Use case diagram (neuro team, home visits). The diagram illustrates the interaction between diffe... more Use case diagram (neuro team, home visits). The diagram illustrates the interaction between different actors in a neuro team (counsellor, occupational therapist, speech therapist, and physiotherapist) with the electronic health record. Use case diagram (patient, care and rehabilitation planning tool, eHealth services for citizens). The diagram illustrates the interaction between a patient and the care and rehabilitation planning tool. Use case diagram (physician & district nurse, electronic health record). The diagram illustrates the interaction between a physician and a district nurse with the electronic health record. (DOCX 451 kb)
Background: The use of patient initiated digital care visits has been increasing and even more so... more Background: The use of patient initiated digital care visits has been increasing and even more so in the era of the Coronavirus (COVID-19) pandemic. Learning more about healthcare professionals’ experience of using such technology would provide valuable insight and a basis for improvement of digital visits.Aim: This study sought to explore the existing literature on healthcare professionals’ experience of performing digital care visits.Methods: A scoping review was performed following Arksey & O’Malley’s proposed framework and utilizing the Preferred Reporting Items for Systematic reviews and Meta-Analyses – Extension for Scoping Reviews (PRISMA-ScR) checklist. Three large databases – PubMed, Web of Science and IEEE Xplore were searched, and 28 studies were included in the review. The collected data was analyzed using thematic content analysis.Results: Five main themes were identified in the literature: positive experiences/benefits, facilitators, negative experiences/challenges, ba...
Making the best choice for an organization when selecting IT applications or eHealth services is ... more Making the best choice for an organization when selecting IT applications or eHealth services is not always easy as there are a lot of parameters to take into account. The aim of this paper is to explore some steps to support effective decision making when selecting and prioritizing eHealth services prior to implementation and/or procurement. The steps presented in this paper were identified by interviewing nine key stakeholders at Stockholm County Council. They are supposed to work as a guide for decision making and aim to identify objectives and expected effects, technical, organizational, and economic requirements, and opportunities important to consider before decisions are taken. The steps and their respective issues and variables are concretized in a number of templates to be filled in by decision makers when selecting and prioritizing eHealth services.
Ge Socialstyrelsen ett nationellt uppdrag att bestalla och ersatta vardgivare av digital vard, fo... more Ge Socialstyrelsen ett nationellt uppdrag att bestalla och ersatta vardgivare av digital vard, foreslar en grupp forskare med anledning av covid-19.
Studies in health technology and informatics, 2020
Chatbots may have the potential to support healthcare education by enabling personalized learning... more Chatbots may have the potential to support healthcare education by enabling personalized learning. Trust is a pre-requisite for the users to accept the chatbots. In this study we analyzed students' assignments of the MSc course "User Needs, Requirements Engineering and Evaluation" at Karolinska Institutet, aiming to explore the chatbots' potential in healthcare education and the design characteristics of chatbots that may enhance the trust. The students identified two courses: pharmacology and medical law, that have the potential to leverage chatbots' characteristics. Our analyses on the design characteristics they suggested resulted in: recognition; visibility of system status; anthropomorphism in communication; knowledge expertise, linguistic consistency; realistic interaction. Our results are in line with previous research. Future studies could investigate the educational impact on the learning outcomes and students' satisfaction when interacting with ch...
Sweden as many other countries uses video consultation to increase patients’ access to primary he... more Sweden as many other countries uses video consultation to increase patients’ access to primary healthcare services particularly during the COVID-19 pandemic. Working in digital care settings and using new technologies, in this case video consultations, require learning new skills and adoption to new workflow. The aim of this study is to explore nurses’ experience of using video consultation in a digital care setting and its impact on their workflow and communication. Fifteen semi-structured interviews were carried out with registered nurses recruited from a private digital healthcare provider. Interviews were recorded, transcribed, and analysed using an abductive approach. Nurses’ workflow was modeled, and several categories and subcategories were identified: nurses’ workflow (efficiency, flexibility, and information accessibility); communication (interaction with patients and interprofessional communication); user experience (change and development of the platform, challenges, and ...
Introduction: Currently healthcare is shifting from a paternalistic model to a more patientcenter... more Introduction: Currently healthcare is shifting from a paternalistic model to a more patientcentered model in which patients’ involvement and self-management play a crucial role. Information and communication technology has the potential to shift the balance of power and responsibility from healthcare professionals to patients and citizens. To provide patients with health information systems and eHealth services which meet their needs and support them throughout their care and rehabilitation processes, there is a need of involving them not only in their care processes but also in the design and evaluation of eHealth. Aim: The overall aim of this research was to explore how a health information system or eHealth service (in this context an electronic care and rehabilitation planning tool) used by post-discharge stroke patients can be designed to improve patient self-management and collaboration between patients, their next-of-kin and different care professionals. Methods: A design res...
Despite the great advances in the field of electronic health records (EHRs) over the past 25 year... more Despite the great advances in the field of electronic health records (EHRs) over the past 25 years, implementation and adoption challenges persist, and the benefits realized remain below expectations. This scoping review aimed to present current knowledge about the effects of EHR implementation and the barriers to EHR adoption and use. A literature search was conducted in PubMed, Web of Science, IEEE Xplore Digital Library and ACM Digital Library for studies published between January 2005 and May 2020. In total, 7641 studies were identified of which 142 met the criteria and attained the consensus of all researchers on inclusion. Most studies (n = 91) were published between 2017 and 2019 and 81 studies had the United States as the country of origin. Both positive and negative effects of EHR implementation were identified, relating to clinical work, data and information, patient care and economic impact. Resource constraints, poor/insufficient training and technical/educational suppor...
Studies in health technology and informatics, 2016
Despite many attempts to provide appropriate tools for supporting stroke patients in their care a... more Despite many attempts to provide appropriate tools for supporting stroke patients in their care and rehabilitation processes, there is still room for improvement. We propose an online care and rehabilitation planning tool as a potential eHealth service for stroke patients. The aim is to study the care professionals' perceived usefulness of the planning tool. We developed and presented a functional prototype to a neurology team in Stockholm. Three focus groups were performed with the care professionals in the team and the data were analysed based on the unified theory of acceptance and use of technology. Although care professionals mentioned challenges such as time limitation for using the tool and issues related to the responsibility of the system, they were positive towards the tool and its potential usefulness in ease of understanding the rehabilitation process and support for collaboration.
Background
Despite the potential of eHealth services to revolutionize the way healthcare and prev... more Background Despite the potential of eHealth services to revolutionize the way healthcare and prevention is provided many applications developed for patients fail to deliver their promise. Therefore, the aim of this study is to use patient journey mapping to explore post-discharge stroke patients’ information needs to propose eHealth services that meet their needs throughout their care and rehabilitation processes.
Methods Three focus groups with younger (<65 years) and older (> = 65 years) stroke patients were performed. Content analysis was used to analyse the data. Stroke patients’ information needs was explored using patient journey model.
Results Four main events (discharge from hospital, discharge from rehab clinic, coming home, and clinical encounters) and two phases (at rehab clinic, at home) have been identified in patients’ post-discharge journey. The main categories identified in this study indicate that patients not only need to have access to health related information about their care and rehabilitation processes but also practical guidance through healthcare and community services. Patients also have different information needs at different events and during different phases. Potential supportive eHealth services were suggested by the researchers considering different parts of the patients’ journeys.
Conclusions Patient journey models and qualitative analysis of patients’ information needs are powerful tools that can be used to improve healthcare from a patient perspective. As patients’ understanding of their illness changes over time, their need of more flexible support throughout the care and rehabilitation processes increases. To design appropriate eHealth services that meet patients’ information needs, it is imperative to understand the current care and rehabilitation processes and identify patients’ information needs throughout their journey.
Studies in health technology and informatics, 2015
Despite many attempts to support stroke patients, there is still room for improvement. The aim of... more Despite many attempts to support stroke patients, there is still room for improvement. The aim of this study is to gain insight into care professionals' perceived usefulness of an online care and rehabilitation planning tool. A functional prototype was developed and presented to a neurology team in a primary care centre in Stockholm. Three focus group meetings were conducted. The data were analysed based on the unified theory of acceptance and use of technology. The results indicate that the care professionals were positive towards the tool and described potential usefulness such as ease of understanding the rehabilitation process and support for collaboration among care providers and also cooperation between the patient and the team. They also identified challenges such as time limitation in daily care.
Lack of appropriate electronic tools for supporting patient involvement and collaboration with ca... more Lack of appropriate electronic tools for supporting patient involvement and collaboration with care professionals is a problem in health care. Care and rehabilitation processes of post-discharge stroke patients were analysed using the concept of interaction points where patients, next-of-kin and care professionals interact and exchange information. Thirteen interviews with care professionals and five non-participatory observations were performed. Data were analysed using content analysis and modelling of interaction points in the patient journey. Patient participation and interaction patterns vary; patients requiring home care have a passive role and next-of-kin or nurses become advocates by coordinating care on behalf of the patient, whereas patients who are able to visit primary care coordinate their own care by initiating interactions. Important categories of participation include the following: participation in care planning, in monitoring risk factors and in rehabilitation plan...
Studies in health technology and informatics, 2013
In this paper we describe initial results from the Swedish innovation project "My Care Pathw... more In this paper we describe initial results from the Swedish innovation project "My Care Pathways" which envisions enabling citizens to track their own health by providing them with online access to their historical, current and prospective future events. We describe an information infrastructure and its base services as well as the use of this solution as an open source platform for open innovation in healthcare. This will facilitate the development of end-user e-services for citizens. We have technically enabled the information infrastructure in close collaboration with decision makers in three Swedish health care regions, and system vendors as well as with National eHealth projects. Close collaboration between heterogeneous actors made implementation in real practice possible. However, a number of challenges, mainly related to legal and business issues, persist when implementing our results. Future work should therefore target the development of business models for sustai...
Abstract. Teamwork, patient participation and involvement of informal caregivers are growing nece... more Abstract. Teamwork, patient participation and involvement of informal caregivers are growing necessities in health and social care as an increasing amount of patients suffers from multiple long-term conditions requiring care from many care providers and professions. Currently, information and communication technology (ICT) remains designed for use within one healthcare organization, and focus on the work of one individual profession rather than supporting collaborative, interprofessional teamwork including patients and informal ...
Use case diagram (neuro team, home visits). The diagram illustrates the interaction between diffe... more Use case diagram (neuro team, home visits). The diagram illustrates the interaction between different actors in a neuro team (counsellor, occupational therapist, speech therapist, and physiotherapist) with the electronic health record. Use case diagram (patient, care and rehabilitation planning tool, eHealth services for citizens). The diagram illustrates the interaction between a patient and the care and rehabilitation planning tool. Use case diagram (physician & district nurse, electronic health record). The diagram illustrates the interaction between a physician and a district nurse with the electronic health record. (DOCX 451 kb)
Background: The use of patient initiated digital care visits has been increasing and even more so... more Background: The use of patient initiated digital care visits has been increasing and even more so in the era of the Coronavirus (COVID-19) pandemic. Learning more about healthcare professionals’ experience of using such technology would provide valuable insight and a basis for improvement of digital visits.Aim: This study sought to explore the existing literature on healthcare professionals’ experience of performing digital care visits.Methods: A scoping review was performed following Arksey & O’Malley’s proposed framework and utilizing the Preferred Reporting Items for Systematic reviews and Meta-Analyses – Extension for Scoping Reviews (PRISMA-ScR) checklist. Three large databases – PubMed, Web of Science and IEEE Xplore were searched, and 28 studies were included in the review. The collected data was analyzed using thematic content analysis.Results: Five main themes were identified in the literature: positive experiences/benefits, facilitators, negative experiences/challenges, ba...
Making the best choice for an organization when selecting IT applications or eHealth services is ... more Making the best choice for an organization when selecting IT applications or eHealth services is not always easy as there are a lot of parameters to take into account. The aim of this paper is to explore some steps to support effective decision making when selecting and prioritizing eHealth services prior to implementation and/or procurement. The steps presented in this paper were identified by interviewing nine key stakeholders at Stockholm County Council. They are supposed to work as a guide for decision making and aim to identify objectives and expected effects, technical, organizational, and economic requirements, and opportunities important to consider before decisions are taken. The steps and their respective issues and variables are concretized in a number of templates to be filled in by decision makers when selecting and prioritizing eHealth services.
Ge Socialstyrelsen ett nationellt uppdrag att bestalla och ersatta vardgivare av digital vard, fo... more Ge Socialstyrelsen ett nationellt uppdrag att bestalla och ersatta vardgivare av digital vard, foreslar en grupp forskare med anledning av covid-19.
Studies in health technology and informatics, 2020
Chatbots may have the potential to support healthcare education by enabling personalized learning... more Chatbots may have the potential to support healthcare education by enabling personalized learning. Trust is a pre-requisite for the users to accept the chatbots. In this study we analyzed students' assignments of the MSc course "User Needs, Requirements Engineering and Evaluation" at Karolinska Institutet, aiming to explore the chatbots' potential in healthcare education and the design characteristics of chatbots that may enhance the trust. The students identified two courses: pharmacology and medical law, that have the potential to leverage chatbots' characteristics. Our analyses on the design characteristics they suggested resulted in: recognition; visibility of system status; anthropomorphism in communication; knowledge expertise, linguistic consistency; realistic interaction. Our results are in line with previous research. Future studies could investigate the educational impact on the learning outcomes and students' satisfaction when interacting with ch...
Sweden as many other countries uses video consultation to increase patients’ access to primary he... more Sweden as many other countries uses video consultation to increase patients’ access to primary healthcare services particularly during the COVID-19 pandemic. Working in digital care settings and using new technologies, in this case video consultations, require learning new skills and adoption to new workflow. The aim of this study is to explore nurses’ experience of using video consultation in a digital care setting and its impact on their workflow and communication. Fifteen semi-structured interviews were carried out with registered nurses recruited from a private digital healthcare provider. Interviews were recorded, transcribed, and analysed using an abductive approach. Nurses’ workflow was modeled, and several categories and subcategories were identified: nurses’ workflow (efficiency, flexibility, and information accessibility); communication (interaction with patients and interprofessional communication); user experience (change and development of the platform, challenges, and ...
Introduction: Currently healthcare is shifting from a paternalistic model to a more patientcenter... more Introduction: Currently healthcare is shifting from a paternalistic model to a more patientcentered model in which patients’ involvement and self-management play a crucial role. Information and communication technology has the potential to shift the balance of power and responsibility from healthcare professionals to patients and citizens. To provide patients with health information systems and eHealth services which meet their needs and support them throughout their care and rehabilitation processes, there is a need of involving them not only in their care processes but also in the design and evaluation of eHealth. Aim: The overall aim of this research was to explore how a health information system or eHealth service (in this context an electronic care and rehabilitation planning tool) used by post-discharge stroke patients can be designed to improve patient self-management and collaboration between patients, their next-of-kin and different care professionals. Methods: A design res...
Despite the great advances in the field of electronic health records (EHRs) over the past 25 year... more Despite the great advances in the field of electronic health records (EHRs) over the past 25 years, implementation and adoption challenges persist, and the benefits realized remain below expectations. This scoping review aimed to present current knowledge about the effects of EHR implementation and the barriers to EHR adoption and use. A literature search was conducted in PubMed, Web of Science, IEEE Xplore Digital Library and ACM Digital Library for studies published between January 2005 and May 2020. In total, 7641 studies were identified of which 142 met the criteria and attained the consensus of all researchers on inclusion. Most studies (n = 91) were published between 2017 and 2019 and 81 studies had the United States as the country of origin. Both positive and negative effects of EHR implementation were identified, relating to clinical work, data and information, patient care and economic impact. Resource constraints, poor/insufficient training and technical/educational suppor...
Studies in health technology and informatics, 2016
Despite many attempts to provide appropriate tools for supporting stroke patients in their care a... more Despite many attempts to provide appropriate tools for supporting stroke patients in their care and rehabilitation processes, there is still room for improvement. We propose an online care and rehabilitation planning tool as a potential eHealth service for stroke patients. The aim is to study the care professionals' perceived usefulness of the planning tool. We developed and presented a functional prototype to a neurology team in Stockholm. Three focus groups were performed with the care professionals in the team and the data were analysed based on the unified theory of acceptance and use of technology. Although care professionals mentioned challenges such as time limitation for using the tool and issues related to the responsibility of the system, they were positive towards the tool and its potential usefulness in ease of understanding the rehabilitation process and support for collaboration.
Background
Despite the potential of eHealth services to revolutionize the way healthcare and prev... more Background Despite the potential of eHealth services to revolutionize the way healthcare and prevention is provided many applications developed for patients fail to deliver their promise. Therefore, the aim of this study is to use patient journey mapping to explore post-discharge stroke patients’ information needs to propose eHealth services that meet their needs throughout their care and rehabilitation processes.
Methods Three focus groups with younger (<65 years) and older (> = 65 years) stroke patients were performed. Content analysis was used to analyse the data. Stroke patients’ information needs was explored using patient journey model.
Results Four main events (discharge from hospital, discharge from rehab clinic, coming home, and clinical encounters) and two phases (at rehab clinic, at home) have been identified in patients’ post-discharge journey. The main categories identified in this study indicate that patients not only need to have access to health related information about their care and rehabilitation processes but also practical guidance through healthcare and community services. Patients also have different information needs at different events and during different phases. Potential supportive eHealth services were suggested by the researchers considering different parts of the patients’ journeys.
Conclusions Patient journey models and qualitative analysis of patients’ information needs are powerful tools that can be used to improve healthcare from a patient perspective. As patients’ understanding of their illness changes over time, their need of more flexible support throughout the care and rehabilitation processes increases. To design appropriate eHealth services that meet patients’ information needs, it is imperative to understand the current care and rehabilitation processes and identify patients’ information needs throughout their journey.
Studies in health technology and informatics, 2015
Despite many attempts to support stroke patients, there is still room for improvement. The aim of... more Despite many attempts to support stroke patients, there is still room for improvement. The aim of this study is to gain insight into care professionals' perceived usefulness of an online care and rehabilitation planning tool. A functional prototype was developed and presented to a neurology team in a primary care centre in Stockholm. Three focus group meetings were conducted. The data were analysed based on the unified theory of acceptance and use of technology. The results indicate that the care professionals were positive towards the tool and described potential usefulness such as ease of understanding the rehabilitation process and support for collaboration among care providers and also cooperation between the patient and the team. They also identified challenges such as time limitation in daily care.
Lack of appropriate electronic tools for supporting patient involvement and collaboration with ca... more Lack of appropriate electronic tools for supporting patient involvement and collaboration with care professionals is a problem in health care. Care and rehabilitation processes of post-discharge stroke patients were analysed using the concept of interaction points where patients, next-of-kin and care professionals interact and exchange information. Thirteen interviews with care professionals and five non-participatory observations were performed. Data were analysed using content analysis and modelling of interaction points in the patient journey. Patient participation and interaction patterns vary; patients requiring home care have a passive role and next-of-kin or nurses become advocates by coordinating care on behalf of the patient, whereas patients who are able to visit primary care coordinate their own care by initiating interactions. Important categories of participation include the following: participation in care planning, in monitoring risk factors and in rehabilitation plan...
Studies in health technology and informatics, 2013
In this paper we describe initial results from the Swedish innovation project "My Care Pathw... more In this paper we describe initial results from the Swedish innovation project "My Care Pathways" which envisions enabling citizens to track their own health by providing them with online access to their historical, current and prospective future events. We describe an information infrastructure and its base services as well as the use of this solution as an open source platform for open innovation in healthcare. This will facilitate the development of end-user e-services for citizens. We have technically enabled the information infrastructure in close collaboration with decision makers in three Swedish health care regions, and system vendors as well as with National eHealth projects. Close collaboration between heterogeneous actors made implementation in real practice possible. However, a number of challenges, mainly related to legal and business issues, persist when implementing our results. Future work should therefore target the development of business models for sustai...
Abstract. Teamwork, patient participation and involvement of informal caregivers are growing nece... more Abstract. Teamwork, patient participation and involvement of informal caregivers are growing necessities in health and social care as an increasing amount of patients suffers from multiple long-term conditions requiring care from many care providers and professions. Currently, information and communication technology (ICT) remains designed for use within one healthcare organization, and focus on the work of one individual profession rather than supporting collaborative, interprofessional teamwork including patients and informal ...
Uploads
Despite the potential of eHealth services to revolutionize the way healthcare and prevention is provided many applications developed for patients fail to deliver their promise. Therefore, the aim of this study is to use patient journey mapping to explore post-discharge stroke patients’ information needs to propose eHealth services that meet their needs throughout their care and rehabilitation processes.
Methods
Three focus groups with younger (<65 years) and older (> = 65 years) stroke patients were performed. Content analysis was used to analyse the data. Stroke patients’ information needs was explored using patient journey model.
Results
Four main events (discharge from hospital, discharge from rehab clinic, coming home, and clinical encounters) and two phases (at rehab clinic, at home) have been identified in patients’ post-discharge journey. The main categories identified in this study indicate that patients not only need to have access to health related information about their care and rehabilitation processes but also practical guidance through healthcare and community services. Patients also have different information needs at different events and during different phases. Potential supportive eHealth services were suggested by the researchers considering different parts of the patients’ journeys.
Conclusions
Patient journey models and qualitative analysis of patients’ information needs are powerful tools that can be used to improve healthcare from a patient perspective. As patients’ understanding of their illness changes over time, their need of more flexible support throughout the care and rehabilitation processes increases. To design appropriate eHealth services that meet patients’ information needs, it is imperative to understand the current care and rehabilitation processes and identify patients’ information needs throughout their journey.
Despite the potential of eHealth services to revolutionize the way healthcare and prevention is provided many applications developed for patients fail to deliver their promise. Therefore, the aim of this study is to use patient journey mapping to explore post-discharge stroke patients’ information needs to propose eHealth services that meet their needs throughout their care and rehabilitation processes.
Methods
Three focus groups with younger (<65 years) and older (> = 65 years) stroke patients were performed. Content analysis was used to analyse the data. Stroke patients’ information needs was explored using patient journey model.
Results
Four main events (discharge from hospital, discharge from rehab clinic, coming home, and clinical encounters) and two phases (at rehab clinic, at home) have been identified in patients’ post-discharge journey. The main categories identified in this study indicate that patients not only need to have access to health related information about their care and rehabilitation processes but also practical guidance through healthcare and community services. Patients also have different information needs at different events and during different phases. Potential supportive eHealth services were suggested by the researchers considering different parts of the patients’ journeys.
Conclusions
Patient journey models and qualitative analysis of patients’ information needs are powerful tools that can be used to improve healthcare from a patient perspective. As patients’ understanding of their illness changes over time, their need of more flexible support throughout the care and rehabilitation processes increases. To design appropriate eHealth services that meet patients’ information needs, it is imperative to understand the current care and rehabilitation processes and identify patients’ information needs throughout their journey.