| 1. |
- Barsaum, Peter, et al.
(författare)
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Internet of Things Technology for Remote Healthcare : A Pilot Study
- 2016
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Ingår i: Proceedings from The 14th Scandinavian Conference on Health Informatics 2016. - Linköping : Linköping University Electronic Press. - 9789176857762 ; , s. 43-48
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)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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| 2. |
- Blusi, Madeleine, et al.
(författare)
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Test av användbarheten hos innovationen TENA Identifi på Viktoriagården i Kramfors
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)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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| 3. |
- Bärkås, Annika, et al.
(författare)
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Analysis of Voluntary User Feedback of the Swedish National PAEHR Service
- 2019
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Ingår i: MEDINFO 2019. - : IOS Press. - 9781643680033 - 9781643680026 ; 264, s. 1126-1130
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Konferensbidrag (refereegranskat)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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| 4. |
- Cajander, Åsa, et al.
(författare)
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Designing eHealth Services for Patients and Relatives : Critical Incidents and Lessons to Learn
- 2016
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Ingår i: PROCEEDINGS OF THE NORDICHI '16. - New York, NY, USA : Association for Computing Machinery (ACM). - 9781450347631
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Konferensbidrag (refereegranskat)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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| 5. |
- Essén, Anna, et al.
(författare)
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Patient access to electronic health records : Differences across ten countries
- 2018
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Ingår i: Health Policy and Technology. - : Elsevier. - 2211-8837 .- 2211-8845. ; 7:1, s. 44-56
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Tidskriftsartikel (refereegranskat)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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| 6. |
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| 7. |
- Grünloh, Christiane, et al.
(författare)
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Using Critical Incidents in Workshops to Inform eHealth Design
- 2017
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Ingår i: Human-Computer Interaction - INTERACT 2017. - Cham : Springer. - 9783319677439 - 9783319677446 ; , s. 364-373
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Konferensbidrag (refereegranskat)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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| 8. |
- Hofflander, Malin
(författare)
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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
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)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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| 9. |
- Huvila, Isto, Professor, 1976-, et al.
(författare)
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Anticipating ageing : Older adults reading their medical records
- 2018
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Ingår i: Information Processing & Management. - : Elsevier. - 0306-4573 .- 1873-5371. ; 54:3, s. 394-407
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Tidskriftsartikel (refereegranskat)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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| 10. |
- Hägglund, Maria, 1975-, et al.
(författare)
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A Socio-Technical Analysis of Patient Accessible Electronic Health Records
- 2017
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Ingår i: The Practice of Patient Centered Care. - : IOS Press. - 9781614998235 - 9781614998242 ; 244, s. 3-7
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Konferensbidrag (refereegranskat)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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| 11. |
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| 12. |
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| 13. |
- Hägglund, Maria, Lektor, 1975-, et al.
(författare)
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Patients’ access to health records
- 2019
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Ingår i: The BMJ. - : BMJ. - 1756-1833 .- 0959-8138. ; 367
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Patients and clinicians are equally frustrated by the slow pace of changeThe international movement pushing to increase transparency by giving patients easy access to their health information parallels a broader shift in healthcare towards increased patient empowerment and participation. In the United States, the philanthropic OpenNotes initiative works to increase transparency by encouraging healthcare organisations to provide patients with access to notes in their electronic health record. It began in 2010 as a pilot that included 105 volunteer primary care providers and their 19 000 patients and has since spread throughout the US, with more than 200 organisations offering roughly 41 million patients access to their clinical notes. In Sweden, the first region-wide implementation of patient access to electronic health records was in 2012, more than 10 years after the first pilot study. All 21 Swedish regions have now offered this e-service through a national patient portal that integrates with all electronic health record systems currently used in Sweden. More than 3 million people (>30% of the population) had accessed their records online by August 2019, and more than 2 million logins occur each month.Similar patient accessible electronic record systems are implemented in other countries, though different strategies and approaches have influenced uptake and impact. Progress has been slow because of legal constraints, technical challenges, and concerns or resistance among healthcare professionals. Low rates of adoption among patients have also been a problem in some areas. Nonetheless, research evidence reports positive outcomes among patients accessing their records, and the concerns expressed by healthcare professionals have not been realised. Patients who read their notes report understanding their care plans better, feeling more in control of their care, doing a better job taking their medications, improved communication with and trust in their clinicians, and improved patient safety.
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| 14. |
- Hägglund, Maria, et al.
(författare)
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Patients' online access to Electronic Health Records : current status and experiences from the implementation in Sweden
- 2017
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Ingår i: MEDINFO 2017. - : IOS Press. - 9781614998297 - 9781614998303 ; 245, s. 723-727
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Konferensbidrag (refereegranskat)abstract
- The number of eHealth services for patients is rapidly increasing worldwide. This paper describes the status of the currently most important eHealth service for patients in Sweden, the Patient Accessible Electronic Health Record. As many countries are facing an introduction of national eHealth services providing health information to the patients, lessons learned from Sweden may improve the deployment and use of PAEHRs and similar eHealth services also elsewhere. Challenges that remain in Sweden have to do with local differences in the implementation that lead to fragmentation and inequal access to information. Initiatives have been taken to reconcile some of the problems, e.g. an updated national regulatiory framework for PAEHR. To date, evaluations are often performed from a healthcare provider perspective, focusing on aspects that are considered important by healthcare professionals and decision makers. Based on experiences of this nation-wide implementation we argue for the need to also base evaluations of eHealth on the perspective of the patients.
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| 15. |
- Hägglund, M., et al.
(författare)
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Reinventing Heuristic Evaluations : Exploring Methods to Engage Clinicians in Usability Evaluations
- 2017
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Ingår i: Informatics for health: Connected Citizen-Led Wellness and Population Health.
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Konferensbidrag (refereegranskat)abstract
- Usability evaluations are essential to the success of health information system implementation, but are often costly and dependent on right expertise being available. Heuristic Evaluation (HE) is considered a straightforward method consisting of clear stages. Involving clinicians in HE may facilitate usability evaluations in healthcare, yet there are challenges. Many questions remain unanswered regarding how to implement user involvement in HE; where and how could clinicians best be involved in this process? To what level of autonomy and with what added benefit? In this workshop, we will explore experiences of involving clinical users in HE, discuss challenges and best practice.
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| 16. |
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| 17. |
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| 18. |
- Hägglund, Maria, et al.
(författare)
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Timing It Right : Patients' Online Access to Their Record Notes in Sweden
- 2018
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Ingår i: Building Continents of Knowledge in Oceans of Data. - : IOS Press. - 9781614998518 - 9781614998525 ; 247, s. 336-340
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Konferensbidrag (refereegranskat)abstract
- In Sweden, and internationally, there is an ongoing debate about the effects of national implementations of Patient Accessible Electronic Health Records (PAEHRs). The purpose of this paper was to describe the current situation in Sweden and compare this with the expectations on reasonable waiting time for information access of users of the Swedish PAEHR. Data were collected from publicly available resources regarding current implementation in the 21 county councils, contrasted with patient experiences, gathered from a national online survey. The results indicate that patients have high expectations on immediate access to information, while this varies greatly in implementation across Sweden.
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| 19. |
- Hägglund, Maria, Lektor, 1975-, et al.
(författare)
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Världsbäst på eHälsa kräver internationellt samarbete
- 2017
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Ingår i: Svenska dagbladet. - Stockholm, Sweden : Svenska Dagbladet AB & Co.. - 1101-2412.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Det är glädjande att myndigheter nu äntligen tittar mer på internationellt delade detaljerade dokumentationsmodeller för innehåll i journaler. Vi hoppas att de ger tillräckligt kraftfulla och tydliga budskap så att de upphandlande vårdgivarna också ser vikten av detta. Om vi ska bli världsbäst på eHälsa krävs internationellt samarbete, skriver flera forskare i medicinsk informatik.
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| 20. |
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| 21. |
- Kolkowska, Ella, 1972-, et al.
(författare)
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A user-centered ethical assessment of welfare technology for elderly
- 2018
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Ingår i: Lect. Notes Comput. Sci.. - Cham : Springer International Publishing. - 9783319920368 - 9783319920375 ; , s. 59-73
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Konferensbidrag (refereegranskat)abstract
- Welfare technology (WT) is often developed with a technical perspective, and little consideration is taken regarding the involvement of important ethical considerations and different values that come up during the development and implementation of WT. Safety, security and privacy are significant, as well as the usability and overall benefit of the tool, but to date assessments often lack a holistic picture of the WT as seen by the users. This paper suggests a user-centered ethical assessment (UCEA) framework for WT to be able to evaluate ethical consequences as a part of the user-centered aspects. Building on established methodologies from research on ethical considerations, as well as the research domain of human-computer interaction, this assessment framework joins knowledge of ethical consequences with aspects affecting the “digitalization with the individual in the center”, e.g. privacy, safety, well-being, dignity, empowerment and usability. The framework was applied during development of an interface for providing symptom information to Parkinson patients. The results showed that the UCEA framework directs the attention to values emphasized by the patients. Thus, functionality of the system was evaluated in the light of values and expected results of the patients, thereby facilitating follow-up of a user-centered assessment. The framework may be further developed and tested, but in this study it served as a working tool for assessing ethical consequences of WT as a part of user-centered aspects.
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| 22. |
- Kolkowska, Ella, 1972-, et al.
(författare)
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Socio-Technical Challenges in Implementation of Monitoring Technologies in Elderly Care
- 2016
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Ingår i: Human Aspects of IT for the Aged Population. - Cham : Springer. - 9783319399485 - 9783319399492 ; , s. 45-56
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Konferensbidrag (refereegranskat)abstract
- Although new monitoring technologies (MT) supporting aging in place are continuously developed and introduced on the market, attempts to implement these technologies as an integrated part of elderly care often fail. According to the literature, the reason for that may be the prevailing technical focus applied during development and implementation of monitoring technologies in real settings. The aim of this paper was to investigate the socio-technical challenges that arise during implementation of monitoring technologies in elderly care. We used a qualitative case study and semi-structured interviews to investigate socio-technical (S/T) challenges in implementation of monitoring technologies generally and social alarms especially. Based on our findings we suggest a framework for classification of S/T challenges arising during implementation of monitoring technologies in elderly care and in this way this paper contributes to a better understanding of these challenges.
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| 23. |
- Kolkowska, Ella, 1972-, et al.
(författare)
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To capture the diverse needs of welfare technology stakeholders – Evaluation of a value matrix
- 2017
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Ingår i: Third International Conference, ITAP 2017, Held as Part of HCI International 2017, Vancouver, BC, Canada, July 9-14, 2017: Proceedings, Part II, Springer, 2017, 404-419 s.. - Cham : Springer International Publishing. - 9783319585352 ; , s. 404-419
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Konferensbidrag (refereegranskat)abstract
- Welfare technology (WT) is often developed with a technical perspective, which does not involve important ethical considerations and different values that come up during the development and implementation of WT within elderly care. This paper presents a study where we have applied an ethical value matrix to support systematic ethical assessments of WT intended for personal health monitoring. The matrix consists of values in a checklist and a number of stakeholders and it is possible to analyze which values are emphasized by which stakeholders. The aim was to assess the matrix and find out how the matrix supports identification of values and interests that drive the various stakeholders in the development and implementation of WT. We have realized that several values specified by different actors as especially important were not included in the matrix and that the values in the matrix did not visualize or enable identification of value conflicts.
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| 24. |
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| 25. |
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| 26. |
- Moll, Jonas, et al.
(författare)
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Identifying the Need of Self-reported Data and Self-measurements for Diagnosis and Treatment of Cancer
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Today, numerous data sources are available to healthcare professionals for diagnosing and treating cancer, but there are also data captured by patients, e.g. related to daily progress, which are not readily accessible to healthcare. In this workshop, we will use the critical incidents technique to inspire participants to elaborate on the need of using new data collections and measurements, for example from continuous self-tracking, as well as utilizing already existing data in new ways for diagnoses and treatment of cancer. Real-life critical incidents related to patients, healthcare professionals, and researchers, will be discussed and used as a basis for scenarios that will illustrate future visions of how self-reported data and self-measurements should be used in combination with existing data sources.
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| 27. |
- Moll, Jonas, 1982-, et al.
(författare)
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Patients’ Experiences of Accessing Their Electronic HealthRecords : National Patient Survey in Sweden
- 2018
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Ingår i: Journal of Medical Internet Research. - : J M I R Publications, Inc.. - 1438-8871. ; 20:11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Internationally, there is a movement toward providing patients a Web-based access to their electronic health records (EHRs). In Sweden, Region Uppsala was the first to introduce patient-accessible EHRs (PAEHRs) in 2012. By the summer of 2016, 17 of 21 county councils had given citizens Web-based access to their medical information. Studies on the effect of PAEHRs on the work environment of health care professionals have been conducted, but up until now, few extensive studies have been conducted regarding patients’ experiences of using PAEHRs in Sweden or Europe, more generally.Objective: The objective of our study was to investigate patients’ experiences of accessing their EHRs through the Swedish national patient portal. In this study, we have focused on describing user characteristics, usage, and attitudes toward the system.Methods: A national patient survey was designed, based on previous interview and survey studies with patients and health care professionals. Data were collected during a 5-month period in 2016. The survey was made available through the PAEHR system, called Journalen, in Sweden. The total number of patients that logged in and could access the survey during the study period was 423,141. In addition to descriptive statistics reporting response frequencies on Likert scale questions, Mann-Whitney tests, Kruskal-Wallis tests, and chi-square tests were used to compare answers between different county councils as well as between respondents working in health care and all other respondents.Results: Overall, 2587 users completed the survey with a response rate of 0.61% (2587/423,141). Two participants were excluded from the analysis because they had only received care in a county council that did not yet show any information in Journalen. The results showed that 62.97% (1629/2587) of respondents were women and 39.81% (1030/2587) were working or had been working in health care. In addition, 72.08% (1794/2489) of respondents used Journalen about once a month, and the main reason for use was to gain an overview of one’s health status. Furthermore, respondents reported that lab results were the most important information for them to access; 68.41% (1737/2539) of respondents wanted access to new information within a day, and 96.58% (2454/2541) of users reported that they are positive toward Journalen.Conclusions: In this study, respondents provided several important reasons for why they use Journalen and why it is important for them to be able to access information in this way—several related to patient empowerment, involvement, and security. Considering the overall positive attitude, PAEHRs seem to fill important needs for patients.
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| 28. |
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| 29. |
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| 30. |
- Scandurra, Isabella, 1973-, et al.
(författare)
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A Living Lab Method for Innovations to Increase Quality of Life for Elderly : A Pilot Case
- 2015
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Ingår i: Human Aspects of IT for the Aged Population. - Heidelberg, Germany : Springer. - 9783319208916 ; , s. 123-133
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Konferensbidrag (refereegranskat)abstract
- A Swedish Living Lab has recently been established offering care organizations a test and evaluation method as an activity in their intrinsic development process. Using the method, innovations for an aging population are assessed, guided by quality criteria as well-being, dignity, value for the elderly and usability.This paper describes the method through a pilot test, carried out in November 2014 by the elderly themselves and health and social care staff at a nursing home together with different academic parts in a multidisciplinary test process. The method allows for interaction between innovators and stakeholders as well as potential end-users in the elderly care sector. Simultaneously, the users’ quality aspects are kept in focus when innovations for the aging society are tested.
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| 31. |
- Scandurra, Isabella, 1973-, et al.
(författare)
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Analysis of the Updated Swedish Regulatory Framework of the Patient Accessible Electronic Health Record in Relation to Usage Experience
- 2017
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Ingår i: MEDINFO 2017. - : IOS Press. - 9781614998303 - 9781614998297 ; , s. 798-802
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Konferensbidrag (refereegranskat)abstract
- In Sweden, all citizens can (in 2017) access their health data online from all county councils using one national eHealth service. However, depending on where the patient lives, different information is provided as care providers have assessed differently how to apply the National Regulatory Framework (NRF). The NRF recently was updated and this paper analyses version 2.0 should now serve as the guideline for all county councils. Potential improvements are analyzed in relation to patient experiences of using the service, and the rationale for each change in the NRF is discussed. Two real case quotations are used to illustrate potential implications for the patient when the new version is placed into operation. Results indicate that this NRF allows for opportunities to create a national eHealth service that better supports patient-centered care and improves health information outcome.
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| 32. |
- Scandurra, Isabella, 1973-, et al.
(författare)
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Developing and implementing national eHealth services for patients : an interactive exploration of challenges and potential solutions
- 2015
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Ingår i: Driving Quality in Informatics.
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Konferensbidrag (refereegranskat)abstract
- Developing and Implementing National eHealth Services for Patients – An Interactive Exploration of Challenges and Potential Solutions Isabella Scandurra, Informatics, School of Business, Örebro University, Sweden; Maria Hägglund, Health Informatics Centre, Karolinska Institutet, Sweden As a means to address current challenges for and demands on health and social care, e.g. quality of care and patient empowerment, information and communication technologies (ICT) are being used to supply citizens with various health services. One example is to give patients web access to their own electronic health records (EHRs). In this workshop, we will provide examples and experiences from ongoing work in Sweden to develop and implement eHealth services for citizens; SUSTAINS [1] and My Care Pathways [2].The workshop participants will be engaged in interactive discussions regarding challenges and potential solutions based on their experiences from different contexts. The aim of the workshop is twofold: 1. To explore challenges for developing and implementing e-health systems for citizens to access their patient information and other e-health services online. 2. To suggest strategies and activities that could provide potential solutions to the identified challenge. Workshop structure The disposition of the workshop is as follows: a 90 minute session, a 15 minutes break and another 75 minute session. The two sessions will contain both presentations from the workshop organizers and interactive discussions and work in smaller groups to engage all participants and share experiences from different contexts. This disposition requires active participants to generate new ideas and knowledge through discussions and reflections where all participants contribute with their knowledge and understanding of the problem. The topic is expected to engage a lot of people, maybe not only those present at the workshop or at the conference. The workshop organizers will encourage live tweeting during the sessions and invite followers.
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| 33. |
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| 34. |
- Scandurra, Isabella, 1973-, et al.
(författare)
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Implications of Swedish National Regulatory Framework of the Patient Accessible Electronic Health Record
- 2016
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Ingår i: Exploring Complexity in Health. - Amsterdam : IOS Press. - 9781614996781 - 9781614996774 ; , s. 695-699
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Konferensbidrag (refereegranskat)abstract
- Online access to your own electronic health record is a controversial issue. In a Swedish county such eHealth service has been in operation since 2012 and it is now being widely deployed in the other counties. This first review presents work regarding current National Regulatory Framework (NRF) related to the public eHealth service Patient Accessible Electronic Health Record (PAEHR) and points out how electable paragraphs have been applied in different counties. Potential implications due to the different decisions made are discussed in terms of patient centricity and health information outcome. In current PAEHR, care providers have assessed differently how to apply the NRF. For the patients, this means that information gathered from the health record may be displayed differently, depending on where, when and why they seek treatment. When a patient visits different care providers such solution may cause confusion and its purpose may go lost. Consequently a revised NRF with less electable paragraphs is recommended, as well as adherence to the next NRF by all county councils.
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| 35. |
- Scandurra, Isabella, 1973-, et al.
(författare)
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Is Access to eHealth Records Important for Patients? : Opinions of Healthcare Personnel
- 2015
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Ingår i: MedInfo 2015. - Amsterdam, Netherlands : IOS Press. - 9781614995647 - 9781614995630 ; , s. 908-908
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Konferensbidrag (refereegranskat)abstract
- Sweden has had significant progress with the the introduction of electronic health records. A pilot county deployed in an eHealth service in 2012, giving access to health records for all of its patients. This eHealth service is, however, a controversial issue. Two surveys were conducted to discover whether healthcare professionals' opinions differ between professionals, and between staff who have had experience with patients using eHealth records and those, to date, who have had none. Experienced nurses found this eHealth service more important for the patients compared to unexperienced nurses outside the pilot county, as well as both semi-experienced physicians.
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| 36. |
- Scandurra, Isabella, 1973-, et al.
(författare)
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Is 'patient's online access to health records' a good reform? : Opinions from Swedish healthcare professionals differ
- 2015
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Ingår i: Conference On Enterprise Information Systems/International Conference On Project Management/Conference On Health And Social Care Information Systems And Technologies, Centeris/Projman / Hcist 2015. - Amsterdam, Netherlands : Elsevier BV. ; 64, s. 964-968
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Konferensbidrag (refereegranskat)abstract
- Patients' access to their own electronic health record is a controversial issue. Many care professionals are concerned about negative effects deriving from patients reading their record information without support from clinicians. Patients on the other hand often think their concerns are outweighed by the benefits. In Sweden a pilot county has provided the health record online to its 350 000 patients for 2.5 years. This study highlights one of the most important questions to handle before and during implementation of such public eHealth services; the opinions of the care professionals regarding online records as a good reform. Results from three questionnaires to various care professions show that opinions from healthcare professionals differ not only between the professions but more importantly also between those who have experience from their patients reading their health record online and those who to date have no real experience. The experienced staff was more positive. This study concludes that in order to provide for successful national implementation, it is important to quickly elicit and disseminate opinions of care professionals with real experience to their unexperienced peers. Healthcare professionals should also be more involved in the implementation of Public eHealth services that regard electronic health records and their work processes.
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| 37. |
- Scandurra, Isabella, 1973-, et al.
(författare)
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Patient Accessible EHR is Controversial : Lack of Knowledge and Diverse Perceptions Among Professions
- 2017
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Ingår i: International Journal of Reliable and Quality E-Healthcare. - : IGI Global. - 2160-9551 .- 2160-956X. ; 6:1, s. 29-46
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, a national eHealth service providing Patient Accessible Electronic Health Records is now being widely deployed, with 400 000 users in January 2016. Although the Patient Data Act states that patients have a right to take part of their health records, the introduction has been controversial. Results from a pre-deployment questionnaire to record-keeping care professions in a healthcare region indicate that perceptions and knowledge differ not only between the professions but, more importantly, that knowledge about current eHealth development and action plans needs to increase as implementation will affect their work processes. Staff perceptions and knowledge are considered being some of the most important issues to handle during the implementation of eHealth services aiming to provide healthcare information and communication tools for patients and relatives. To cover the gaps, specific training is needed, and all record-keeping professionals need to be more involved in the implementation of such eHealth services.
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| 38. |
- Scandurra, Isabella, 1973-
(författare)
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Patient’s Access to own Electronic Health Record : State of the Art in Sweden
- 2015
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Ingår i: X Jornadas de Sistemas de Información en Salud del Hospital Italiano de Buenos Aires. - Buenos Aires.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- In this Key Note, experiences of the introduction of a public eHealth service is discussed: the Patients’ Online Access to their Electronic Health Records. Results from the Swedish pilot project on how access to patient records via Internet affects the development of care for patients as well as for healthcare professionals are presented as well as examples in the form of a live demonstrations of the eHealth service and its ongoing work will be provided. Challenges and potential solutions will be discussed together with the audience.
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| 39. |
- Scandurra, Isabella, 1973-, et al.
(författare)
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Ten Demands of Improved Usability in eHealth and Some Progress - Co-creation by Health and Social Care Professionals
- 2016
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Ingår i: Nursing Informatics 2016. - Amsterdam : IOS Press. - 9781614996583 - 9781614996576 ; , s. 227-231
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Konferensbidrag (refereegranskat)abstract
- Current healthcare organizations often do not accomplish the intended effects of their eHealth systems due to inadequate usability. Commissioned by the Swedish Ministry of Health and Social Affairs, the usability of current eHealth systems in Swedish health and social care has been analysed from the perspective of their professionals. The objective of the study was to report on current problems, potential solutions as well as to relate these to research in relevant areas. Using a participatory approach, nine workshops were held where health informatics researchers guided staff from different care organizations, representatives of the national associations of health and social care professionals and the national eHealth system vendor organization. This paper presents ten demands that Swedish health and social care professionals find imperative to prioritize. The study emphasizes that development of eHealth systems must be integrated into the care practice improvement process and iteratively evaluated regarding usability.
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| 40. |
- Scandurra, Isabella, 1973-, et al.
(författare)
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When do people read their health record? analysis of usage data of a national eHealth service giving patients access to their electronic health record
- 2017
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: eHealth services for citizens provide support for patients and families, as well as for healthcare professionals. In Sweden different eHealth services have been developed since the late 1990s and they are now used by millions of users. One of the national eHealth services that provides opportunities for increased participation in care is the Patient Accessible Electronic Health Record (PAEHR). To date (February 2017) over one million citizens (of 10 million inhabitants) have accessed their own electronic health record (EHR). In this study, we describe current usage by analysing log-data from the service. Who are the users, and how and when do they use the service?Method: Data collection of routinely captured usage data was administered by Inera AB, owner of all Swedish national eHealth services. Data was analyzed through IBM SPSS in accordance with the declaration of Helsinki. Queries for this quantitative study were created based on previously published results regarding concerns often expressed by healthcare professionals (HCP) as well as routinely captured log-data. Descriptive usage statistics were analysed towards such HCP concerns, e.g. increased workload due to worried patients reading but not understanding the PAEHR content.Results: Current status of the Swedish PAEHR is presented, e.g. number of users, demographic data (age, gender) in relation to log-in statistics. Regarding log-ins, first-time users and unique hits show that attention by national media has an impact a news cast resulted in 31,000 logged in compared to a week day average of 20,000. To date more than 1 million citizens have chosen to log in and the numbers are increasing. A newly connected region (Örebro) has an average of 500 new users a day. This can be compared to the first region (Uppsala) which during the first year (2012- 2013) had approx. 100 new users a day, although the strategy then was not to advertise the service. In total 10,000 to 13,000 new users log in every day nationally. More women than men log in and their mean age are 23-32 years. The older the users get the less they use the PAEHR, however some users are older than 93 years. During weekends the activity decreases, as opposed to HCP expectations. More often, users log in on week days, e.g. on Monday morning.Discussion: Usage statistics were related to concerns of HCP, which seem to have little resemblance to reality. One concern was that the service would not provide benefit for patients, here contradicted by the increasing number of both first-time and recurrent users. However, such indicators need to be further analysed. Paper records and PAEHR usage are difficult to compare, due to lack of statistics regarding printout reading. Usage comparisons between PAEHR solutions of different counties would however be interesting.Conclusion: Recurrent concerns of mainly HCP seem to be contradicted by actual usage by patients. This may lead to a decreased controversy of how PAEHR is experienced by patients and HCP. Knowledge about how users actually use PAEHR may also improve the service as such.
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| 41. |
- Sjölinder, Marie, et al.
(författare)
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Effects of Using Care Professionals in the Development of Social Technology for Elderly
- 2015
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Ingår i: Human Aspects of IT for the Aged Population. - Heidelberg, Germany : Springer. - 9783319209128 ; , s. 181-192
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Konferensbidrag (refereegranskat)abstract
- In some situations when developing technology for elderly, the intended users are too fragile and cannot participate themselves in the design process. The aim with this study was to investigate the use of care personnel as mediators for the elderly in the design process. The system that was developed was an information and communication technology system for sharing information and for keeping in touch with friends and family. Initially the care personnel misunderstood the need of technology among the elderly. During the project the care personnel changed their view and suggested new ways of using the technology. When the devices where placed in the rooms of the elderly the usage was low, but when the system was used in the dining areas as something to gather around, e.g. to show each other pictures of friends and family, the system became a success.
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| 42. |
- Sjölinder, Marie, et al.
(författare)
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Perspectives on design of sensor based exergames targeted towards older adults
- 2018
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Ingår i: Human Aspects of IT for the Aged Population. Applications in Health, Assistance, and Entertainment. - Cham : Springer. - 9783319920368 - 9783319920375 ; , s. 395-414
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Konferensbidrag (refereegranskat)abstract
- Serious games are an established field of study, where exergames provide a combination of conducting exercises and playing games. The aim of this work was to identify important features to include in, and design recommendations for exergames using sensor technology. The outcome of this work was two-folded. Firstly, a literature review of design guidelines with respect to older adults as users of exergames resulted in a categorized summary of design guidelines for specific target groups, e.g. people undergoing physical rehabilitation after stroke or injury or users suffering from a chronic disease. Secondly, these guidelines are discussed from various perspectives, based on insights from several years of work in the area. A general design guidelines covered by most of the literature is that exergames should provide a wide range of difficulty levels and be possible to adjust to individual needs. Insights from own work in the area highlight the importance of task and context relevant tools and devices. The result will serve as a starting point for a framework consisting of both general and domain specific design guidelines when designing sensor-based exergames for older adults.
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| 43. |
- Sjölinder, Marie, et al.
(författare)
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To Meet the Needs of Aging Users and the Prerequisites of Innovators in the Design Process Lessons Learned from Three Pilot Projects
- 2016
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Ingår i: Human Aspects of IT for the Aged Population. - Cham : Springer. - 9783319399423 - 9783319399430 ; , s. 92-104
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Konferensbidrag (refereegranskat)abstract
- The aim of this paper is to analyze cases where participatory design with different stakeholder groups was a beacon in the development of innovations. An important aspect was a strong foundation both in the needs of the elderly and in the feasibility from the market side. Three cases were analyzed from aspects as: environment and development phase of product; participation of different stakeholders; and proxy involvement of care professionals. The impact of this approach is a benefit for aging end-users as well as increased feasibility for the innovation companies, as a result when collaboration of different stakeholders focuses on balancing the demands of the users and the prerequisites of the industry.
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| 44. |
- Sjölinder, Marie, et al.
(författare)
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Using care professionals as proxies in the design process of welfare technology – Perspectives from municipality care
- 2017
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Konferensbidrag (refereegranskat)abstract
- Bringing real users into the design process is often seen as a successful way of creating useful IT systems. However, when it comes to designing for elderly, this is not always possible since many elderly suffer from age-related decline, both with respect to physical and cognitive abilities. This paper elaborates on the approach of working with proxies, in this case elderly care personnel. Different groups of people (N = 117) working with elderly and well familiar with needs and contexts around elderly were engaged in this study. Using a questionnaire and a more in-depth workshop we explored with municipality care professionals their experiences as well as the need to create a framework to improve such a proxy approach, and whether a method using care professionals as mediators could be possible to establish in elderly care. The results described in this paper are complementary to ours and others previous knowledge and show promising commitment and willingness to work in accordance with the proposed method.
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| 45. |
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| 46. |
- Traore, Lamine, et al.
(författare)
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User-Centered Design of the C3-Cloud Platform for Elderly with Multiple Diseases : Functional Requirements and Application Testing
- 2019
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Ingår i: Studies in Health Technology and Informatics. - : IOS Press. - 0926-9630 .- 1879-8365. - 9781643680026 - 9781643680033 ; 264, s. 843-847
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Tidskriftsartikel (refereegranskat)abstract
- The number of patients with multimorbidity has been steadily increasing in the modern aging societies. The European C3-Cloud project provides a multidisciplinary and patient-centered “Collaborative Care and Cure-system” in the management of elderly with multimorbidity, enabling continous coordination of care activities between multidisciplinary care teams (MDTs), patients and informal care givers (ICG). In this paper, we report how various components of the infrastructure were tested to fulfill the functional requirements and how the entire system was subjected to an early application testing involving different groups of end-users. MDTs from participating European regions were involved in requirement elicitation and test formulation, resulting in 57 questions, distributed via an internet platform, to 48 test participants (22 MDTs, 26 patients) from three pilot sites. The results indicate an overall high level of satisfaction for all Information and Communication Technologie (ICT) components among the users. The early testing also provided user feedback important to consider for technical improvement of the entire system.
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| 47. |
- Ålander, Ture, et al.
(författare)
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Experiences of Healthcare Professionals to the Introduction in Sweden of a Public eHealth Service : Patients' Online Access to their Electronic Health Records
- 2015
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Ingår i: Studies in Health Technology and Informatics. - Amsterdam, Netherlands : IOS Press. - 0926-9630 .- 1879-8365. ; 216, s. 153-157, s. 153-157
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Tidskriftsartikel (refereegranskat)abstract
- Patients' increasing demands for medical information, the digitization of health records and the fast spread of Internet access form a basis of introducing new eHealth services. An international trend is to provide access for patients to health information of various kind. In Sweden, access by patients to their proper electronic health record (EHR) has been provided in a pilot county since November 2012. This eHealth service is controversial and criticism has arised from the clinical professions, mainly physicians. Two web surveys were conducted to discover whether the opinions of healthcare professionals differ; between staff that have had experience with patients accessing their own EHR and those who have no such expericence. Experienced nurses found the EHR more important for the patients and a better reform, compared to unexperienced nurses in the rest of the country. Similarly, physicians with their own experience had a more positive attitude compared to non-experienced physicians. The conclusion of this study is that healthcare professionals must be involved in the implementation of public eHealth services such as EHRs and that real experiences of the professionals should be better disseminated to their inexperienced peers.
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| 48. |
- Östlund, Britt, et al.
(författare)
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Lessons learnt to promote nurses participation in implementation of home healthcare systems
- 2015
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Ingår i: Nursing Informatics.
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- This paper promotes nurses increased opportunities for active participation in the implementation of the healthcare system with special attention to implementation outside clinics, in patient's homes. The aim is to increase understanding of which rationality that underlies implementation with examples from two international projects implementing health care systems in several European countries 2012-2015.Starting up with the discourse on linear and integrated care four factors related to rationality are discussed: time planning and project progress; the elicitation of user needs; evaluation methods and safety and security as more than technical data. To balance technology and health care needs the use of a caring- or context rationality is suggested.
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