a health wearable. Practical implications of this conceptual article include an improved understanding of how and why consumers may disclose personal data to health wearables, and potential impacts for public policy and ethics regarding how wearables and their manufacturers entice disclosure of private health information.
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| 13. |
- Stevenson-Ågren, Jean, et al.
(author)
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Recording signs of deterioration in acute patients : The documentation of vital signs within electronic health records in patients who suffered in-hospital cardiac arrest
- 2016
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In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 22:1, s. 21-33
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Journal article (peer-reviewed)abstract
- Vital sign documentation is crucial to detecting patient deterioration. Little is known about the documentation of vital signs in electronic health records. This study aimed to examine documentation of vital signs in electronic health records. We examined the vital signs documented in the electronic health records of patients who had suffered an in-hospital cardiac arrest and on whom cardiopulmonary resuscitation was attempted between 2007 and 2011 (n = 228), in a 372-bed district general hospital. We assessed the completeness of vital sign data compared to VitalPACTM Early Warning Score and the location of vital signs within the electronic health records. There was a noticeable lack of completeness of vital signs. Vital signs were fragmented through various sections of the electronic health records. The study identified serious shortfalls in the representation of vital signs in the electronic health records, with consequential threats to patient safety.
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| 14. |
- Stevenson-Ågren, Jean, et al.
(author)
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Vital sign documentation in electronic records : the development of workarounds
- 2018
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In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 24:2, s. 206-215
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Journal article (peer-reviewed)abstract
- Workarounds are commonplace in health care settings. An increase in the use of electronic health records (EHR) has led to an escalation of workarounds as health care professionals cope with systems which are inadequate for their needs. Closely related to this, the documentation of vital signs in EHR has been problematic. The accuracy and completeness of vital sign documentation has a direct impact on the recognition of deterioration in a patient’s condition. We examined work flow processes to identify workarounds related to vital signs in a 372-bed hospital in Sweden. In three clinical areas a qualitative study was performed with data collected during observations and interviews and analysed through thematic content analysis. We identified paper workarounds in the form of hand-written notes and a total of eight pre-printed paper observation charts. Our results suggested that nurses created workarounds to allow a smooth workflow and to ensure patients safety.
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| 15. |
- Throfast, Victoria, et al.
(author)
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e-Learning for the elderly on drug utilization : a pilot study
- 2019
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In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 25:2, s. 227-239
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Journal article (peer-reviewed)abstract
- This study explores the attitudes of elderly people to the use of electronic educational technology (e-learning) on drug utilization, with particular emphasis on the layout, usability, content, and level of knowledge in the tool. e-Learning modules were evaluated by a group of elderly people (aged ⩾65 years, n = 16) via a questionnaire comprising closed and open-ended questions. Both qualitative and quantitative analyses of the responses showed mostly positive reviews. The results indicate that the e-learning modules are a suitable tool for distributing information and education and that they can be managed by elderly individuals who are familiar with computers, allowing them to learn more about medication use.
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| 16. |
- Vallo Hult, Helena, 1976-, et al.
(author)
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Flipped healthcare for better or worse
- 2019
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In: Health Informatics Journal. - : SAGE Publications. - 1460-4582 .- 1741-2811. ; 25:3, s. 587-597
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Journal article (peer-reviewed)abstract
- The medical profession is highly specialized, demanding continuous learning, while also undergoing rapid development in the rise of data-driven healthcare. Based on clinical scenarios, this study explores how resident physicians view their roles and practices in relation to informed patients and patient-centric digital technologies. The paper illustrates how the new role of patients alters physicians’ work and use of data to learn and update their professional practice. It suggests new possibilities for developing collegial competence and using patient experiences more systematically. Drawing on the notion of flipped healthcare, we argue that there is a need for new professional competencies in everyday data work, along with a change in attitudes, newly defined roles, and better ways to identify and develop reliable online sources. Finally, the role of patients, not only as consumers but also producers of healthcare, is a rather formidable and complex cultural change to be addressed. © The Author(s) 2019.
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| 17. |
- Van Grootven, Bastiaan, et al.
(author)
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The European Union's Ambient and Assisted Living Joint Programme : An evaluation of its impact on population health and well-being
- 2019
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In: Health Informatics Journal. - : SAGE Publications. - 1460-4582 .- 1741-2811. ; 25:1, s. 27-40
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Journal article (peer-reviewed)abstract
- The Ambient Assisted Living Joint Programme, instituted in 2008 by the European Union, aimed to create better living conditions for older adults through the funding of information and communications technology projects. This review aimed to uncover what can be learned from the Ambient Assisted Living Joint Programme by determining (1) the target populations served, (2) technology-based interventions used and (3) effects on health and well-being outcomes. Information from the Ambient Assisted Living catalogue, project websites and deliverables and from papers in PubMed and EMBASE was reviewed. Overall, 152 projects from the first six rounds of funding were identified. Sensors, computers, phones, tablets and televisions were used for various purposes, that is, monitoring, feedback, coaching, reminders and communication. In total, 12 projects reported evaluating health and well-being outcomes; however, these evaluations demonstrated poor methodological quality. Only three projects reported exact values. For all other projects, published evidence on the effect of these projects on health and well-being outcomes was not available.
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| 18. |
- Wass, Sofie, et al.
(author)
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Exploring patients’ perceptions of accessing electronic health records : Innovation in healthcare
- 2019
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In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 25:1, s. 203-215
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Journal article (peer-reviewed)abstract
- The more widespread implementation of electronic health records has led to new ways of providing access to healthcare information, allowing patients to view their medical notes, test results, medicines and so on. In this article, we explore how patients perceive the possibility to access their electronic health record online and whether this influences patient involvement. The study includes interviews with nine patients and a survey answered by 56 patients. Our results show that patients perceive healthcare information to be more accessible and that electronic health record accessibility improves recall, understanding and patient involvement. However, to achieve the goal of involving patients as active decision-makers in their own treatment, electronic health records need to be fully available and test results, referrals and information on drug interactions need to be offered. As patient access to electronic health records spreads, it is important to gain a deeper understanding of how documentation practices can be changed to serve healthcare professionals and patients.
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| 19. |
- Wass, Sofie, et al.
(author)
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Same, same but different : Perceptions of patients’ online access to electronic health records among healthcare professionals
- 2019
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In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 25:4, s. 1538-1548
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Journal article (peer-reviewed)abstract
- In this study, we explore how healthcare professionals in primary care and outpatient clinics perceive the outcomes of giving patients online access to their electronic health records. The study was carried out as a case study and included a workshop, six interviews and a survey that was answered by 146 healthcare professionals. The results indicate that professionals working in primary care perceive that an increase in information-sharing with patients can increase adherence, clarify important information to the patient and allow the patient to quality-control documented information. Professionals at outpatient clinics seem less convinced about the benefits of patient accessible electronic health records and have concerns about how patients manage the information that they are given access to. However, the patient accessible electronic health record has not led to a change in documentation procedures among the majority of the professionals. While the findings can be connected to the context of outpatient clinics and primary care units, other contextual factors might influence the results and more in-depth studies are therefore needed to clarify the concerns.
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| 20. |
- Winge, Monica, et al.
(author)
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The coordination hub : Toward patient-centered and collaborative care processes
- 2015
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In: Health Informatics Journal. - : SAGE Publications. - 1460-4582 .- 1741-2811. ; 21:4, s. 284-305
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Journal article (peer-reviewed)abstract
- The organization and processes of today's health and social care are becoming ever more complex as a consequence of societal trends, including an aging population and an increased reliance on care at home. One aspect of the increased complexity is that a single patient may receive care from several care providers, which easily results in situations with potentially incoherent, uncoordinated, and interfering care processes. In order to describe and analyze such situations, the article introduces the notion of a process conglomeration. This is defined as a set of patient-care processes that all concern the same patient, that are overlapping in time, and that all are sharing the overall goal of improving or maintaining the health and social well-being of the patient. Problems and challenges of process conglomerations are investigated using coordination theory and models for continuous process improvement. In order to address the challenges, a solution is proposed in the form of a Coordination Hub, being an integrated software service that offers a number of information services for coordinating the activities of the processes in a process conglomeration.
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| 21. |
- Åhlfeldt, Rose-Mharie, et al.
(author)
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Supporting Active Patient and Health Care Collaboration : A Prototype for Future Health Care Information Systems
- 2016
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In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 22:4, s. 839-853
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Journal article (peer-reviewed)abstract
- This article presents and illustrates the main features of a proposed process-oriented approach for patient information distribution in future health care information systems, by using a prototype of a process support system. The development of the prototype was based on the Visuera method, which includes five defined steps. The results indicate that a visualized prototype is a suitable tool for illustrating both the opportunities and constraints of future ideas and solutions in e-Health. The main challenges for developing and implementing a fully functional process support system concern both technical and organizational/management aspects.
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