To Örebro University

oru.seÖrebro University Publications
Change search
Refine search result
123 1 - 50 of 125
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1.
    Andersson, Susanne
    et al.
    Department of Health Sciences, University West, Trollhättan, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Nyström, Ulrika
    Health Centre Dagson Uddevalla, Primary Care Västra Götalandsregionen and Municipal Care, Trollhättan, Sweden.
    Varemo, Marika
    Department of Medicine, Northern Älvsborg County Hospital, Trollhättan, Sweden.
    Hellstrand Tang, Ulla
    Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Experiences of a Novel Structured Foot Examination Form for Patients With Diabetes From the Perspective of Health Care Professionals: Qualitative Study2023In: JMIR nursing, E-ISSN 2562-7600, Vol. 6, article id e45501Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Diabetes is a growing threat to public health, and secondary diseases like foot complications are common. Foot ulcers affect the individual's quality of life and are a great cost to society. Regular foot examinations prevent foot ulcers and are a recommended approach both in Sweden and worldwide. Despite existing guidelines, there are differences in the execution of the foot examination, which results in care inequality. A structured foot examination form based on current guidelines was developed in this study as the first step toward digitalized support in the daily routine, and was validated by diabetes health care professionals.

    OBJECTIVE: The study aimed to validate a structured foot examination form by assessing health care professionals' experiences of working with it "foot side" when examining patients with diabetes.

    METHODS: Semistructured interviews were held in a focus group and individually with 8 informants from different diabetes professions, who were interviewed regarding their experiences of working with the form in clinical practice. The users' data were analyzed inductively using qualitative content analysis. The study is part of a larger project entitled "Optimised care of persons with diabetes and foot complications," with Västra Götaland Region as the responsible health care authority, where the results will be further developed.

    RESULTS: Experiences of working with the form were that it simplified the foot examination by giving it an overview and a clear structure. Using the form made differences in work routines between individuals apparent. It was believed that implementing the form routinely would contribute to a more uniform execution. When patients had foot ulcers, the risk categories (established in guidelines) were perceived as contradictory. For example, there was uncertainty about the definition of chronic ulcers and callosities. The expectations were that the future digital format would simplify documentation and elucidate the foot examination, as well as contribute to the accessibility of updated and relevant data for all individuals concerned.

    CONCLUSIONS: The foot examination form works well as a support tool during preventive foot examination, creates a basis for decision-making, and could contribute to a uniform and safer foot examination with more care equality in agreement with current guidelines.

    TRIAL REGISTRATION: ClinicalTrials.gov NCT05692778; https://clinicaltrials.gov/ct2/show/NCT05692778.

  • 2.
    Barsaum, Peter
    et al.
    School of Business, Örebro University, Örebro, Sweden .
    Berg, Paul
    School of Business, Örebro University, Örebro, Sweden .
    Hagman, Andreas
    School of Business, Örebro University, Örebro, Sweden .
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Internet of Things Technology for Remote Healthcare: A Pilot Study2016In: Proceedings from The 14th Scandinavian Conference on Health Informatics 2016, Linköping: Linköping University Electronic Press , 2016, Vol. 122, no 122, p. 43-48Conference paper (Other academic)
    Abstract [en]

    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.

  • 3. Blusi, Madeleine
    et al.
    Dalin, Rolf
    Näslund, Pär
    Palmgren, Katarina
    Scandurra, Isabella
    Department of information technology, Uppsala university, Uppsala, Sweden.
    Test av användbarheten hos innovationen SenseSoft i äldreomsorgen i Sundsvalls kommun2014Report (Other academic)
  • 4.
    Blusi, Madeleine
    et al.
    R&D Department, The Association of Local Authorities in Västernorrland County, Härnösand, Sweden.
    Dalin, Rolf
    R&D Department, The Association of Local Authorities in Västernorrland County, Härnösand, Sweden.
    Näslund, Pär
    Palmgren, Katarina
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Test av användbarheten hos innovationen TENA Identifi på Viktoriagården i Kramfors2015Report (Other academic)
    Abstract [sv]

    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.

  • 5.
    Bärkås, Annika
    et al.
    Department of Women's and Children's Health, Uppsala University, Sweden.
    Hägglund, Maria
    Department of Women's and Children's Health, Uppsala University, Sweden.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Cajander, Åsa
    Department of Information Technology, Uppsala University, Sweden.
    Rexhepi, Hanife
    School of Informatics, Skövde University, Sweden.
    Hörhammer, Iiris
    Department of Industrial Engineering and Management, Aalto University, Finland.
    Blease, Charlotte
    General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Patients' Access to Their Psychiatric Records: A Comparison of Four Countries2022In: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 294, p. 510-514Article in journal (Refereed)
    Abstract [en]

    Several Nordic and Baltic countries are forerunners in the digitalization of patient ehealth services and have since long implemented psychiatric records as parts of the ehealth services. There are country-specific differences in what clinical information is offered to patients concerning their online patient accessible psychiatric records. This study explores national differences in Sweden, Norway, Finland, and Estonia in patient access to their psychiatric records. Data was collected through a socio-technical data collection template developed during a workshop series and then analyzed in a cross-country comparison focusing on items related to psychiatry records online. The results show that psychiatric records online are offered to patients in all four countries, and provide the same functionality and similar psychiatry information. Overall, the conclusion is that experiences of various functionalities should be scrutinized to promote transparency of psychiatric records as part of the national eHealth services to increase equality of care and patient empowerment.

  • 6.
    Bärkås, Annika
    et al.
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; MedTech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden.
    Kharko, Anna
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; MedTech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden; Faculty of Health, University of Plymouth, Plymouth, United Kingdom.
    Blease, Charlotte
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; MedTech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden; Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
    Cajander, Åsa
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Johansen Fagerlund, Asbjørn
    Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway.
    Huvila, Isto
    Department of ALM, Uppsala University, Uppsala, Sweden.
    Johansen, Monika Alise
    Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, Telemedicine and E-health Research Group, Arctic University of Norway, Tromsø, Norway.
    Kane, Bridget
    Business School, Karlstad University, Karlstad, Sweden.
    Kujala, Sari
    Department of Computer Science, Aalto University, Espoo, Finland.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Rexhepi, Hanife
    School of Informatics, University of Skövde, Skövde, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Wang, Bo
    Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway.
    Hägglund, Maria
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; MedTech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden.
    Errors, Omissions, and Offenses in the Health Record of Mental Health Care Patients: Results from a Nationwide Survey in Sweden2023In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 25, article id e47841Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Previous research reports that patients with mental health conditions experience benefits, for example, increased empowerment and validation, from reading their patient-accessible electronic health records (PAEHRs). In mental health care (MHC), PAEHRs remain controversial, as health care professionals are concerned that patients may feel worried or offended by the content of the notes. Moreover, existing research has focused on specific mental health diagnoses, excluding the larger PAEHR userbase with experience in MHC.

    OBJECTIVE: The objective of this study is to establish if and how the experiences of patients with and those without MHC differ in using their PAEHRs by (1) comparing patient characteristics and differences in using the national patient portal between the 2 groups and (2) establishing group differences in the prevalence of negative experiences, for example, rates of errors, omissions, and offenses between the 2 groups.

    METHODS: Our analysis was performed on data from an online patient survey distributed through the Swedish national patient portal as part of our international research project, NORDeHEALTH. The respondents were patient users of the national patient portal 1177, aged 15 years or older, and categorized either as those with MHC experience or with any other health care experience (nonmental health care [non-MHC]). Patient characteristics such as gender, age, education, employment, and health status were gathered. Portal use characteristics included frequency of access, encouragement to read the record, and instances of positive and negative experiences. Negative experiences were further explored through rates of error, omission, and offense. The data were summarized through descriptive statistics. Group differences were analyzed through Pearson chi-square.

    RESULTS: Of the total sample (N=12,334), MHC respondents (n=3131) experienced errors (1586/3131, 50.65%, and non-MHC 3311/9203, 35.98%), omissions (1089/3131, 34.78%, and non-MHC 2427/9203, 26.37%) and offenses (1183/3131, 37.78%, and non-MHC 1616/9203, 17.56%) in the electronic health record at a higher rate than non-MHC respondents (n=9203). Respondents reported that the identified error (MHC 795/3131, 50.13%, and non-MHC 1366/9203, 41.26%) and omission (MHC 622/3131, 57.12%, and non-MHC 1329/9203, 54.76%) were "very important," but most did nothing to correct them (MHC 792/3131, 41.29%, and non-MHC 1838/9203, 42.17%). Most of the respondents identified as women in both groups.

    CONCLUSIONS: About 1 in 2 MHC patients identified an error in the record, and about 1 in 3 identified an omission, both at a much higher rate than in the non-MHC group. Patients with MHC also felt offended by the content of the notes more commonly (1 in 3 vs 1 in 6). These findings validate some of the worries expressed by health care professionals about providing patients with MHC with PAEHRs and highlight challenges with the documentation quality in the records.

  • 7.
    Bärkås, Annika
    et al.
    Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Hägglund, Maria
    Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden; Department of Women's and Children's Health, Uppsala university, Uppsala, Sweden.
    Analysis of Voluntary User Feedback of the Swedish National PAEHR Service2019In: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 264, p. 1126-1130Article in journal (Refereed)
    Abstract [en]

    "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.

  • 8.
    Bärkås, Annika
    et al.
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Rexhepi, Hanife
    School of Informatics, Skövde University, Skövde, Sweden.
    Blease, Charlotte
    General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA, USA.
    Cajander, Åsa
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Hägglund, Maria
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Patients' Access to Their Psychiatric Notes: Current Policies and Practices in Sweden2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 17, article id 9140Article in journal (Refereed)
    Abstract [en]

    Patients' access to electronic health records (EHRs) is debated worldwide, and access to psychiatry records is even more criticized. There is a nationwide service in Sweden which offers all citizens the opportunity to read their EHR, including clinical notes. This study aims to explore Swedish national and local policy regulations regarding patients' access to their psychiatric notes and describe to what extent patients currently are offered access to them. The rationale behind the study is that current policies and current practices may differ between the 21 self-governing regions, although there is a national regulation. We gathered web-based information from policy documents and regulations from each region's website. We also conducted key stakeholder interviews with respondents from the regions and cross-regional private care providers, using a qualitative approach. The results show that 17 of 21 regions share psychiatric notes with patients, where forensic psychiatric care was the most excluded psychiatric care setting. All private care providers reported that they mainly follow the regions' guidelines. Our findings show that regional differences concerning sharing psychiatric notes persist, despite Swedish regulations and a national policy that stipulates equal care for everyone. The differences, however, appear to have decreased over time, and we report evidence that the regions are moving toward increased transparency for psychiatry patients.

  • 9.
    Cajander, Åsa
    et al.
    Uppsala University, Uppsala, Sweden.
    Grünloh, Christiane
    KTH Royal Institute of Technology, Stockholm, Sweden.
    Lind, Thomas
    Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Designing eHealth Services for Patients and Relatives: Critical Incidents and Lessons to Learn2016In: Proceedings of the NordiCHI '16: The 9th Nordic Conference on Human-Computer Interaction - game changing design, Association for Computing Machinery (ACM), 2016Conference paper (Refereed)
    Abstract [en]

    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.

  • 10.
    Cajander, Åsa
    et al.
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Huvila, Isto
    Department of Archive, Library and Museum Studies, Uppsala University, Uppsala, Sweden.
    Salminen-Karlsson, Minna
    Centre for Gender Studies, Uppsala University, Uppsala, Sweden.
    Lind, Thomas
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Effects of patient accessible electronic health records on nurses' work environment: a survey study on expectations in Sweden2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 11, article id e059188Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The introduction of information and communication technology influences the work environment of large groups of employees in healthcare. In Sweden, a national healthcare service providing patient accessible electronic health records (PAEHR) has been deployed, and this paper investigates nurses' expected effects of this implementation.

    SETTING: Nurses associated with the Swedish Association of Health Professionals working in healthcare such as primary care, hospitals and midwives in Sweden. Before a full-scale national implementation of PAEHR, a web survey study was distributed nationally. The respondents represented all 21 Swedish regions. Questions included five-point Likert scale questions and open questions.

    PARTICIPANTS: A survey link was distributed via email to 8460 registered nurses, midwives and union representatives in Sweden. The response rate was 35.4% (2867 respondents: registered nurses 84%; midwives 6%; chief position 5%; in projects 2% and other 3%). Three reminders were sent out, all of them increasing the response rate. A majority of the respondents were female (89.9%), 8.4% male, whereas 1.7% did not indicate their gender. 31.4% were under 40 years old, 53.8% 40-59 and 13.7% over 60.

    RESULTS: Data were analysed using exploratory factor analysis with principal component analysis as the extraction method. The analysis revealed three distinct factors related to nurses' expectations of PAEHR: (1) PAEHR improves the quality of care, (2) PAEHR improves the quality of the work environment and (3) risk and fears concerning patients' well-being. Some interesting results include that more experienced nurses are more favourable to PAEHR. Our analysis also shows that the view of the nurse-patient relationship is an essential underlying factor related to positive or negative expectations.

    CONCLUSIONS: Results show that the expectations and perceptions of PAEHR vary depending on the nurse's view of who the electronic record belongs to. Younger nurses are somewhat more negative towards PAEHR than older nurses.

  • 11.
    Cajander, Åsa
    et al.
    Uppsala University, Uppsala, Sweden.
    Hägglund, Maria
    Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Wolf, Axel
    University of Gothenburg, Gothenburg, Sweden.
    Personcentrering med journalåtkomst och andra e-hälsotjänster2021In: Medicinsk informatik / [ed] Göran Petersson, Martin Rydmark och Anders Thurin, Stockholm: Liber , 2021, p. 347-355Chapter in book (Other (popular science, discussion, etc.))
  • 12.
    Department of Computer and Information Science (IDA) Linköpings Universitet, SE - 581 83 Linköping, Sweden, Vivian
    et al.
    Department of Computer and Information Science (IDA) Linköpings Universitet, Linköping, Sweden.
    Olve, Nils-Göran
    Department of Computer and Information Science Linköping University, Sweden .
    Scandurra, Isabella
    Centre for eHealth, Uppsala University, Sweden; Department of Medical Sciences, Uppsala University, Sweden .
    Koch, Sabine
    Centre for eHealth, Uppsala University, Sweden; Department of Medical Sciences, Uppsala University, Sweden .
    Organizational effects of the use of information and communication technology (ICT) in elderly homecare: a case study2008In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 14, no 3, p. 195-209Article in journal (Refereed)
    Abstract [en]

    The use of information and communication technology (ICT) to support integrated healthcare services in elderly homecare is becoming more established. In particular, ICT can enable information exchange, knowledge sharing and documentation at the point-of-care (POC). The aim of this study was to explore these effects using the Old@Home prototype. Old@Home was perceived to contribute in developing horizontal links for communication between individuals who work together, independent of geographical distance or organizational affiliation, and to contribute to increased work efficiency. The prototype was further seen to reduce professional isolation by providing a holistic overview of the care process. User centred design and implementation of Old@Home was considered key to facilitating acceptance of organizational changes. Participation of care professionals not only led to a better understanding of the needs of involved organizations, but also increased end-users' involvement and commitment, stimulating them to test and improve the prototype until the final version.

  • 13. Dieroff Hay, Susanne
    et al.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Wengström, Yvonne
    Karolinska institutet, Solna, Sweden.
    Brandberg, Yvonne
    Karolinska institutet, Solna, Sweden.
    Starta ett digitalt centrum för cancerrehabilitering2020In: Dagens medicin. Oberoende nyhetstidning för hela sjukvården, E-ISSN 1402-1943, no 3 juliArticle in journal (Other (popular science, discussion, etc.))
  • 14.
    Ekman, Björn
    et al.
    Lunds universitet.
    Milos Nymberg, Veronica
    Lunds universitet; Centrum för primärvårdsforskning, Malmö.
    Richter Sundberg, Linda
    Umeå universitet.
    Nilsen, Per
    Institutionen för hälsa, medicin och vård, Linköpings universitet.
    Pestoff, Rebecka
    Centrum för sällsynta diagnoser Sydöst, Region Östergötland; Institutionen för hälsa, medicin och vård, Linköpings universitet.
    Calling, Susanna
    Centrum för primärvårdsforskning, Lunds universitet.
    Ekstedt, Mirjam
    Linnéuniversitetet, Kalmar/Växjö.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Farrokhnia, Nasim
    Institutionen för klinisk forskning och utbildning på Södersjukhuset, Karolinska institutet; Kry.
    Hägglund, Maria
    Uppsala universitet; Akademiska Sjukhuset, Uppsala; Harvard Medical School.
    Klein, Gunnar O.
    Örebro University, Örebro University School of Business.
    Fagerström, Cecilia
    Linnéuniversitetet; Blekinge Kompetenscentrum.
    Davoody, Nadia
    Karolinska Institutet.
    Gabrielsson Järhult, Felicia
    Jönköping Academy for Improvement of Health and welfare, Jönköping University.
    Kristensson Ekwall, Anna
    Lunds universitet.
    Skala upp den befintliga digitala vården i Sverige2020In: Dagens Medicin, ISSN 1104-7488Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Ge Socialstyrelsen ett nationellt uppdrag att beställa och ersätta vårdgivare av digital vård, föreslår en grupp forskare med anledning av covid-19.

  • 15.
    Engström, Maria
    et al.
    University of Gävle.
    Scandurra, Isabella
    Centre for eHealth, Uppsala University, Uppsala, Sweden.
    Lindqvist, R
    Ljunggren, B
    Koch, Sabine
    Karolinska University.
    Evaluation of OLD@HOME Virtual Health Record: Staff opinions of the system and satisfaction with work2009In: Telemedicine journal and e-health, ISSN 1530-5627, E-ISSN 1556-3669, Vol. 15, no 1, p. 53-61Article in journal (Refereed)
    Abstract [en]

    The aim of the present research was to study outcomes of use of the OLD@HOME Virtual Health Record with regard to staff opinions about information, communication technology, and satisfaction with work. A quasi-experimental design was used. Staff opinions about the information and communication technology were assessed using a study-specific questionnaire at the test site (n =22) and at other settings in the municipality (n =172). Staff (n =22) job satisfaction, perceived quality of care, and psychosomatic health were assessed using the Satisfaction with Work Questionnaires before and after a 5-month period of testing the technology in an intervention and a comparison group. Staff opinions about the information and communication technology were significantly more positive at the test site compared to other settings in the municipality. For the total scale of quality of care and the factor documentation, there were significant differences in change scores between intervention and comparison groups, with improvements for the comparison group. For job satisfaction and psychosomatic health, there were no differences in change scores between the groups. Participatory design enhances staff opinions about information and communication technology. However, a 5-month test period showed no benefits regarding staff satisfaction with work when compared to a comparison group. On the contrary, the comparison group improved in documentation, and for the intervention group, there was a trend toward deterioration, which may be due to their knowing how to document, but not having time when using both paper-based and electronic systems.

  • 16.
    Essén, Anna
    et al.
    SIR (Stockholm School of Economics Institute for Research), Stockholm School of Economics, Stockholm, Sweden; Learning Informatics Management and Ethics Medical Management Center, Karolinska Institutet, Stockholm, Sweden .
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Gerrits, Reinie
    Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
    Humphrey, Gayl
    National Institute for Health Innovation, University of Auckland, Auckland, New Zealand.
    Johansen, Monika Alise
    Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, the Artic University of Norway (UIT), Tromsø, Norway.
    Kiergegaard, Patrick
    Innovation, Networks & Knowledge (INK), University of Michigan, Ann Arbor, USA.
    Koskinen, Jani
    Information Systems Science, University of Turku, Turku, Finland.
    Liaw, Siaw-Teng
    University of New South Wales Medicine, Sydney, Australia; Academic GP Unit, SW Sydney Local Health District, Warwick Farm NSW, Australia; Ingham Institute, Liverpool NSW, Australia.
    Odeh, Souad
    Department of informatics, University Claude Bernad Llyon, Villeurbanne, France; Nautibus, Villeurbanne, France.
    Ross, Peeter
    Department of Health Technologies, Tallinn University of Technology (TUT), Tallinn, Estonia; Diagnostic Clinic, East Tallinn Central Hospital, Tallinn, Estonia.
    Ancker, Jessica S.
    Department of Healthcare Policy & Research, Division of Health Informatics, Weill Cornell Medical College, New York NY, USA.
    Patient access to electronic health records: Differences across ten countries2018In: Health Policy and Technology, ISSN 2211-8837, E-ISSN 2211-8845, Vol. 7, no 1, p. 44-56Article in journal (Refereed)
    Abstract [en]

    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.

  • 17.
    Essén, Anna
    et al.
    SIR (Stockholm School of Economics Institute for Research), Stockholm School of Economics, Stockholm, Sweden; Learning Informatics Management and Ethics Medical Management Center, Karolinska Institutet, Stockholm, Sweden .
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Gerrits, Reinie
    Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands .
    Humphrey, Gayl
    National Institute for Health Innovation, University of Auckland, Auckland, New Zealand .
    Johansen, Monika Alise
    Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, the Artic University of Norway (UIT), Tromsø, Norway .
    Kierkegaard, Patrick
    Innovation, Networks & Knowledge (INK) University of Michigan, Perry Ann Arbor MI, USA.
    Koskinen, Jani
    Information Systems Science, University of Turku, Turku, Finland .
    Liaw, Siaw-Teng
    UNSW Medicine Australia, Sydney, Australia; Academic GP Unit, SW Sydney Local Health District and Ingham Institute, Sydney, Australia .
    Odeh, Souad
    Department of informatics, University Claude Bernad lyon 1, Villeurbanne, France .
    Ross, Peeter
    Tallinn University of Technology (TUT), Department of Health Technologies, Tallinn, Estonia; Diagnostic Clinic, East Tallinn Central Hospital, Tallinn, Estonia .
    Ancker, Jessica S.
    Department of Healthcare Policy & Research, Division of Health Informatics, Weill Cornell Medical College, New York NY, USA .
    Patient Access to Electronic Health Records: Differences Across Ten Countries (vol 7, pg 44, 2018)2018In: Health Policy and Technology, ISSN 2211-8837, E-ISSN 2211-8845, Vol. 7, no 2, p. 224-224Article in journal (Refereed)
  • 18.
    Grünloh, Christiane
    et al.
    KTH Royal Institute of Technology, Stockholm, Sweden; TH Köln, Gummersbach, Germany.
    Hallewell Haslwanter, Jean D.
    Fachhochschule Oberösterreich (FH Oberösterreich), Wels, Austria; TU Wien, Vienna, Austria.
    Kane, Bridget
    Karlstad University Business School, Karlstad, Sweden.
    Lee, Eunji
    Stiftelsen for industriell og teknisk forskning (SINTEF), Information and communications technology (ICT), Oslo, Norway.
    Lind, Thomas
    Uppsala University, Uppsala, Sweden.
    Moll, Jonas
    Uppsala University, Uppsala, Sweden.
    Rexhepi, Hanife
    University of Skövde, Skövde, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Using Critical Incidents in Workshops to Inform eHealth Design2017In: Human-Computer Interaction - INTERACT 2017: 16th IFIP TC 13 International Conference, Mumbai, India, September 25–29, 2017, Proceedings, Part I / [ed] Bernhaupt, Regina; Dalvi, Girish; Joshi, Anirudha; K. Balkrishan, Devanuj; O'Neill, Jacki; Winckler, Marco, Springer International Publishing , 2017, 10513, p. 364-373Chapter in book (Refereed)
    Abstract [en]

    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.

  • 19.
    Hagström, Josefin
    et al.
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Blease, Charlotte
    Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
    Haage, Barbara
    Department of Health Technologies, Tallinn University of Technology, Tallinn, Estonia.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Hansson, Scharlett
    Department of Health Technologies, Tallinn University of Technology, Tallinn, Estonia.
    Hägglund, Maria
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Use of and Experiences With Online Access to Electronic Health Records for Parents, Children, and Adolescents: Protocol for a Scoping Review2022In: JMIR Research Protocols, E-ISSN 1929-0748, Vol. 11, no 6, article id e36158Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: As patient online access to electronic health records becomes the standard, implementation of access for adolescents and parents varies across providers, regions, and countries. There is currently no international compilation of evidence to guide policy decisions in matters such as age limit for access and the extent of parent proxy access.

    OBJECTIVE: This paper presents the protocol for a scoping review of different stakeholders' (including but not limited to end users) perspectives on use, opinions, and experiences pertaining to online access to electronic health records by parents, children, and adolescents.

    METHODS: This scoping review will be conducted according to the Arksey and O'Malley framework. Several databases will be used to conduct a literature search (PubMed, CINAHL, and PsycInfo), in addition to literature found outside of these databases. All authors will participate in screening identified papers, following the research question: How do different stakeholders experience parents', children's, and adolescents' online access to the electronic health records of children and adolescents? Data abstraction will include but will not be limited to publication type, publication year, country, sample characteristics, setting, study aim, research question, and conclusions. The data to be analyzed are from publicly available secondary sources, so this study does not require an ethics review.

    RESULTS: The results from this scoping review will be presented in a narrative form, and additional data on study characteristics will be presented in diagrams or tabular format. This scoping review protocol was first initiated by Uppsala University in June 2021 as part of the NordForsk-funded research project NORDeHEALTH. The results are expected to be presented in a scoping review in June 2022. The results will be disseminated through stakeholder meetings, scientific conference presentations, oral presentations to the public, and publication in a peer-reviewed journal.

    CONCLUSIONS: This is, to our knowledge, the first study to map the literature on the use and experiences of parents' and adolescents' online access to the electronic health records of children and adolescents. The findings will describe what benefits and risks have been experienced by different stakeholders so far in different countries. A mapping of studies could inform the design and implementation of future regulations around access to patient-accessible electronic health records.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/36158.

  • 20.
    Hagström, Josefin
    et al.
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Blease, Charlotte
    Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
    Haage, Barbara
    Department of Health Technologies, Tallinn University of Technology, Tallinn, Estonia.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Hansson, Scharlett
    Department of Health Technologies, Tallinn University of Technology, Tallinn, Estonia.
    Hägglund, Maria
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Views, Use, and Experiences of Web-Based Access to Pediatric Electronic Health Records for Children, Adolescents, and Parents: Scoping Review2022In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 24, no 11, p. e40328-, article id e40328Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: Ongoing efforts worldwide to provide patients with patient-accessible electronic health records (PAEHRs) have led to variability in adolescent and parental access across providers, regions, and countries. There is no compilation of evidence to guide policy decisions in matters such as access age and the extent of parent proxy access. In this paper, we outline our scoping review of different stakeholders' (including but not limited to end users) views, use, and experiences pertaining to web-based access to electronic health records (EHRs) by children, adolescents, and parents.

    OBJECTIVE: The aim of this study was to identify, categorize, and summarize knowledge about different stakeholders' (eg, children and adolescents, parents, health care professionals [HCPs], policy makers, and designers of patient portals or PAEHRs) views, use, and experiences of EHR access for children, adolescents, and parents.

    METHODS: A scoping review was conducted according to the Arksey and O'Malley framework. A literature search identified eligible papers that focused on EHR access for children, adolescents, and parents that were published between 2007 and 2021. A number of databases were used to search for literature (PubMed, CINAHL, and PsycINFO).

    RESULTS: The approach resulted in 4817 identified articles and 74 (1.54%) included articles. The papers were predominantly viewpoints based in the United States, and the number of studies on parents was larger than that on adolescents and HCPs combined. First, adolescents and parents without access anticipated low literacy and confidentiality issues; however, adolescents and parents who had accessed their records did not report such concerns. Second, the main issue for HCPs was maintaining adolescent confidentiality. This remained an issue after using PAEHRs for parents, HCPs, and other stakeholders but was not an experienced issue for adolescents. Third, the viewpoints of other stakeholders provided a number of suggestions to mitigate issues. Finally, education is needed for adolescents, parents, and HCPs.

    CONCLUSIONS: There is limited research on pediatric PAEHRs, particularly outside the United States, and on adolescents' experiences with web-based access to their records. These findings could inform the design and implementation of future regulations regarding access to PAEHRs. Further examination is warranted on the experiences of adolescents, parents, and HCPs to improve usability and utility, inform universal principles reducing the current arbitrariness in the child's age for own and parental access to EHRs among providers worldwide, and ensure that portals are equipped to safely and appropriately manage a wide variety of patient circumstances.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/36158.

  • 21.
    Hagström, Josefin
    et al.
    Department of Women's and Children's Health, Uppsala University, Sweden.
    Blease, Charlotte
    Informatics, School of Business Örebro University, Örebro, Sweden.
    Kharko, Anna
    Informatics, School of Business Örebro University, Örebro, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Hägglund, Maria
    Department of Women's and Children's Health, Uppsala University, Sweden.
    Adolescents Identifying Errors and Omissions in Their Electronic Health Records: A National Survey2023In: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 302, p. 242-246Article in journal (Refereed)
    Abstract [en]

    Patient accessible electronic health records (PAEHRs) have been proposed as a means to improve patient safety and documentation quality, as patients become an additional source to detect mistakes in the records. In pediatric care, healthcare professionals (HCP) have noted a benefit of parent proxy users correcting errors in their child's records. However, the potential of adolescents has so far been overlooked, despite reports of reading records to ensure accuracy. The present study examines errors and omissions identified by adolescents, and whether patients reported following up with HCPs. Survey data was collected during three weeks in January and February 2022 via the Swedish national PAEHR. Of 218 adolescent respondents, 60 reported having found an error (27.5%) and 44 (20.2%) had found missing information. Most adolescents did not take any action upon identifying an error or an omission (64.0%). Omissions were more often perceived as serious than errors. These findings call for development of policy and PAEHR design that facilitates reports of errors and omissions for adolescents, which could both improve trust and support the individual's transition into an involved and engaged adult patient.

  • 22.
    Hagström, Josefin
    et al.
    Dept. of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Blease, Charlotte
    Dept. of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Rexhepi, Hanife
    School of Informatics, University of Skövde, Skövde, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Hägglund, Maria
    Dept. of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Adolescents' and Young Adults' Experiences of Offense from Reading Their Health Records Online2024In: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 310, p. 1422-1423Article in journal (Refereed)
    Abstract [en]

    Patients feeling offended by reading records online is a concern among healthcare professionals, however previously published work has focused on adult patients. Here, a survey was used to explore and compare experiences of offense among adolescents (15-19 years old) and young adults (20-24 years old). Findings indicated that while the ratio of those offended did not differ between adolescents and young adults, reasons for feeling offended did.

  • 23.
    Hagström, Josefin
    et al.
    Healthcare Sciences and E-health, Dept Women's and Children's Health, Uppsala University, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Blease, Charlotte
    General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
    Haage, Barbara
    Dept of Health Technologies, Tallinn University of Technology, Estland.
    Hörhammer, Iiris
    Dept of Industrial Engineering and Management, Aalto University, Espoo, Finland.
    Hägglund, Maria
    Healthcare Sciences and E-health, Dept Women's and Children's Health, Uppsala University, Sweden.
    Minor and Parental Access to Electronic Health Records: Differences Across Four Countries2022In: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 294, p. 495-499Article in journal (Refereed)
    Abstract [en]

    An increasing number of countries are implementing patient access to electronic health records (EHR). However, EHR access for parents, children and adolescents presents ethical challenges of data integrity, and regulations vary across providers, regions, and countries. In the present study, we compare EHR access policy for parents, children and adolescents in four countries. Documentation from three areas: upper age limit of minors for which parents have access; age at which minors obtain access; and possibilities of access restriction and extension was collected from Sweden, Norway, Finland, and Estonia. Results showed that while all systems provided parents with automatic proxy access, age limits for its expiry differed. Furthermore, a lower minimum age than 18 for adolescent access was present in two of four countries. Differences between countries and potential implications for adolescents are discussed. We conclude that experiences of various approaches should be explored to promote the development of EHR regulations for parents, children and adolescents that increases safety, quality, and equality of care.

  • 24.
    Hagström, Josefin
    et al.
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden.
    Åhlfeldt, Rose-Mharie
    School of Informatics, University of Skövde, Skövde, Sweden.
    Blease, Charlotte
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden; Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
    Cajander, Åsa
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Rexhepi, Hanife
    School of Informatics, University of Skövde, Skövde, Sweden.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Kane, Bridget
    Business School, Karlstad University, Karlstad, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Hägglund, Maria
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden.
    Security and Privacy of Online Record Access: A Survey of Adolescents' Views and Experiences in Sweden2024In: Journal of Adolescent Health, ISSN 1054-139X, E-ISSN 1879-1972Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Ensuring security of online health records and patients' perceptions of security are concerns in adolescent healthcare. Little is known about adolescents' perceptions about healthcare's ability to protect online health records. This article explores adolescents' perspectives on security and privacy of their online health records, potential differences based on gender and health, attitudes to sharing information, and perceptions of what constitutes sensitive information.

    METHODS: This study included a subset of items from a national online patient survey conducted in Sweden (January-February 2022), focusing on respondents aged 15-19 years. Gender and health status differences were calculated using the Kruskal-Wallis test.

    RESULTS: Of 218 adolescent respondents (77.1% female), a minority had security and privacy concerns. A notable proportion (41.3%) wished to control who could see their records, and those who reported better perceived health were more likely to want to manage access to their electronic health record (H = 13.569, p = .009). Most had not experienced unauthorized access to their records (75.2%) and had never shared health information on other online applications (85.8%). More than half (56.0%) perceived some information as sensitive, where mental health was the most common (76.0%). Most felt that reading their notes improved their trust for their healthcare professional (65.6%) and supported better communication with healthcare professionals (66.5%).

    DISCUSSION: In this national survey, adolescents generally reported few concerns about patient portals. Findings emphasize the need for security and privacy protection and to empower adolescents with greater control over access to their health information housed in electronic health record systems.

  • 25.
    Hellstrand Tang, Ulla
    et al.
    Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Sundberg, Leif
    Gothenburg Diabetes Association, Gothenburg, Sweden.
    Annersten Gershater, Magdalena
    Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.
    Zügner, Roland
    Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Patients' Expectations of Evidence-Based Service at the Pharmacy Regarding Information on Self-Care of the Feet for Persons with Diabetes at Risk of Developing Foot Ulcers - A Cross-Sectional Observational Study in Sweden2023In: Patient Preference and Adherence, E-ISSN 1177-889X, Vol. 17, p. 3557-3576Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Self-care of the feet is one of the cornerstones in the prevention of diabetic foot ulcers (DFU). Often, individuals with diabetes seek help at the pharmacy, but it is still unclear whether the service meets their expectations and needs. The aims were to explore patients' expectations of support from the pharmacy regarding self-care of their feet and explore how patients with diabetes felt that they managed the self-care of their feet.

    PATIENTS AND METHODS: The included participants (n = 17), aged 70 ± 9 years, answered surveys regarding their expectations of support from the pharmacy related to self-care of the feet and how they felt that they managed the self-care of their feet. By using software, MyFoot Diabetes, they assessed their risk of developing DFU (ranging from 1 = no risk to 4 = DFU). In addition, a healthcare professional assessed the risk grade.

    RESULTS: Sixteen patients had not received any information from the pharmacy regarding how to take care of their feet. Several suggestions for ways the pharmacy could help patients with diabetes to take care of their feet were registered. They included having the necessary skills and competence, giving advice regarding self-care, giving information regarding the products they market and have for sale and giving advice on ointments/creams. The participants gave several examples of how they self-managed their feet: by wearing shoes indoors and outdoors, wearing socks and compression stockings as often as possible, being physically active, inspecting their feet, being aware of the fact that their feet have no problems, washing, moisturising their feet, cutting their nails and finally seeking help to prevent DFU.

    CONCLUSION: The participants thought that they should receive competent information from the personnel at the pharmacy to improve the self-care of their feet, eg, being given information about which ointments/creams to use.

    CLINICAL TRIAL: NCT05692778.

  • 26.
    Huvila, Isto
    et al.
    Department of ALM, Uppsala University, Uppsala, Sweden; Information Studies, Åbo Akademi University, Finland.
    Enwald, Heidi
    Information Studies, University of Oulu, Oulu, Finland; Åbo Akademi University, Åbo, Finland.
    Eriksson-Backa, Kristina
    Information Studies, Åbo Akademi University, Åbo, Finland.
    Hirvonen, Noora
    Information Studies, University of Oulu, Oulu, Finland; Åbo Akademi University, Åbo, Finland.
    Nguyen, Hai
    Information Studies, Åbo Akademi University, Åbo, Finland.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Anticipating ageing: Older adults reading their medical records2018In: Information Processing & Management, ISSN 0306-4573, E-ISSN 1873-5371, Vol. 54, no 3, p. 394-407Article in journal (Refereed)
    Abstract [en]

    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.

  • 27.
    Hägglund, M.
    et al.
    Department of Women's and Children's Health, Uppsala university, Uppsala, Sweden.
    Blease, C.
    Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, USA.
    Johansen, M. A.
    Department of Clinical Medicine, the Artic University of Norway (UIT), Tromsø, Norway .
    Kujala, S.
    Aalto University, Department of Computer Science, Finland.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Exploration of A Socio-Technical Analysis Template for Patient Accessible Electronic Health Records2020Conference paper (Refereed)
  • 28.
    Hägglund, M.
    et al.
    Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden.
    Marcilly, R.
    NSERM CIC-IT, Lille, France.
    Pelayo, S.
    EVALAB INSERM CIC-IT, Lille, France.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Reinventing Heuristic Evaluations: Exploring Methods to Engage Clinicians in Usability Evaluations2017In: Informatics for health: Connected Citizen-Led Wellness and Population Health, 2017Conference paper (Refereed)
    Abstract [en]

    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.

  • 29.
    Hägglund, Maria
    et al.
    Department of Women's and Children's Health, Uppsala university, Uppsala, Sweden.
    Blease, Charlotte
    Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, USA.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Mobile Access and Adoption of the Swedish National Patient Portal2020In: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 275, p. 82-86Article in journal (Refereed)
    Abstract [en]

    Patient portals are used as a means to facilitate communication, performing administrative tasks, or accessing one's health record. In a retrospective analysis of real-world data from the Swedish National Patient Portal 1177.se, we describe the rate of adoption over time, as well as how patterns of device usage have changed over time. In Jan 2013, 53% of all visits were made from a computer, and 38% from a mobile phone. By June 2020, 77% of all visits were made from a mobile phone and only 20% from a computer. These results underline the importance of designing responsive patient portals that allow patients to use any device without losing functionality or usability.

  • 30.
    Hägglund, Maria
    et al.
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden .
    DesRoches, Catherine
    Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
    Petersen, Carolyn
    Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Patients' access to health records2019In: The BMJ, E-ISSN 1756-1833, Vol. 367, article id l5725Article in journal (Refereed)
  • 31.
    Hägglund, Maria
    et al.
    Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden.
    Heinze, Oliver
    Department of Medical Information Systems, Univ. Hospital, Heidelberg, Germany.
    Pobiruchin, Monika
    GECKO Institute for Medicine, Informatics and Economics, Heilbronn University, Heilbronn University, Germany.
    Pohl, Anna-Lena
    Institute for eHealth and Management in HealthCare, Flensburg University, Flensburg, Germany.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Schreiweis, Björn
    Department of Medical Information Systems, Univ. Hospital, Heidelberg, Germany.
    Wiesner, Martin
    Dept. of Medical Informatics, Heilbronn University, Germany.
    Opportunities and Challenges of Consumer-centric eHealth Services: An Interdisciplinary Workshop2016Conference paper (Other academic)
  • 32.
    Hägglund, Maria
    et al.
    Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden.
    Heinze, Oliver
    Department of Medical Information Systems, Univ. Hospital Heidelberg, Germany.
    Pobiruchin, Monika
    GECKO Institute for Medicine, Informatics and Economics, Heilbronn University, Germany.
    Pohl, Anna-Lena
    Institute for eHealth and Management in HealthCare, Flensburg University, Germany.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Schreiweis, Björn
    Department of Medical Information Systems, Univ. Hospital Heidelberg, Germany.
    Wiesner, Martin
    Dept. of Medical Informatics, Heilbronn University, Germany.
    Report on the HEC 2016 Workshop: Opportunities and Challenges of Consumer-centric eHealth Services – An Interdisciplinary Workshop2016Report (Other academic)
    Download full text (pdf)
    Report on the HEC 2016 Workshop: Opportunities and Challenges of Consumer-centric eHealth Services – An Interdisciplinary Workshop
  • 33.
    Hägglund, Maria
    et al.
    Department of Women's and Children's Health, Uppsala university, Uppsala, Sweden; Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, USA.
    Helsing, Emma
    Department of Women's and Children's Health, Uppsala university, Uppsala, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Personalized Communication: People with Hearing Loss' Experiences of Using a National Patient Portal2020In: Digital Personalized Health and Medicine / [ed] Louise B. Pape-Haugaard, Christian Lovis, Inge Cort Madsen, Patrick Weber, Per Hostrup Nielsen, Philip Scott, IOS Press, 2020, Vol. 270, p. 1031-1035Conference paper (Refereed)
    Abstract [en]

    Patient portals are used as a means to facilitate communication, performing administrative tasks, or accessing one's health record. A qualitative study was therefore performed to understand how people with hearing loss experience using the Swedish national patient portal 1177.se and the patient accessible electronic health record Journalen. Data was collected through focus groups and individual interviews. Ten persons with varying degree of hearing loss, age and years of using a hearing aid participated. The data was analyzed through thematic content analysis and three themes emerged; access to written information, patient-created information and personalized communication. Although the study is limited in size, we believe that important lessons can be learned regarding the needs for personalized communication, including access to written information.

  • 34.
    Hägglund, Maria
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Karlsson, Daniel
    Linköping University, Linköping, Sweden.
    Klein, Gunnar O.
    Örebro University, Örebro University School of Business.
    Koch, Sabine
    Karolinska Institutet, Stockholm, Sweden.
    Lindgren, Helena
    Umeå University, Umeå, Sweden.
    Nyström, Mikael
    Linköping University, Linköping, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Sundvall, Erik
    Linköping University, Linköping, Sweden.
    ”Världsbäst på eHälsa kräver internationellt samarbete”2017In: Svenska Dagbladet, ISSN 2001-3868, no 21 septemberArticle in journal (Other (popular science, discussion, etc.))
  • 35.
    Hägglund, Maria
    et al.
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden.
    Kharko, Anna
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden; School of Psychology, Faculty of Health, University of Plymouth, Plymouth, United Kingdom.
    Hagström, Josefin
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden.
    Bärkås, Annika
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden.
    Blease, Charlotte
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden; Department of Medicine, Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
    Cajander, Åsa
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    DesRoches, Catherine
    Department of Medicine, Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
    Fagerlund, Asbjørn Johansen
    Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway.
    Haage, Barbara
    E-Medicine Centre, Department of Health Technologies, Tallinn University of Technology, Tallinn, Estonia.
    Huvila, Isto
    Department of Archives, Libraries & Museums, Uppsala University, Uppsala, Sweden.
    Hörhammer, Iiris
    Department of Computer Science, Aalto University, Espoo, Finland.
    Kane, Bridget
    Business School, Karlstad University, Karlstad, Sweden.
    Klein, Gunnar O.
    Örebro University, Örebro University School of Business.
    Kristiansen, Eli
    Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway.
    Luks, Kerli
    E-Medicine Centre, Department of Health Technologies, Tallinn University of Technology, Tallinn, Estonia.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Muli, Irene
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden.
    Raphaug, Eline Hovstad
    Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway.
    Rexhepi, Hanife
    School of Informatics, University of Skövde, Skövde, Sweden.
    Riggare, Sara
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden.
    Ross, Peeter
    E-Medicine Centre, Department of Health Technologies, Tallinn University of Technology, Tallinn, Estonia.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Simola, Saija
    Department of Computer Science, Aalto University, Espoo, Finland.
    Soone, Hedvig
    E-Medicine Centre, Department of Health Technologies, Tallinn University of Technology, Tallinn, Estonia.
    Wang, Bo
    Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway.
    Ghorbanian Zolbin, Maedeh
    Department of Computer Science, Aalto University, Espoo, Finland.
    Åhlfeldt, Rose-Mharie
    School of Informatics, University of Skövde, Skövde, Sweden.
    Kujala, Sari
    Department of Computer Science, Aalto University, Espoo, Finland.
    Johansen, Monika Alise
    Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, Telemedicine and E-health Research Group, Arctic University of Norway, Tromsø, Norway.
    The NORDeHEALTH 2022 Patient Survey: Cross-Sectional Study of National Patient Portal Users in Norway, Sweden, Finland, and Estonia2023In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 25, article id e47573Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although many surveys have been conducted on patients accessing their own health records in recent years, there is a limited amount of nationwide cross-country data available on patients' views and preferences. To address this gap, an international survey of patient users was conducted in the Nordic eHealth project, NORDeHEALTH.

    OBJECTIVE: We aimed to investigate the sociodemographic characteristics and experiences of patients who accessed their electronic health records (EHRs) through national patient portals in Norway, Sweden, Finland, and Estonia.

    METHODS: A cross-sectional web-based survey was distributed using the national online health portals. The target participants were patients who accessed the national patient portals at the start of 2022 and who were aged ≥15 years. The survey included a mixture of close-ended and free-text questions about participant sociodemographics, usability experience, experiences with health care and the EHR, reasons for reading health records online, experience with errors, omissions and offense, opinions about security and privacy, and the usefulness of portal functions. In this paper, we summarized the data on participant demographics, past experience with health care, and the patient portal through descriptive statistics. RESULTS: In total, 29,334 users completed the survey, of which 9503 (32.40%) were from Norway, 13,008 (44.35%) from Sweden, 4713 (16.07%) from Finland, and 2104 (7.17%) from Estonia. National samples were comparable according to reported gender, with about two-thirds identifying as women (19,904/29,302, 67.93%). Age distributions were similar across the countries, but Finland had older users while Estonia had younger users. The highest attained education and presence of health care education varied among the national samples. In all 4 countries, patients most commonly rated their health as "fair" (11,279/29,302, 38.48%). In Estonia, participants were more often inclined to rate their health positively, whereas Norway and Sweden had the highest proportion of negative health ratings. Across the whole sample, most patients received some care in the last 2 years (25,318/29,254, 86.55%). Mental health care was more common (6214/29,254, 21.24%) than oncological care (3664/29,254, 12.52%). Overall, most patients had accessed their health record "2 to 9 times" (11,546/29,306, 39.4%), with the most frequent users residing in Sweden, where about one-third of patients accessed it "more than 20 times" (4571/13,008, 35.14%).

    CONCLUSIONS: This is the first large-scale international survey to compare patient users' sociodemographics and experiences with accessing their EHRs. Although the countries are in close geographic proximity and demonstrate similar advancements in giving their residents online records access, patient users in this survey differed. We will continue to investigate patients' experiences and opinions about national patient-accessible EHRs through focused analyses of the national and combined data sets from the NORDeHEALTH 2022 Patient Survey.

  • 36.
    Hägglund, Maria
    et al.
    Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden.
    Moll, Jonas
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Åhlfeldt, Rose-Mharie
    School of Informatics, University of Skövde, Skövde, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Timing It Right: Patients' Online Access to Their Record Notes in Sweden2018In: Building Continents of Knowledge in Oceans of Data: The Future of Co-Created eHealth / [ed] Adrien Ugon, Daniel Karlsson, Gunnar O. Klein, Anne Moen, IOS Press, 2018, Vol. 247, p. 336-340Conference paper (Refereed)
    Abstract [en]

    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.

  • 37.
    Hägglund, Maria
    et al.
    Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    A Socio-Technical Analysis of Patient Accessible Electronic Health Records2017In: The Practice of Patient Centered Care: Empowering and Engaging Patients in the Digital Era / [ed] Rolf Engelbrecht, Ran Balicer, Mira Hercigonja-Szekeres, IOS Press, 2017, Vol. 244, p. 3-7Conference paper (Refereed)
    Abstract [en]

    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.

  • 38.
    Hägglund, Maria
    et al.
    Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business. APRI eHealth, Själevad, Sweden.
    Does user centred design work in homecare for elderly?: a retrospective on the OLD@HOME case2011In: International Journal of Integrated Care, ISSN 1568-4156, E-ISSN 1568-4156, Vol. 11Article in journal (Refereed)
    Abstract [en]

    Introduction: Mobile information and communication technology (ICT) has been suggested to improve collaboration in integrated homecare, yet, few successful implementations are available. User centred design (UCD) can improve the usefulness of ICT, however, it is often claimed to be expensive and difficult to use in healthcare. In the action research project OLD@HOME (Sweden 2002–2005) a user centred approach was adapted to the specific context of integrated homecare for elderly.

    Aim: To revisit OLD@HOME and explore what methodological adjustments were needed to adapt UCD to integrated homecare of elderly, and what the long-term effects of using UCD were.

    Results: Our collaborative design method included all stakeholders and enabled development of both new work situations and new tools. Five years after implementation, the system is still used by home help service personnel, for both homecare- and office-based work, as it provides ubiquitous access to information and communication. Technical support is rarely needed; experienced users handle occurring problems, training and introduction of new users.

    Conclusions: We consider the development method a key factor for the OLD@HOME system’s success as it enabled the design of a homecare system that is not only easy to use, but adapted to the context of integrated homecare for elderly

  • 39.
    Hägglund, Maria
    et al.
    Karolinska University.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Empowering patients and relatives in elderly care by information access2008Conference paper (Refereed)
  • 40.
    Hägglund, Maria
    et al.
    Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden .
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Patients' online access to Electronic Health Records: current status and experiences from the implementation in Sweden2017In: MEDINFO 2017: Precision Healthcare through Informatics / [ed] Adi V. Gundlapalli, Marie-Christine Jaulent, Dongsheng Zhao, IOS Press, 2017, Vol. 245, p. 723-727Conference paper (Refereed)
    Abstract [en]

    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.

  • 41. Hägglund, Maria
    et al.
    Scandurra, Isabella
    Centre for eHealth, Uppsala University, Uppsala, Sweden.
    Studying intersection points – an analysis of information needs in shared homecare of elderly2009In: Journal on Information Technology in Healthcare, ISSN 1479-649X, The journal on information technology in healthcare, ISSN 1479-649X, Vol. 7, no 1, p. 23-42Article in journal (Refereed)
    Abstract [en]

    Objectives: Elderly patients are increasingly receiving care in their own homes but this process is not well supported by existing systems which suffer from limited integration of health and social care services. The result is fragmentation of care, lack of coordination between services, duplication of services, and limited participation of patients and informal carers in the care process. In this study we attempt to identify the key intersection points, i.e. where different actors involved in the homecare of elderly patients interact, and to analyse their individual information requirements. How these requirements can be met using information and communication technology (ICT) is discussed.

    Methods: The study involved 13 participants representing professional health and social careworkers, patients and relatives. Their interactions and information needs were obtained using a variety of methods including multi-disciplinary thematic seminars, participatory observations, interviews, inventory of current information systems, scenarios, sketching and prototyping. 

    Results: The key intersection points where information exchange between different actors isneeded are (i) Initiation of patient specific changes in homecare provision, (ii) Consultations, (iii) Delegation of duties, (iv) Referrals, (v) Important health events and general care (vi) Coordination of planned activities. Shared information objects which would be beneficial include(i) Contact information of all parties, (ii) Patient care plan, (iii) Patient's medication list, (iv) Risk factors, (v) Updates to medical records, (vi) Patient medical summaries, (vii) Patient centred calendar (viii) Assessment of their homecare needs. An ICT solution implemented to meet these requirements must be integrated with existing systems to minimise any additional work that staff will have to do and also address major issues such as security, design of mobile applications (including both interface design and synchronisation issues), interoperability and ethical and legal aspects. 

    Conclusion: This study has identified the information that needs to be shared at key intersection points between different actors involved in providing homecare for the elderly. It has also indicated how this information can be made available through ICT and highlighted the challenges that will have to be overcome in order to support patient centred care.

  • 42.
    Hägglund, Maria
    et al.
    Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Usability of the Swedish Accessible Electronic Health Record: Qualitative Survey Study.2022In: JMIR Human Factors, E-ISSN 2292-9495, Vol. 9, no 2, article id e37192Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Patient portals are increasingly being implemented worldwide to ensure that patients have timely access to their health data, including patients' access to their electronic health records. In Sweden, the e-service Journalen is a national patient-accessible electronic health record (PAEHR), accessible on the web through the national patient portal. User characteristics and perceived benefits of using a PAEHR will influence behavioral intentions to use and adoption; however, poor usability, which increases effort expectancy, may have a negative impact. Therefore, it is of interest to further explore how users of the PAEHR Journalen perceive its usability and usefulness.

    OBJECTIVE: On the basis of the analysis of the survey respondents' experiences of the usability of the Swedish PAEHR, this study aimed to identify specific usability problems that may need to be addressed in the future.

    METHODS: A survey study was conducted to elicit opinions and experiences of patients using Journalen. Data were collected from June to October 2016. The questionnaire included a free-text question regarding the usability of the system, and the responses were analyzed using content analysis with a sociotechnical framework as guidance when grouping identified usability issues.

    RESULTS: During the survey period, 423,141 users logged into Journalen, of whom 2587 (0.61%) completed the survey (unique users who logged in; response rate 0.61%). Of the 2587 respondents, 186 (7.19%) provided free-text comments on the usability questions. The analysis resulted in 19 categories, which could be grouped under 7 of the 8 dimensions in the sociotechnical framework of Sittig and Singh. The most frequently mentioned problems were related to regional access limitations, structure and navigation of the patient portal, and language and understanding.

    CONCLUSIONS: Although the survey respondents, who were also end users of the PAEHR Journalen, were overall satisfied with its usability, they also experienced important challenges when accessing their records. For all patients to be able to reap the benefits of record access, it is essential to understand both the usability challenges they encounter and, more broadly, how policies, regulations, and technical implementation decisions affect the usefulness of record access. The results presented here are specific to the Swedish PAEHR Journalen but also provide important insights into how design and implementation of record access can be improved in any context.

  • 43.
    Hägglund, Maria
    et al.
    Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    User Evaluation of the Swedish Patient Accessible Electronic Health Record: System Usability Scale2021In: JMIR Human Factors, E-ISSN 2292-9495, Vol. 8, no 3, article id e24927Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Transparency is increasingly called for in health care, especially, when it comes to patients' access to their electronic health records. In Sweden, the e-service Journalen is a national patient accessible electronic health record (PAEHR), accessible online via the national patient portal. User characteristics and perceived benefits of using a PAEHR influence behavioral intention for use and adoption, but poor usability that increases the effort expectancy can have a negative impact. It is, therefore, of interest to explore how users of the PAEHR Journalen perceive its usability and usefulness.

    OBJECTIVE: The aim of this study was to explore how the users of the Swedish PAEHR experience the usability of the system and to identify differences in these experiences based on the level of transparency of the region.

    METHODS: A survey study was conducted to elicit opinions and experiences of patients using Journalen. The data were collected from June to October 2016. The questionnaire included questions regarding the usability of the system from the System Usability Scale (SUS). The SUS analysis was the focus of this paper. Analysis was performed on different levels: nationally looking at the whole data set and breaking it down by focusing on 2 different regions to explore differences in experienced usability based on the level of transparency.

    RESULTS: During the survey period, 423,141 users logged into Journalen, of which 2587 unique users completed the survey (response rate 0.61%). The total mean score for all respondents to the SUS items was 79.81 (SD 14.25), which corresponds to a system with good usability. To further explore whether the level of transparency in a region would affect the user's experience of the usability of the system, we analyzed the 2 regions with the most respondents: Region Uppsala (the first to launch, with a high level of transparency), and Region Skåne (an early implementer, with a low level of transparency at the time of the survey). Of the participants who responded to at least 1 SUS statement, 520 stated that they had received care in Region Skåne, whereas 331 participants had received care in Region Uppsala. Uppsala's mean SUS score was 80.71 (SD 13.41), compared with Skåne's mean of 79.37 (SD 13.78).

    CONCLUSIONS: The Swedish national PAEHR Journalen has a reasonably good usability (mean SUS score 79.81, SD 14.25); however, further research into more specific usability areas are needed to ensure usefulness and ease of use in the future. A somewhat higher SUS score for the region with high transparency compared with the region with low transparency could indicate a relationship between the perceived usability of a PAEHR and the level of transparency offered, but further research on the relationship between transparency and usability is required.

  • 44.
    Hägglund, Maria
    et al.
    Department of Medical Sciences, Biomedical Informatics and Engineering, Uppsala University, University Hospital, Uppsala, Sweden.
    Scandurra, Isabella
    Department of Medical Sciences, Biomedical Informatics and Engineering, Uppsala University, University Hospital, Uppsala, Sweden.
    Koch, Sabine
    Department of Medical Sciences, Biomedical Informatics and Engineering, Uppsala University, University Hospital, Uppsala, Sweden.
    Integrated Care Plan for Shared Home Care: the technical architecture2005In: Journal on Information Technology in Healthcare, ISSN 1479-649X, Vol. 3, no 5, p. 287-294Article in journal (Refereed)
    Abstract [en]

    The move towards decentralising healthcare services from traditional care settings towards home care has produced new requirements for care planning and documentation of procedures performed in the home environment. To meet these requirements, a virtual care plan (VCP) has been developed that gives both district nurses and home help service personnel (HHS) access to their respective care plans in a mobile work situation. In this paper we present the technical architecture of this VCP, and describe how it integrates information from different feeder systems and allows for documentation at the point of care (POC) using mobile devices.

  • 45.
    Hägglund, Maria
    et al.
    Medical Informatics and Engineering, Uppsala University, University Hospital, Uppsala, Sweden.
    Scandurra, Isabella
    Medical Informatics and Engineering, Uppsala University, University Hospital, Uppsala, Sweden.
    Koch, Sabine
    Medical Informatics and Engineering, Uppsala University, University Hospital, Uppsala, Sweden.
    Integrated Care Plan for Shared Home Care: the technical architecture2005In: Telemedicine and eHealth in Recent Years: Meeting the Challenges / [ed] Kioulafas K, Katharaki M, National and Kapodistrian University of Athens , 2005, no 5, p. 377-382Conference paper (Refereed)
  • 46. Hägglund, Maria
    et al.
    Scandurra, Isabella
    Centre for eHealth, Uppsala University, Akademiska sjukhuset, Uppsala, Sweden.
    Koch, Sabine
    Scenarios to Capture Work Processes in Shared Home Care – from analysis to application2010In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 79, no 6, p. 126-134Article in journal (Refereed)
    Abstract [en]

    Background

    Shared homecare is increasingly common, and in order to develop ICT that support such complex cooperative and interdisciplinary work it is crucial to obtain an understanding of work processes at the clinical level before the development is initiated. It is also crucial, but difficult, to correctly transfer this insight to the development team.

    Method

    User-centered scenario building in interdisciplinary working groups is applied for capturing cooperative work routines, information demands, and other central preconditions in shared homecare.

    Results

    Use of scenarios for analysis of cooperative work and as information carrier is described via a case from the multi-disciplinary OLD@HOME project. Both current and future work scenarios were elicited. To illustrate the process of transforming scenarios into more technical descriptions (use cases), and finally into an application, examples showing the transparency in resulting use cases and in the implemented system are provided.

    Conclusion

    In this case study, scenarios proved to be useful not only in initial system development phases but throughout the entire development process, improving accessibility and assessment of end user needs. For the development team, scenarios assisted in solving usability issues, and served as a basis for describing use cases and for further system development. More importantly, the shared care scenarios ensured the provision of different perspectives on common work processes, which are often neglected in conventional requirements specifications. This also improved understanding between different clinical groups and between clinicians and developers.

  • 47.
    Hägglund, Maria
    et al.
    Karolinska Institute, Stockholm, Sweden.
    Scandurra, Isabella
    APRI | eHealth, Själevad, Sweden.
    Koch, Sabine
    Karolinska Institute, Stockholm, Sweden.
    Supporting Citizen-centred Care for Seniors: Experiences from Two Swedish Research Projects2012In: 25th International Symposium on Computer-Based Medical Systems (CBMS), 2012 / [ed] Paolo Soda; Francesco Tortorella; Sameer Antani; Mykola Pechenizkiy; Mario Cannataro; Alexey Tsymbal, Rome, Italy: IEEE conference proceedings, 2012, article id 6266377Conference paper (Refereed)
    Abstract [en]

    The development of information and communication technology (ICT) for citizen-centered care requires insight into concrete problems in care processes as well as an understanding of the goals and values that should guide these. In this retrospective study we return to results from two research projects focusing on the needs of senior citizens and stroke patients. We describe the intersections between health care services, social care services and private services, and analyze these with focus on the needs of independence, continuity and participation. The current state of ICT in relation to the identified needs is also addressed. In conclusion, an increasing number of solutions are available to support senior citizens in different parts of their lives, yet they remain isolated and have limited impact. In order to harness value for senior citizens, it is imperative to continue with multidisciplinary research focusing on socio-technical aspects; addressing technological, organizational, legal and business-related aspects.

  • 48.
    Hägglund, Maria
    et al.
    Dept of Medicial Sciences, Uppsala University, University Hospital, Uppsala, Sweden; Centre for EHealth, Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Dept of Medicial Sciences, Uppsala University, University Hospital, Uppsala, Sweden; Centre for EHealth, Uppsala University, Uppsala, Sweden.
    Koch, Sabine
    Dept of Medicial Sciences, Uppsala University, University Hospital, Uppsala, Sweden; Centre for EHealth, Uppsala University, Uppsala, Sweden.
    User-centred deployment process for ICT in health care teams: experiences from the OLD@HOME project2006In: Ubiquity - Technologies for Better Health in Aging Societies: Proceedings of MIE2006 / [ed] A. Hasman, R. Haux, J. Van der Lei, IOS Press, 2006, p. 167-172Chapter in book (Refereed)
    Abstract [en]

    Objective: To present a user-centred method for introducing ICT in health care organisations, taking factors that influence acceptance into account.

    Methods: User centred methods are used in combination with previous research regarding factors that affect user acceptance, in order to facilitate users' acceptance of new ICT tools.

    Results: A method is presented that supports the introduction of ICT in team work. The method consists of three major steps; (1) the start-up seminar, (2) end user education and (3) continuous follow-up during the deployment phase. Important results of the start-up seminar are documentation of the users' expectations, and an agreement of ground rules that supports both the social norm factor and the users' perceived behavioural control. Education and follow-up also improve perceived behavioural control, and by involving super users perceived usefulness and ease of use can be improved through subjective norm.

    Conclusion: Key factors in the deployment process are; user participation, end user experience and education, and continuous follow-up of the process.

  • 49.
    Hägglund, Maria
    et al.
    Dept of Medicial Sciences, Uppsala University, University Hospital, Uppsala, Sweden; Centre for EHealth, Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Dept of Medicial Sciences, Uppsala University, University Hospital, Uppsala, Sweden; Centre for EHealth, Uppsala University, Uppsala, Sweden.
    Koch, Sabine
    Dept of Medicial Sciences, Uppsala University, University Hospital, Uppsala, Sweden; Centre for EHealth, Uppsala University, Uppsala, Sweden.
    Using Scenarios to Capture Work Processes in Shared Home Care2007In: Information Technology in Health Care 2007: Proceedings of the 3rd International Conference on Information Technology in Health Care -- Socio-technical Approaches / [ed] E. Coiera, J.I. Westbrook, J.L. Callen, IOS Press, 2007, p. 233-239Chapter in book (Refereed)
    Abstract [en]

    Shared home care is increasingly common, and in order to develop ICT that support such complex cooperative work it is crucial obtain an understanding of the work routines, information demands, and other central preconditions at the clinical level before the development is initiated. Scenarios are proposed as a technique that can be useful for capturing work processes in shared home care and experiences from the Old@Home project are presented. The scenarios are useful not only in the initial phases of the development project but throughout the development process, improving the accessibility of end user requirements and usability issues for the design team, and as a basis for use cases and further design.

  • 50.
    Hägglund, Maria
    et al.
    Department of Medical Sciences, Medical Informatics and Engineering, Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Department of Medical Sciences, Medical Informatics and Engineering, Uppsala University, Uppsala, Sweden.
    Koch, Sabine
    Department of Medical Sciences, Medical Informatics and Engineering, Uppsala University, Uppsala, Sweden.
    Virtual Health Record: User Specific Information Access in a Mobile Work Situation2003Conference paper (Other academic)
123 1 - 50 of 125
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf