| 1. |
- Hu, Yan, 1985-
(författare)
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Cloud Computing for Achieving Interoperability in Home-based Healthcare
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The care of chronic disease has become the main challenge for healthcare institutions around the world. As the incidence and prevalence of chronic diseases continue to increase, it is a big challenge for traditional hospital-based healthcare to meet requirements of patients. To meet the growing needs of patients, moving the front desk of healthcare from hospital to home is essential. Home-based healthcare for chronic disease involves many different organizations and healthcare providers. Therefore, there are interoperability problems for cooperation among the various organizations and healthcare providers to provide efficient and seamless home-based healthcare. This thesis aims to point out an appropriate technical solution to interoperability problems in home-based healthcare. There are different levels of interoperability, such as pragmatic, semantic and syntactic. We explored alternative solutions specifically for syntactic interoperability. We started to identify the interoperability problems among different healthcare centers by interviews and online surveys. Based on this empirical study, we mainly used two current techniques, namely peer-to-peer (P2P) networks and cloud computing, to design prototypes for sharing healthcare data. Comparing these two techniques, we found the cloud-based solution figured out most of the problems encountered in healthcare interoperability. To identify state of the art, and pinpoint the challenges and possible future directions for applying a cloud-based solution, a systematic literature review was carried out on cloud-based healthcare solutions. Based on the literature reviewed, we suggest a hybrid cloud model, with access controls and techniques for securing data, could be an acceptable solution for home-based healthcare in the future. This cloud model would work as a community for both healthcare providers and recipients, as well as other stakeholders, such as family members and other patients with similar symptoms. Then we conducted a questionnaire study with healthcare recipients and interviewed healthcare providers to gather the requirements for the design of the community. Based on the concept of ‘community’ from the activity theory model, we designed a prototype to demonstrate our proposed solution. Finally, we proposed the conceptual hybrid cloud model. In our hybrid cloud model, hospitals and primary healthcare centers could continue using their own databases as private clouds. For home-based healthcare data, we argued, the best approach is to store and process the data in public clouds. Healthcare recipients, as the owners of their health data in public clouds, should then decide who can access their data and the conditions for sharing. To evaluate this model, we conducted a two-step case study of diabetes healthcare in Blekinge, Sweden. We found that our improved hybrid cloud model will be feasible in the future for home-based healthcare, and it will benefit both healthcare providers and recipients.To apply this model in practice, we suggest that a professional IT healthcare education team should be created to support both healthcare providers and recipients.
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| 2. |
- Lundberg, Jonas, 1974-
(författare)
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Shaping electronic news : A case study of genre perspectives on interaction design
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis describes and analyzes implications of going from hypertext news to hypermedia news through a process of design, involving users and producers. As in any product development, it is difficult to conceive design of a novel news format that does not relate to earlier genres, and thus to antecedent designs. The hypothesis is that this problem can be addressed by explicitly taking a genre perspective to guide interaction design. This thesis draws on genre theory, which has previously been used in rhetoric, literature, and information systems. It is also informed by theories from humancomputer interaction. The methodological approach is a case study of the ELIN project, in which new tools for online hypermedia newspaper production were developed and integrated. The study follows the project from concept design to interaction design and implementation of user interfaces, over three years. The thesis makes three contributions. Firstly, a genre perspective on interaction design is described, revealing broadly in what respects genre affects design. Secondly, the online newspaper genre is described. Based on a content analysis of online newspaper front-pages, and interviews with users and producers, genre specific design recommendations regarding hypertext news front-page design are given. A content analysis of Swedish online newspapers provides a basis for a design rationale of the context stream element, which is an important part of the news context on article pages. Regarding hypervideo news, design rationale is given for the presentation of hypervideo links, in the context of a hypermedia news site. The impact on news production in terms of dynamics of convergence is also discussed. Thirdly, the design processes in cooperative scenario building workshops are evaluated, regarding how the users and producers were able to contribute. It provides implications and lessons learned for the workshop phase model. A discourse analysis also reveals important facilitator skills and how participants relied on genre in the design process.
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| 3. |
- Rahimi, Bahlol, 1975-
(författare)
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Supporting Collaborative Work through ICT : How End-users Think of and Adopt Integrated HealthInformation Systems
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Health Information Systems (HISs) are implemented to support individuals,organizations, and society, making work processes integrated andcontributing to increase service quality and patient safety. However, theoutcomes of many HIS implementations in both primary care and hospitalsettings have either not met yet all the expectations decision-makersidentified or have failed in their implementation. There is, therefore, agrowing interest in increasing knowledge about prerequisites to be fulfilledin order to make the implementation and adoption of HIS more effective andto improve collaboration between healthcare providers.The general purpose of the work presented in this thesis is to explore issuesrelated to the implementation, use, and adoption of HISs and its contributionfor improving inter- and intra-organizational collaboration in a healthcarecontext. The studies included have, however, different research objectivesand consequently used different research methods such as case study,literature review, meta-analysis, and surveys. The selection of the researchmethodology has thus depended on the aim of the studies and their expectedresults.In the first study performed we showed that there is no standard frameworkto evaluate effects and outputs of implementation and use of ICT-basedapplications in the healthcare setting, which makes the comparison ofinternational results not possible yet.Critical issues, such as techniques employed to teach the staff when usingintegrated system, involvement of the users in the implementation process,and the efficiency of the human computer interface were particularlyreported in the second study included in this thesis. The results of this studyalso indicated that the development of evidence-based implementation processes should be considered in order to diminish unexpected outputs thataffect users, patients and stakeholders.We learned in the third study, that merely implementing of a HIS will notautomatically increase organizational efficiency. Strategic, tactical, andoperational actions have to be taken into consideration, includingmanagement involvement, integration in healthcare workflow, establishingcompatibility between software and hardware, user involvement, andeducation and training.When using an Integrated Electronic Prescribing System (IEPS), pharmaciesstaff declared expedited the processing of prescriptions, increased patientsafety, and reduced the risk for prescription errors, as well as the handingover of erroneous medications to patients. However, they stated also that thesystem does not avoid all mistakes or errors and medication errors stilloccur. We documented, however, in general, positive opinions about theIEPS system in the fifth article. The results in this article indicated thatsafety of the system compared to a paper-based one has increased. Theresults showed also an impact on customer relations with the pharmacy; andprevention of errors. However, besides finding an adoption of the IEPS, weidentified a series of undesired and non planned outputs that affect theefficiency and efficacy of use of the system.Finally, we captured in the sixth study indications for non-optimality in thecomputer provider entry system. This is because; the system was not adaptedto the three-quarters of physicians and one-half of nurses’ specificprofessional practice. Respondents pointed out also human-computerinteraction constrains when using the system. They indicated also the factthat the system could lead to adverse drug events in some circumstances.The work presented in this thesis contributes to increase knowledge in thearea of health informatics on how ICT supports inter- and intraorganizationalcollaborative work in a healthcare context and to identifyfactors and prerequisites needed to be taken into consideration whenimplementing new generations of HIS.
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| 4. |
- Skågeby, Jörgen, 1972-
(författare)
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Gifting Technologies : Ethnographic Studies of End-users and Social Media Sharing
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis explores what dimensions that can be used to describe and compare the sociotechnical practice of content contribution in online sharing networks. Data was collected through online ethnographical methods, focusing on end-users in three large media sharing networks. The method includes forum message elicitation, online interviews, and application use and observation. Gift-giving was used as an applied theoretical framework and the data was analyzed by theory-informed thematic analysis. The results of the analysis recount four interrelated themes: what kind of content is given; to whom is it given; how is it given; and why is it given? The five papers in this thesis covers the four themes accordingly: Paper I presents the research area and proposes some initial gifting dimensions that are developed over the following papers. Paper II proposes a model for identifying conflicts of interest that arise for end-users when considering different types of potential receivers. Paper III presents five analytical dimensions for representing how online content is given. The dimensions are: direction (private-public); identification (anonymous-identified); initiative (active-passive); incentive (voluntary-enforced); and limitation (open-restricted). Paper IV investigates photosharing practices and reveals how social metadata, attached to media objects, are included in sharing practices. The final paper further explores how end-users draw on social metadata to communicate bonding intentions when gifting media content. A general methodological contribution is the utilization of sociotechnical conflicts as units of analysis. These conflicts prove helpful in predicting, postulating and researching end-user innovation and conflict coordination. It is suggested that the conflicts also provide potent ways for interaction design and systems development to take end-user concerns and intentions on board.
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| 5. |
- Vimarlund, Vivian, 1951-
(författare)
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An economic perspective on the analysis of impacts of information technology : from case studies in health-care towards general models and theories
- 1999
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Organizations of all types want to have individuals utilize the Information Technology (IT) they purchase. For this reason, the identification of factors that cause individuals to use IT, factors that are important when developing IT, and factors that influence organizations' performance when IT is implemented, provides helpful guidelines for decision-makers.The empirical studies included in this thesis refer to health-care organizations and cover a span from the presentation of the economic effects of the implementation of computer based patient records, and the perceived risk that can arise during the development of IT, to the importance of stimulating direct user participation in system development processes. In the theoretical studies, basic techniques are suggested for the analysis of the economic effects of the use of methods that stimulate users' involvement, e.g. Participatory Design. Furthermore, this part also proposes an IT maturity indicator that can be used to analyze the fulfillment of integration and sophistication in the use of IT in contemporary organizations.The results which emphasize the interaction between IT, human, and economic aspects, indicate the need to include measures of user preferences in system development and implementation processes. They also suggest that successful IT strategies almost inevitably involve simultaneous investment in organizational change, innovative business strategies, and employee human capital. The fmdings provide new insights into problems that forced organizations to re-examine criteria for investing resources when choices related to the development, introduction and use of IT are made, or when it is necessary to select approaches to system development. They also raise questions regarding resource scarcity and alternative use of invested resources.
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| 6. |
- Wass, Sofie
(författare)
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The importance of eHealth innovations : Lessons about patient accessible information
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Access to digital information and communication has an increasing importance in both the work of healthcare professionals and in patients’ everyday life and has transformed what we do and how we carry out activities. It changes the way in which healthcare is delivered, how information is exchanged within and between organizations and how patients and other actors access and manage information. Currently, innovation is imperative in the healthcare sector and today there is a focus on how different eHealth services can improve healthcare. With increased access to various eHealth services, there is a need to know more about the impact of eHealth innovations on healthcare.The aim of this thesis is to acquire more knowledge about eHealth innovations in healthcare. The focus is on prerequisites to realize innovative eHealth services and eHealth services that provide patients with access to health information. The theoretical background addresses innovation, services and business models. This thesis is a compilatory work and includes five qualitative research papers. The first study is an interview study, the second is a literature review and the remaining three are case studies. The data collection consisted of interviews, surveys, workshops and secondary data collected from documents. The interview study and the case studies were performed in the Swedish eHealth setting.The research contributes to our understanding of eHealth innovations with insights on prerequisites to realize eHealth innovations and knowledge on patient accessible information. The first study provides a classification of prerequisites that need to be considered to realize innovative eHealth services. When dealing with eHealth services, organizational and sematic interoperability are still a challenge, and they transcend organizational boundaries. This thesis provides knowledge on the recent trend of opening up electronic health records to patients. The knowledge derived from the studies on patient accessible electronic health records show that there is a discrepancy between the perceptions of patients and healthcare professionals. The thesis concludes that patients feel more involved and that the patient-professional relationship improves with patient access to electronic health records, whereas healthcare professionals have concerns about how patients will manage access to health information. This thesis also provides empirical insights on how business models can be represented in a public eHealth setting. By viewing public eHealth services as social innovations, the thesis contributes to the research on business models in a public healthcare setting by incorporating societal value into the representation of the business model.The research in this thesis contributes to research in health informatics by discussing issues related to eHealth innovations and patient accessible information. Its practical importance lies in identifying issues that are important when discussing eHealth initiatives and the implications of giving patients online access to their electronic health record.
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