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  • 1.
    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.

  • 2.
    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.

  • 3.
    Cajander, Åsa
    et al.
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Daniels, Mats
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Golay, Diane
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Moll, Jonas
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Nylén, Aletta
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Pears, Arnold
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Peters, Anne-Kathrin
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    McDermott, Roger
    School of Computer Science and Digital Media, Robert Gordon University, Aberdeen, UK.
    Unexpected student behaviour and learning opportunities: Using the theory of planned behaviour to analyse a critical incident2017In: Proceedings - Frontiers in Education Conference, FIE, IEEE Press , 2017Conference paper (Refereed)
    Abstract [en]

    One of the challenges in being a teacher is to set up an educational setting where the students receive relevant learning opportunities for the specific course, the students' education in general, and for their future. However, efforts to create such educational settings do not always work in the way that faculty has intended. In this paper we investigate one such effort seen from a critical incident perspective. Central to the analysis in this paper is how the Theory of Planned Behaviour (TPB) can provide explanations for the incident. The critical incident can be summarised as students refusing to take part in a non-compulsory, but from the faculty perspective highly educational, activity. We describe the incident in depth, give the background for the educational intervention, and analyse the incident from the perspective of TPB. This paper makes two major contributions to engineering education research. The first is the development of a method for analysing critical teaching and learning incidents using the TPB. The critical incident analysis illustrates how the method is used to analyse and reason about the students' behaviour. Another contribution is the development of a range of insights which deal with challenges raised by learning interventions, especially those involved with acquiring hidden or "invisible skills" not usually seen or acknowledged by students to belong to core subject area of a degree program.

  • 4.
    Cajander, Åsa
    et al.
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Moll, Jonas
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Englund, Sara
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Hansman, Anastasia
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Medical records online for patients and effects on the work environment of nurses2018In: Building Continents of Knowledge in Oceans of Data: The Future of Co-Created eHealth / [ed] Klein G.O., Karlsson D., Moen A., Ugon A., Amsterdam, The Netherlands: IOS Press , 2018, Vol. 247, p. 271-275Conference paper (Refereed)
    Abstract [en]

    In 2012 Patients Accessible Electronic Health Records (PAEHR) was introduced in Region Uppsala, Sweden. When PAEHR was introduced heath care professionals were very concerned especially in relation to potential negative effects on their work environment. However, few studies exist that investigate in what way work environments have been affected, and no studies have focused on the nurses' working in primary care. Hence, the purpose of this study was to fill this gap through seven interviews with primary care nurses that were transcribed and thematically analysed. The study shows that the nurses' experiences an altered contact as patients accessing PAEHR came prepared to meetings with more informed questions. They also experienced that the service had increased their work load and that it creates uncertainty for nurses who do not know when to inform the patient about test results etc. Finally, some implications are discussed in relation to the patients' role in shared decision making.

  • 5.
    Frid, Emma
    et al.
    Sound and Music Computing, CSC, KTH Royal Institute of Technology, Stockholm, Sweden.
    Bresin, Roberto
    Sound and Music Computing, CSC, KTH Royal Institute of Technology, Stockholm, Sweden.
    Moll, Jonas
    Interaction Design, CSC, KTH Royal Institute of Technology, Stockholm, Sweden.
    Sallnäs Pysander, Eva-Lotta
    Interaction Design, CSC, KTH Royal Institute of Technology, Stockholm, Sweden.
    Sonification of haptic interaction in a virtual scene2014In: SMC Sweden 2014 Sound and Music Computing: Bridging science, art, and industry / [ed] Roberto Bresin, Stockholm: KTH Royal Institute of Technology , 2014, p. 14-16Conference paper (Refereed)
    Abstract [en]

    This paper presents a brief overview of work-in-progress for a study on correlations between visual and haptic spatial attention in a multimodal single-user application comparing different modalities. The aim is to gain insight into how auditory and haptic versus visual representations of temporal events may affect task performance and spatial attention. For this purpose, a 3D application involving one haptic model and two different sound models for interactive sonification are developed.

    Download full text (pdf)
    Sonification of Haptic Interaction in a Virtual Scene
  • 6.
    Frid, Emma
    et al.
    KTH Royal Institute of Technology, Stockholm, Sweden.
    Bresin, Roberto
    KTH Royal Institute of Technology, Stockholm, Sweden.
    Sallnäs Pysander, Eva-Lotta
    KTH Royal Institute of Technology, Stockholm, Sweden.
    Moll, Jonas
    Uppsala University, Uppsala, Sweden.
    An exploratory study on the effect of auditory feedback on gaze behavior in a virtual throwing task with and without haptic feedback2017In: Proceedings of the 14th Sound and Music Computing Conference 2017 / [ed] Tapio Lokki, Jukka Pätynen, Vesa Välimäki, Aalto University , 2017, p. 242-249Conference paper (Refereed)
    Abstract [en]

    This paper presents findings from an exploratory study on the effect of auditory feedback on gaze behavior. A total of 20 participants took part in an experiment where the task was to throw a virtual ball into a goal in different conditions: visual only, audiovisual, visuohaptic and audio-visuohaptic. Two different sound models were compared in the audio conditions. Analysis of eye tracking metrics indicated large inter-subject variability; difference between subjects was greater than difference between feed-back conditions. No significant effect of condition could be observed, but clusters of similar behaviors were identified. Some of the participants’ gaze behaviors appeared to have been affected by the presence of auditory feedback, but the effect of sound model was not consistent across subjects. We discuss individual behaviors and il-lustrate gaze behavior through sonification of gaze trajectories. Findings from this study raise intriguing questions that motivate future large-scale studies on the effect of auditory feedback on gaze behavior.

  • 7.
    Frid, Emma
    et al.
    KTH Royal Institute of Technology, Stockholm, Sweden.
    Moll, Jonas
    Uppsala University, Uppsala, Sweden.
    Bresin, Roberto
    KTH Royal Institute of Technology, Stockholm, Sweden.
    Sallnäs Pysander, Eva-Lotta
    KTH Royal Institute of Technology, Stockholm, Sweden.
    Correction to: Haptic feedback combined with movement sonification using a friction sound improves task performance in a virtual throwing task2019In: Journal on Multimodal User Interfaces, ISSN 1783-7677, E-ISSN 1783-8738, Vol. 13, no 4, p. 291-291Article in journal (Refereed)
    Abstract [en]

    The original version of this article unfortunately contained mistakes. The presentation order of Fig 5 and Fig. 6 was incorrect. The plots should have been presented according to the order of the sections in the text; the “Mean Task Duration” plot should have been presented first, followed by the “Perceived Intuitiveness” plot.

  • 8.
    Frid, Emma
    et al.
    KTH Royal Institute of Technology, Stockholm, Sweden.
    Moll, Jonas
    Uppsala University, Uppsala, Sweden.
    Bresin, Roberto
    KTH Royal Institute of Technology, Stockholm, Sweden.
    Sallnäs Pysander, Eva-Lotta
    KTH Royal Institute of Technology, Stockholm, Sweden.
    Haptic feedback combined with movement sonification using a friction sound improves task performance in a virtual throwing task2019In: Journal on Multimodal User Interfaces, ISSN 1783-7677, E-ISSN 1783-8738, Vol. 13, no 4, p. 279-290Article in journal (Refereed)
    Abstract [en]

    In this paper we present a study on the effects of auditory- and haptic feedback in a virtual throwing task performed with a point-based haptic device. The main research objective was to investigate if and how task performance and perceived intuitiveness is affected when interactive sonification and/or haptic feedback is used to provide real-time feedback about a movement performed in a 3D virtual environment. Emphasis was put on task solving efficiency and subjective accounts of participants’ experiences of the multimodal interaction in different conditions. The experiment used a within-subjects design in which the participants solved the same task in different conditions: visual-only, visuohaptic, audiovisual and audiovisuohaptic. Two different sound models were implemented and compared. Significantly lower error rates were obtained in the audiovisuohaptic condition involving movement sonification based on a physical model of friction, compared to the visual-only condition. Moreover, a significant increase in perceived intuitiveness was observed for most conditions involving haptic and/or auditory feedback, compared to the visual-only condition. The main finding of this study is that multimodal feedback can not only improve perceived intuitiveness of an interface but that certain combinations of haptic feedback and movement sonification can also contribute with performance-enhancing properties. This highlights the importance of carefully designing feedback combinations for interactive applications.

  • 9.
    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.

  • 10.
    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.

  • 11.
    Hagström, Josefin
    et al.
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; MedTech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden.
    Blease, Charlotte
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Cajander, Åsa
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Rexhepi, Hanife
    School of Informatics, University of Skövde, Skövde, Sweden.
    Hägglund, Maria
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; MedTech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden.
    Adolescents' reasons for accessing their health records online, perceived usefulness and experienced provider encouragement: a national survey in Sweden2024In: BMJ Paediatrics Open, E-ISSN 2399-9772, Vol. 8, no 1, article id e002258Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Having online access to electronic health records (EHRs) may help patients become engaged in their care at an early age. However, little is known about adolescents using patient portals. A national survey conducted within the Nordic eHealth project NORDeHEALTH provided an important opportunity to advance our understanding of adolescent users of patient portals. The present study explored reasons for reading the EHRs, the perceived usefulness of information and functions in a patient portal and the association between frequency of use and encouragement to read the EHR.

    METHODS: Data were collected in a survey using convenience sampling, available through the Swedish online health portal during 3 weeks in January and February 2022. This study included a subset of items and only respondents aged 15-19. Demographic factors and frequencies on Likert-style questions were reported with descriptive statistics, while Fisher's exact test was used to explore differences in use frequency based on having been encouraged to read by a healthcare professional (HCP).

    RESULTS: Of 13 008 users who completed the survey, 218 (1.7%) were unique users aged 15-19 (females: 77.1%). One-fifth (47/218, 21.6%) had been encouraged by HCPs to read their records, and having been encouraged by HCPs was related to higher use frequency (p=0.018). All types of information were rated high on usefulness, while some functions were rated low, such as blocking specific clinical notes from HCPs and managing services for family members. The main reason for reading their health records online was out of curiosity.

    CONCLUSIONS: Adolescents who read their records online perceive it to be useful. Encouragement by HCPs can lead to increased use of patient portals among adolescents. Findings should be considered in the future design of patient portals for adolescents.

  • 12.
    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.

  • 13.
    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.

  • 14.
    Hellberg, Ann-Sofie
    et al.
    Örebro University, Örebro University School of Business.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    A point with pointsification? Clarifying and separating pointsification from gamification in education2023In: Frontiers in Education, E-ISSN 2504-284X, Vol. 8, article id 1212994Article in journal (Refereed)
    Abstract [en]

    Gamification gained popularity in the 2010s, with educational professionals quickly adopting it as a way to transfer the motivational effects of games to a learning situation. However, the rapid implementation of gamification without proper planning led to a misunderstanding of the concept, namely that the use of points and rewards is enough. Proper gamification in education requires careful planning and a game-thinking approach to the design of the learning environment. The simple addition of points and badges is therefore a misuse of the gamification concept, which has been referred to as pointsification. This misuse leads to confusion and mixed results as studies using pointsification are often still labeled as gamification. This paper clarifies the differences and uses of gamification and pointsification by analyzing the effects of pointsification in a higher education course and discussing these effects in relation to gamification. The research employs a mixed-methods approach, examining project grades, individual grades, and students' opinions. The objective is to show how pointsification can be implemented in education to lead to better learning in a way that both prevents previously identified problems associated with pointsification and also addresses them effectively. Although the use of points and badges has received criticism, studies have also demonstrated that pointsification can improve student engagement and motivation. As such, pointsification should be considered a distinct concept that focuses solely on the use of points and rewards to motivate students, while gamification should encompass a broader game-thinking approach.

  • 15.
    Hellberg, Ann-Sofie
    et al.
    Örebro University, Örebro University School of Business.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    An effective online learning for complex theoretical content: experience of Community of Inquiry2022In: 2022 IEEE Frontiers in Education Conference (FIE), IEEE, 2022Conference paper (Refereed)
    Abstract [en]

    In this research to practice full paper we describe our implementation of CoI (Community of Inquiry). CoI is a framework for designing an effective online learning environment. It originates from Charles Sanders Pierce’s ideas that knowledge can only be created in a community through inquiry. We applied the framework in a highly interactive course that was forced to be held online because of the pandemic. The theoretical core of the course is cognitive psychology, a topic considered difficult to learn in a short time. Besides describing our implementation, we evaluate the results of the students’ inquiries and compare it with results from the previous year when we did not use CoI for this part of the course. Our findings show that the most important instructional strategy is to facilitate for students to work individually according to a scientific inquiry and then, in a community, use the knowledge gained in critical discourse to build an overall understanding. When the students worked according to this, the results exceeded our expectations, both regarding the depth of understanding and ability to apply the knowledge in ongoing course projects. Because more teaching will likely take place at a distance in the future, as a side effect of the pandemic, we believe that this could be a way to meet an increasing demand for online instruction, especially when designing educational settings for complex theoretical content.

  • 16.
    Hellberg, Ann-Sofie
    et al.
    Örebro University, Örebro University School of Business.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Virtual teams2022In: Designing Courses with Digital Technologies: Insights and Examples from Higher Education / [ed] Stefan Hrastinski, Routledge , 2022, p. 81-86Chapter in book (Other (popular science, discussion, etc.))
    Abstract [en]

    Designing Courses with Digital Technologies offers guidance for higher education instructors integrating digital technologies into their teaching, assessment and overall support of students. Written by and for instructors from a variety of disciplines, this book presents evaluations that the contributors have implemented in real-life courses, spanning blended and distance learning, flipped classrooms, collaborative technologies, video-supported learning and beyond. Chapter authors contextualize their approaches beyond simple how-tos, exploring both the research foundations and professional experiences that have informed their use of digital tools while reflecting on their successes, challenges and ideas for future development.

  • 17.
    Holmberg, Lars
    et al.
    Uppsala universitet, Uppsala, Sweden; King's College, London, UK.
    Sjöblom, Tobias
    Uppsala universitet, Uppsala, Sweden.
    Rönnberg, Henrik
    Sveriges Lantbruksuniversitet, Uppsala, Sweden.
    Cajander, Åsa
    Uppsala universitet, Uppsala, Sweden.
    Moll, Jonas
    Uppsala universitet, Uppsala, Sweden.
    Johansson, Birgitta
    Uppsala universitet, Uppsala, Sweden.
    Demmelmaier, Ingrid
    Uppsala universitet, Uppsala, Sweden.
    Bongcam, Erik
    Sveriges Lantbruksuniversitet, Uppsala, Sweden.
    Klingström, Tomas
    Sveriges Lantbruksuniversitet, Uppsala, Sweden.
    Grundmark, Birgitta
    Uppsala Monitoring Centre, Uppsala, Sweden.
    Cavelier, Lucia
    Uppsala universitet, Uppsala, Sweden.
    Moustakas, Aristidis
    Uppsala universitet, Uppsala, Sweden.
    Lööf, Lars
    Uppsala universitet, Uppsala, Sweden.
    Trovalla, Ulrika
    Uppsala universitet, Uppsala, Sweden.
    Sollerbrant, Kerstin
    Barncancerfonden, Sweden.
    Kössler, Ingrid
    Regionalt Cancercentrum Väst, Sweden.
    Dags att ställa fler krassa frågor om cancervården2018Other (Other (popular science, discussion, etc.))
  • 18.
    Huvila, Isto
    et al.
    Department of ALM, Uppsala University, Uppsala, Sweden; Information Studies, Åbo Akademi University, Turku, Finland.
    Cajander, Asa
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Enwald, Heidi
    Information Studies, Åbo Akademi University, Turku, Finland; Information Studies, University of Oulu, Oulu, Finland.
    Eriksson-Backa, Kristina
    Information Studies, Åbo Akademi University, Turku, Finland.
    Rexhepi, Hanife
    School of Informatics, University of Skövde, Skövde, Sweden.
    Technological and informational frames: explaining age-related variation in the use of patient accessible electronic health records as technology and information2022In: Information Technology and People, ISSN 0959-3845, E-ISSN 1758-5813, Vol. 35, no 8, p. 1-22Article in journal (Refereed)
    Abstract [en]

    Purpose: Data from a national patient survey (N = 1,155) of the Swedish PAEHR "Journalen" users were analysed, and an extended version of the theory of technological frames was developed to explain the variation in the technological and informational framing of information technologies found in the data.

    Design/methodology/approach: Patient Accessible Electronic Health Records (PAEHRs) are implemented globally to address challenges with an ageing population. However, firstly, little is known about age-related variation in PAEHR use, and secondly, user perceptions of the PAEHR technology and the health record information and how the technology and information-related perceptions are linked to each other. The purpose of this study is to investigate these two under-studied aspects of PAEHRs and propose a framework based on the theory of technological frames to support studying the second aspect, i.e. the interplay of information and technology-related perceptions.

    Findings: The results suggest that younger respondents were more likely to be interested in PAEHR contents for general interest. However, they did not value online access to the information as high as older ones. Older respondents were instead inclined to use medical records information to understand their health condition, prepare for visits, become involved in their own healthcare and think that technology has a much potential. Moreover, the oldest respondents were more likely to consider the information in PAEHRs useful and aimed for them but to experience the technology as inherently difficult to use.

    Research limitations/implications: The sample excludes non-users and is not a representative sample of the population of Sweden. However, although the data contain an unknown bias, there are no specific reasons to believe that it would differently affect the survey's age groups.

    Practical implications: Age should be taken into account as a key factor that influences perceptions of the usefulness of PAEHRs. It is also crucial to consider separately patients' views of PAEHRs as a technology and of the information contained in the EHR when developing and evaluating existing and future systems and information provision for patients.

    Social implications: This study contributes to bridging the gap between information behaviour and systems design research by showing how the theory of technological frames complemented with parallel informational frames to provide a potentially powerful framework for elucidating distinct conceptualisations of (information) technologies and the information they mediate. The empirical findings show how information and information technology needs relating to PAEHRs vary according to age. In contrast to the assumptions in much of the earlier work, they need to be addressed separately.

    Originality/value: Few earlier studies focus on (1) age-related variation in PAEHR use and (2) user perceptions of the PAEHR technology and the health record information and how the technology and information-related perceptions are linked to each other.

  • 19.
    Huvila, Isto
    et al.
    Uppsala University, Uppsala, Sweden; Åbo Akdemi University, Åbo, Finland.
    Eriksson-Backa, Kristina
    Åbo Akdemi University, Åbo, Finland.
    Moll, Jonas
    Uppsala University, Uppsala, Sweden.
    Myreteg, Gunilla
    Uppsala University, Uppsala, Sweden.
    Hägglund, Maria
    Uppsala University, Uppsala, Sweden.
    Differences in the experiences of reading medical records online: Elderly, Older and Younger Adults compared2018In: Informaatiotutkimus, ISSN 1797-9137, Vol. 37, no 3, p. 51-54Article in journal (Refereed)
  • 20.
    Huvila, Isto
    et al.
    Uppsala University, Department of ALM, Uppsala, Sweden.
    Moll, Jonas
    Uppsala University, Department of Information Technology, Uppsala, Sweden.
    Enwald, Heidi
    University of Oulu, Oulo, Finland.
    Hirvonen, Noora
    University of Oulu, Oulo, Finland.
    Åhlfeldt, Rose-Mharie
    University of Skövde, Skövde, Sweden.
    Cajander, Åsa
    Uppsala Univ, Dept Informat Technol, Human Comp Interact, Sweden.
    Age-related differences in seeking clarification to understand medical record information2019In: Information research, E-ISSN 1368-1613, Vol. 24, no 1, article id isic1834Article in journal (Refereed)
    Abstract [en]

    Introduction: Patient accessible electronic health records can be used to inform and empower patients. However, their use may require complementary information seeking since they can be difficult to interpret. So far, relatively little is known of the information seeking that takes place in connection to health record use, and especially the way it varies in different age groups. A better understanding of patients' preferences of where and how to find explanatory information provides valuable input for the development of health information provision and counselling services.

    Method: The analysis is based on the results of a national survey of Swedish individuals (N=1,411) who had used a national patient accessible electronic health record system (Journalen).

    Analysis: The data were analysed in SPSS 24.0 using Kruskal-Wallis tests for detecting groupwise differences and Jonckheere-Terpstra tests for discovering age-related trends in the data.

    Findings: Older patients were more likely to use a telephone and younger patients to use socia l contacts to ask for clarification. Generally, older adults born between 1946-1960 appear as passive information seekers.

    Conclusion: Age gro ups differ in their preferences on how to seek clarification, which underlines the importance of a better understanding of individual differences in delivering not only technically but also intellectually accessible health information. Calling by telephone could be a habit of present older generations whereas, to a degree, searching information online could be a comparable habit of current younger generations.

  • 21.
    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, Great Britain.
    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, USA.
    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, USA.
    Johansen Fagerlund, Asbjørn
    Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway.
    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.
    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. Centre for Empirical Research on Information systems.
    Kristiansen, Eli
    Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway.
    Moll, Jonas
    Örebro University, Örebro University School of Business. Centre for Empirical Research on Information systems.
    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.
    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, EstoniaE.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business. Centre for Empirical Research on Information systems.
    Simola, Saija
    Department of Computer Science, Aalto University, Espoo, Finland.
    Soone, Hedvig
    E-Medicine Centre Department of Health Technologies, Tallinn University of Technology, Tallinn, EstoniaE.
    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.
    Alise Johansen, Monika
    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.
    NORDeHEALTH – Learning from the Nordic Experiences of Patient Online Record Access2023In: Journal of Medical Internet Research, E-ISSN 1438-8871Article in journal (Other academic)
    Abstract [en]

    The Nordic countries are forerunners in online record access (ORA) which has now become widespread. The importance of accessible and structured health data has also been highlighted by policymakers internationally. To ensure the full realization of ORA’spotential in the short and long term, there is a pressing need to study ORA from a cross-disciplinary, technical, clinical, humanistic, and social sciences perspective that looks beyond strictly technical aspects. In this viewpoint paper, we explore the policy changes in the European Health Data Space (EHDS) proposal to advance ORA across the European Union, and introduce a Nordic-led research project that carries out the first of its kind, large-scale international investigation of patients’ ORA; NORDeHEALTH. We argue that the EHDS proposal will pave the way for patients to access and control third-party access to their electronic health records (EHRs). This will have implications within Europe and globally as it will further extend the boundaries for accessing and using EHRs for primary and secondary data use. Research such as that led by the NORDeHEALTH project is essential in guiding the design and implementation of solutions to meet the requirements of the EHDS proposal. Further international collaboration and research are needed to ensure that socio-technical and contextual factors are considered to ensure successful and secure implementation.

  • 22.
    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.

  • 23.
    Josefsson, Pernilla
    et al.
    KTH Royal Institute of Technology, Stockholm, Sweden.
    Moll, Jonas
    Uppsala University, Uppsala, Sweden.
    A teacher-led Facebook group as a complementary communication channel2018Conference paper (Other academic)
    Abstract [en]

    A Facebook group was used as a complementary communication channel during a course in human-computer interaction, autumn 2017. All 63 students and three involved teachers were invited to the group right before the course started. This was done within the scope of a pedagogical study aiming at investigating how a teacher administrated Facebook group affects student and teacher roles and communication between students as well as between students and teachers. The study included a pre-survey on social media literacy, collection of posts and user reactions, and a post-survey eliciting student attitudes towards Facebook as well as opinions about the use of Facebook during the course. Posts and comments were analyzed using a content analysis approach. 48/63 students chose to join the group and of these 40 were active participants. Most student posts and comments concerned the ongoing project work and logistics.

  • 24.
    Kujala, Sari
    et al.
    Department of Computer Science, Aalto University, Espoo, Finland.
    Simola, Saija
    Department of Computer Science, Aalto University, Espoo, Finland.
    Wang, Bo
    Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.
    Soone, Hedvig
    E-Medicine Centre, Department of Health Technologies, Tallinn University of Technology, Tallinn, Estonia.
    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.
    Hörhammer, Iiris
    Department of Computer Science, Aalto University, Espoo, Finland.
    Cajander, Åsa
    Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden.
    Johansen Fagerlund, Asbjørn
    Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.
    Kane, Bridget
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Karlstad University Business School, Karlstad, 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.
    Kristiansen, Eli
    Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Rexphepi, Hanife
    School of Informatics, University of Skövde, Sköve, Sweden.
    Hägglund, Maria
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Johansen, Monika A.
    Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.
    Benchmarking usability of patient portals in Estonia, Finland, Norway, and Sweden2024In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 181, article id 105302Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Poor usability is a barrier to widespread adoption of electronic health records (EHR). Providing good usability is especially challenging in the health care context, as there is a wide variety of patient users. Usability benchmarking is an approach for improving usability by evaluating and comparing the strength and weaknesses of systems. The main purpose of this study is to benchmark usability of patient portals across countries.

    METHODS: A mixed-methods survey approach was applied to benchmark the national patient portals offering patient access to EHR in Estonia, Finland, Norway, and Sweden. These Nordic countries have similar public healthcare systems, and they are pioneers in offering patients access to EHR for several years. In a survey of 29,334 patients, both patients' quantitative ratings of usability and their qualitative descriptions of very positive and very negative peak experiences of portal use were collected.

    RESULTS: The usability scores ranged from good to fair level of usability. The narratives of very positive and very negative experiences included the benefits of the patient portals and experienced usability issues. The regression analysis of results showed that very positive and negative experiences of patient portal use explain 19-35% of the variation of usability scores in the four countries. The percentage of patients who reported very positive or very negative experiences in each country was unrelated to the usability scores across countries.

    CONCLUSIONS: The survey approach could be used to evaluate usability with a wide variety of users and it supported learning from comparison across the countries. The combination of quantitative and qualitative data provided an approximation of the level of the perceived usability, and identified usability issues to be improved and useful features that patients appreciate. Further work is needed to improve the comparability of the varied samples across countries.

  • 25.
    Moll, Jonas
    et al.
    Örebro University, Örebro University School of Business.
    Cajander, Åsa
    Department of Information Technology, Uppsala University, Sweden.
    On Patient Accessible Electronic Health Records and the Experienced Effect on the Work Environment of Nurses2020In: 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. 1021-1025Conference paper (Refereed)
    Abstract [en]

    The work environment for nurses is challenging, and even though new technology has major advantages, it has often also caused new stressors and problems for nurses. When Patient Accessible Electronic Health Records (PAEHR) was introduced in Sweden, research showed that nurses were worried about possible negative effects for patients as well as on their work. However, to this date there are very few follow up studies on the more long term effects of PAEHR, despite research pointing to the fact that reactions after long term use might differ from initial experiences. In this paper we present an interview study to fill this research gap. An analysis based on interviews with physicians and nurses in Oncology care reveals three areas where nurses' work is experienced to have been affected: 1) nurses receive more questions from patients after PAEHR has been introduced, 2) nurses have changed their documentation practices and 3) the log list functionality has made nurses feel questioned. Finally, these results are discussed in relation to nurses' work environment from a sociotechnical and gender perspective.

  • 26.
    Moll, Jonas
    et al.
    Örebro University, Örebro University School of Business.
    Cajander, Åsa
    Uppsala University, Uppsala, Sweden.
    Oncology health-care professionals' perceived effects of patient accessible electronic health records 6 years after launch: A survey study at a major university hospital in Sweden2020In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 26, no 2, p. 1392-1403Article in journal (Refereed)
    Abstract [en]

    Patient accessible electronic health records have been launched in many countries, and generally, health-care professionals have had strong initial concerns related to the areas patient contact, documentation practices and quality of care. Especially, oncology care was discussed in media when launching patient accessible electronic health records in Sweden. However, few studies have investigated clinician-perceived effects several years after the launch. A survey covering these areas, as well as supposed effects for patients, was distributed to oncology health-care professionals 6 years after the launch of patient accessible electronic health records and answered by N = 176. Results show that patient accessible electronic health records have had small effects within the covered areas, and that the area most affected was documentation practices. Very few significant differences could be found between physicians and nurses. A comparison with results from interviews and surveys conducted shortly after the launch of patient accessible electronic health records clearly indicates that the experienced negative effects are not as big as originally feared.

  • 27.
    Moll, Jonas
    et al.
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Frid, Emma
    2Department of Media Technology and Interaction Design, KTH Royal Institute of Technology, Stockholm, Sweden.
    Using eye-tracking to study the effect of haptic feedback on visual focus during collaborative object managing in a multimodal virtual interface2017In: Proceedings of the 13th SweCog conference, Högskolan i Skövde , 2017, p. 49-51Conference paper (Refereed)
    Download full text (pdf)
    Using Eye-Tracking to Study the Effect of Haptic Feedback on Visual Focus During Collaborative Object Managing in a Multimodal Virtual Interface
  • 28.
    Moll, Jonas
    et al.
    Örebro University, Örebro University School of Business.
    Gao, Shang
    Örebro University, Örebro University School of Business.
    Awarding bonus points as a motivator for increased engagement in course activities in a theoretical system development course2022In: 2022 IEEE Frontiers in Education Conference (FIE), IEEE, 2022Conference paper (Refereed)
    Abstract [en]

    This research to practice full paper focuses on gamification in a theoretical university course. Gamification has been applied in many different educational contexts as a means to motivate students to engage with course material. One commonly used gamification element is bonus points. This study aimed to investigate the use of bonus points as a motivator for increased engagement in course activities in a theoretical system development course in higher education. A mixed method approach, based on statistical analysis of course achievement, survey data and student group interviews has been applied to address this aim. According to the results, we found that awarding bonus points in the course seminars had positive effects on students’ learning motivation and engagement, as well as students’ achievements on the final course examination. This study contributes to the current literature of gamification in education by studying the implementation of bonus points in a theoretical course in higher education – two areas where there is currently a lack of studies. Furthermore, practical insights in how to implement a bonus points system in higher education have been highlighted.

  • 29.
    Moll, Jonas
    et al.
    Örebro University, Örebro University School of Business.
    Josefsson, P.
    Södertörn University, Huddinge, Sweden.
    Communication patterns among students and teachers when using Facebook in a University course2020In: INTED2020: Proceedings / [ed] Chova, LG; Martinez, AL; Torres, IC, IATED , 2020, p. 3656-3662Conference paper (Refereed)
    Abstract [en]

    During the autumn 2017 in a human-computer interaction course at Uppsala University, Sweden, the teachers implemented Facebook as an additional communication channel. The initiative was based on the teachers' previous experience of the use of social media in teaching contexts as well as earlier research. The communication that arose was analysed using a mixed methods approach and the result shows several trends regarding interaction patterns. For example, students were more active in commenting and responding to posts than teachers. There was also a difference in the type of messages that students and teachers posted, and patterns in the types of posts that received comments and reactions can be distinguished.

    The relatively low number of posts makes it difficult to draw conclusions about how the medium affects roles that teachers and students take in the interaction; however, we found a tendency that students sometimes answer questions primarily formulated as posed to teachers. This has here been interpreted as the students taking on the traditional teacher role.

  • 30.
    Moll, Jonas
    et al.
    Uppsala University, Uppsala, Sweden.
    Josefsson, Pernilla
    KTH Royal Institute of Technology, Stockholm, Sweden.
    Twitter i en kommunikationskurs2018In: Digitalisering av högre utbildning / [ed] Stefan Hrastinski, Lund: Studentlitteratur AB, 2018, 1, p. 49-53Chapter in book (Other academic)
    Abstract [sv]

    Alla lärosäten vill bli mer digitala. Strategier och visioner lyfter fram digitalisering som en framtidsfråga för högre utbildning. Universitetslärare förväntas att använda såväl fysiska som digitala lärandemiljöer för att främja studenters lärande. Men, hur kan egentligen kurser inom högre utbildning digitaliseras?

    Syftet med denna bok är att dela goda exempel på hur digitala verktyg kan användas inom högre utbildning. Boken är skriven av och för lärare, med en grund i forskning och evidens. I boken finns många konkreta exempel på kurser där lärare aktivt använder digitala verktyg i sin undervisning. Exemplen är organiserade i olika teman där en bakgrund ges baserat på vad vi vet från forskningen.

    Boken kan läsas från början till slut för att ta del av samtliga teman och exempel på hur högre utbildning kan digitaliseras. Den kan även användas som handbok, där du som läsare kan välja att läsa om de teman eller kurser som känns mest inspirerande för dig.

  • 31.
    Moll, Jonas
    et al.
    Örebro University, Örebro University School of Business.
    Myreteg, Gunilla
    Department of Business Studies, Uppsala University, Uppsala, Sweden.
    Rexhepi, Hanife
    School of Informatics, University of Skövde, Skövde, Sweden.
    Experiences of Patients With Mental Health Issues Having Web-Based Access to Their Records: National Patient Survey2024In: JMIR Mental Health, E-ISSN 2368-7959, Vol. 11, article id e48008Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Sharing mental health notes through patient accessible electronic health records (PAEHRs) is controversial. Many psychiatric organizations and regions in Sweden have resisted the implementation, as clinicians worry about possible harms when patients are reading their notes. Despite the documented benefits of PAEHRs, there is still a lack of knowledge regarding whether patients with mental health issues could reap similar benefits of reading their notes as other patient groups.

    OBJECTIVE: The aim of the study is to examine the use, attitudes, and experiences of patients with mental health issues by reading their notes in the PAEHR and, moreover, whether their experiences differ from other patient groups, and if so, how.

    METHODS: A national patient survey was conducted with answers from 2587 patients from different patient groups. In total, 504 respondents (19.5%) indicated that they experienced a mental health disease. Answers from this patient group were compared to the answers from all other respondents. Survey questions related to attitudes, information usage, and effects on contacts with care were selected for analysis. Mann-Whitney U tests were used to detect groupwise differences. RESULTS: Patients with mental health issues use PAEHRs for checking that they have received the right care (mean_mental health 2.83, SD_mental health 1.39; mean_others 2.62, SD_others 1.37; P=.002) or suspected inaccuracies (mean_mental health 2.55, SD_mental health 1.34; mean_others 2.31, SD_others 1.30; P=.001), blocking access for professionals in other specialties (mean_mental health 3.43, SD_mental health 1.46; mean_others 3.04, SD_others 1.42; P<.001), and checking which care professionals have accessed their record (mean_mental health 4.28, SD_mental health 1.14; mean_others 4.05, SD_others 1.25; P<.001) to a significantly higher degree than other patients. On the other hand, the results show that a significantly lower proportion of patients with mental health issues (mean_mental health 3.38, SD_mental health 1.21; mean_others 3.52, SD_others 1.18; P=.02) believe that PAEHRs help them in shared decision-making compared to other patient groups.

    CONCLUSIONS: Patients with mental health issues who took part in the survey, as a group, express some minor differences in both the use of the PAEHR and their experiences regarding its usefulness, as compared to other patients, as a group. This patient group shows a slightly higher interest in 2 types of use: checking for accuracy of care in the record and blocking access to mental health notes for professionals from other parts of the health care system. Compared to other patient groups, these patients are less likely to experience that the PAEHR is a support in shared decision-making. The study indicates that the benefits of PAEHR on a general level are the same for this patient group as for other patients. The study does not support clinicians' worry about possible harm to this patient group. Further research is however needed.

  • 32.
    Moll, Jonas
    et al.
    Örebro University, Örebro University School of Business. Centre for empirical research on information systems.
    Rexhepi, Hanife
    Department of Information Technology, University of Skövde, Skövde, Sweden.
    The Effect of Patient Accessible Electronic Health Records on Communication and Involvement in Care: A National Patient Survey in Sweden2020In: 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. 1056-1060Conference paper (Refereed)
    Abstract [en]

    During recent years, patient accessible electronic health records (PAEHRs) have been implemented nationally in Sweden, as well as internationally, as a means of supporting patient engagement and shared decision making. Few studies have, however, investigated the long-term effects of PAEHRs on communicaiton with care professionals and involvement in care. The national survey study presented here, answered by 2587 patients in Sweden, focuses on these aspects specifically. The results show that the Swedish PAEHR system Journalen has had a positive impact on communication with care overall (84% agree or strongly agree with that communication with medical staff has improved), but only 31% agree or strongly agree with that the content of the PAEHR is discussed with care professionals. Journalen also seems to have a positive impact on involvement in care, but the results are mixed when it comes to effects on shared decision making.

  • 33.
    Moll, Jonas
    et al.
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Rexhepi, Hanife
    School of Informatics, University of Skövde, Skövde, Sweden.
    Cajander, Åsa
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Grünloh, Christiane
    School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, Stockholm, Sweden; Institute of Informatics, TH Köln University of Applied Sciences, Gummersbach, Germany.
    Huvila, Isto
    Department of ALM, Uppsala University, Uppsala, Sweden.
    Hägglund, Maria
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Myreteg, Gunilla
    Department of Information Technology, Uppsala University, Uppsala, Sweden; Department of Business Studies, Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business. Centre for Empirical Research on Information Systems.
    Åhlfeldt, Rose-Mharie
    School of Informatics, University of Skövde, Skövde, Sweden.
    Patients' Experiences of Accessing Their Electronic Health Records: National Patient Survey in Sweden2018In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 20, no 11, article id e278Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Internationally, there is a movement toward providing patients a Web-based access to their electronic health records (EHRs). In Sweden, Region Uppsala was the first to introduce patient-accessible EHRs (PAEHRs) in 2012. By the summer of 2016, 17 of 21 county councils had given citizens Web-based access to their medical information. Studies on the effect of PAEHRs on the work environment of health care professionals have been conducted, but up until now, few extensive studies have been conducted regarding patients' experiences of using PAEHRs in Sweden or Europe, more generally.

    OBJECTIVE: The objective of our study was to investigate patients' experiences of accessing their EHRs through the Swedish national patient portal. In this study, we have focused on describing user characteristics, usage, and attitudes toward the system.

    METHODS: A national patient survey was designed, based on previous interview and survey studies with patients and health care professionals. Data were collected during a 5-month period in 2016. The survey was made available through the PAEHR system, called Journalen, in Sweden. The total number of patients that logged in and could access the survey during the study period was 423,141. In addition to descriptive statistics reporting response frequencies on Likert scale questions, Mann-Whitney tests, Kruskal-Wallis tests, and chi-square tests were used to compare answers between different county councils as well as between respondents working in health care and all other respondents.

    RESULTS: Overall, 2587 users completed the survey with a response rate of 0.61% (2587/423,141). Two participants were excluded from the analysis because they had only received care in a county council that did not yet show any information in Journalen. The results showed that 62.97% (1629/2587) of respondents were women and 39.81% (1030/2587) were working or had been working in health care. In addition, 72.08% (1794/2489) of respondents used Journalen about once a month, and the main reason for use was to gain an overview of one's health status. Furthermore, respondents reported that lab results were the most important information for them to access; 68.41% (1737/2539) of respondents wanted access to new information within a day, and 96.58% (2454/2541) of users reported that they are positive toward Journalen.

    CONCLUSIONS: In this study, respondents provided several important reasons for why they use Journalen and why it is important for them to be able to access information in this way-several related to patient empowerment, involvement, and security. Considering the overall positive attitude, PAEHRs seem to fill important needs for patients.

  • 34.
    Moll, Jonas
    et al.
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Sallnäs Pysander, Eva-Lotta
    Department of Media Technology and Interaction Design, KTH Royal Institute of Technology, Stockholm, Sweden.
    Haptic communicative functions and their effects on communication in collaborative multimodal virtual environments2017In: Proceedings 13th SweCog Conference, Högskolan i Skövde , 2017, p. 63-64Conference paper (Refereed)
    Download full text (pdf)
    Haptic communicative functions and their effects on communication in collaborative multimodal virtual environments
  • 35.
    Moll, Jonas
    et al.
    Royal Institute of Technology, Stockholm, Sweden.
    Sallnäs Pysander, Eva-Lotta
    Royal Institute of Technology, Stockholm, Sweden.
    Severinsson Eklundh, Kerstin
    Royal Institute of Technology, Stockholm, Sweden.
    Hellström, Sten-Olof
    Royal Institute of Technology, Stockholm, Sweden.
    The Effects of Audio and Haptic Feedback on Collaborative Scanning and Placing2014In: Interacting with computers, ISSN 0953-5438, E-ISSN 1873-7951, Vol. 26, no 3, p. 177-195Article in journal (Refereed)
    Abstract [en]

    This paper presents a study aimed at exploring the effects of different modality combinations on collaborative task performance and employed joint task-solving strategies in a shared interface. The modality combinations visual/haptic, visual/audio and visual/haptic/audio were compared in an experiment in which users solved a task together, working in pairs in adjacent rooms. The application used contained a flat surface in a 3D interface on which piles of cubes were randomly placed in a grid. The task involved scanning for empty cells and placing continuously falling cubes until all empty cells were filled. The cubes and the flat surface were designed in such a way that they could be felt and heard and thus could be recognized by different kinds of haptic and audio feedback cues. This made it possible to scan the environment and read both absolute and relative positions in the grid. A quantitative analysis of task performance and a qualitative analysis of video recordings and interview data were performed. Results showed that task completion times were significantly faster in the visual/haptic/audio condition compared with the other conditions and that there were also significantly fewer errors, result checks of one's own actions and double checks of the partner's actions in the visual/haptic/audio condition than in the other conditions. Qualitative results show that participants work simultaneously to a larger extent in the visual/haptic/audio condition and that less communication occurred in the visual/haptic/audio condition compared with the other conditions. We argue that more modalities improved the awareness of the environment resulting in the participants feeling more confident with their interaction in the environment in the visual/haptic/audio condition. This resulted in improved task performance. The visual/audio feedback was better suited for solving the task than the visual/haptic feedback even though haptic feedback gave a significant added value in the visual/haptic/audio condition.

  • 36.
    Moll, Jonas
    et al.
    Örebro University, Örebro University School of Business. Centre for Empirical Research on Information systems.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business. Centre for Empirical Research on Information systems.
    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; Digital Psychiatry Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA.
    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.
    Hörhammer, Iiris
    Department of Computer Science, Aalto University, Espoo, Finland.
    Kane, Bridget
    Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Karlstad University Business School, Karlstad, Sweden.
    Kristiansen, Eli
    Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway.
    Ross, Peeter
    E-Medicine Centre Department of Health Technologies, Tallinn University of Technology, Tallinn, Estonia.
    Åhlfeldt, Rose-Mharie
    School of Informatics, University of Skövde, Skövde, Sweden.
    Klein, Gunnar O.
    Örebro University, Örebro University School of Business. Centre for Empirical Research on Information systems, School of Business, Örebro University, Örebro, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Contextual Factors of Patients' Access to Electronic Health Records in Four European Countries: A Socio-Technical Cross-Country Analysis2024In: Journal of Medical Internet Research, E-ISSN 1438-8871Article in journal (Refereed)
    Abstract [en]

    Background: The NORDeHEALTH project studies patient access to electronic health records in Estonia, Finland, Norway and Sweden. Such country comparisons require an analysis of the socio-technical context of these services.

    Objective: To develop a method for a socio-technical analysis of patient accessible electronic health records (PAEHRs) that advances a framework first presented by Sitting and Singh. This first article in a series presents the evaluation of the method and a cross-country comparison of the contextual factors that enable PAEHR access and use.

    Methods: The dimensions of the framework for socio-technical analysis were discussed and extended in a series of discussions with international stakeholders. A spreadsheet with relevant questions related to the studied services was constructed and distributed to the four participating countries, and the project participants researched various national sources to provide the relevant data for the comparisons in ten socio-technical dimensions.

    Results: Three dimensions were added to the method of Sittig and Singh to separate clinical content from features and functions of PAEHRs and to demonstrate basic characteristics of the different countries regarding national and regional steering of healthcare and ICT developments. The final framework contained the following dimensions: Metadata, Hardware and Software Computing Infrastructure, Features and Functions, Clinical Content Shared with Patients, Human Computer Interface, People, Workflow and Communication, Healthcare Organization’s Internal Policies, Procedures and Culture, National Rules, Regulations and Incentives, System Measurement and Monitoring and Healthcare System Context. Several similarities were identified between the compared countries, especially regarding Hardware and Software Computing Infrastructure. When it comes to the dimension Healthcare System Context most of the differences could be identified. One important difference concerned the governing of ICT development where different levels (state, region, municipality) were responsible in different countries.

    Conclusions: This is the first large-scale international socio-technical analysis of services for patients to access their electronic health records; the present study compared services in Estonia, Finland, Norway and Sweden. A methodology for such an analysis was developed and is presented to enable comparison studies in other national contexts.

  • 37.
    Nurgalieva, Leysan
    et al.
    Trinity College Dublin, Dublin, Ireland; University of Trento, Trento, Italy.
    Cajander, Åsa
    Uppsala University, Uppsala, Sweden.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Åhlfeldt, Rose-Mharie
    University of Skövde, Skövde, Sweden.
    Huvila, Isto
    Uppsala University, Uppsala, Sweden; Åbo Akademi University, Åbo, Finland.
    Marchese, Maurizio
    University of Trento, Trento, Italy.
    'I do not share it with others. No, it's for me, it's my care': On sharing of patient accessible electronic health records2020In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 26, no 4, p. 2554-2567Article in journal (Refereed)
    Abstract [en]

    This study explores patients' perspectives on sharing their personal health data, which is traditionally shared through discussions with peers and relatives. However, other possibilities for sharing have emerged through the introduction of online services such as Patient Accessible Electronic Health Records (PAEHR). In this article, we investigate strategies that patients adopt in sharing their PAEHR. Data were collected through a survey with 2587 patients and through 15 semi-structured interviews with cancer patients. Results show that surprisingly few patients share their information, and that older patients and patients with lower educational levels share more frequently. A large majority of patients trust the security of the system when sharing despite the high sensitivity of health information. Finally, we discuss the design implications addressing identified problems when sharing PAEHR, as well as security and privacy issues connected to sharing.

  • 38.
    Rexhepi, Hanife
    et al.
    University of Skövde, Skövde, Sweden.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Huvila, Isto
    Uppsala University, Uppsala, Sweden.
    Online electronic healthcare records: Comparing the views of cancer patients and others2020In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 26, no 4, p. 2915-2929Article in journal (Refereed)
    Abstract [en]

    This study investigates differences in attitudes towards, and experiences with, online electronic health records between cancer patients and patients with other conditions, highlighting what is characteristic to cancer patients. A national patient survey on online access to electronic health records was conducted, where cancer patients were compared with all other respondents. Overall, 2587 patients completed the survey (response rate 0.61%). A total of 347 respondents (13.4%) indicated that they suffered from cancer. Results showed that cancer patients are less likely than other patients to use online electronic health records due to general interest (p < 0.001), but more likely for getting an overview of their health history (p = 0.001) and to prepare for visits (p < 0.001). Moreover, cancer patients rate benefits of accessing their electronic health records online higher than other patients and see larger positive effects regarding improved communication with and involvement in healthcare.

  • 39.
    Rexhepi, Hanife
    et al.
    University of Skövde, Skövde, Sweden.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Huvila, Isto
    Uppsala University, Uppsala, Sweden.
    Åhlfeldt, Rose-Mharie
    University of Skövde, Skövde, Sweden.
    Do you want to receive bad news through your patient accessible electronic health record? A national survey on receiving bad news in an era of digital health2020In: Proceedings of the Eighteenth International Symposium for Health Information Management Research, Kalmar: Linnaeus University, University of Sheffield , 2020, p. 169-178Conference paper (Refereed)
    Abstract [en]

    Despite the fact that patient accessible electronic health records (PAEHRs) have been around for many years in several countries, there is a lack of research investigating patients' preferences for receiving bad news, including through PAEHRs. Little is also known about the characteristics of the patients who prefer to receive bad news through the PAEHR in terms of e.g. medical diagnosis, age and educational level.This study, based on a national patient survey in Sweden (N=2587), investigated this. Results show that, generally, receiving bad news by reading in the PAEHR is still among the least preferred options. Additionally, a higher proportion of men want to receive bad news in the PAEHR compared to women (p=0.001), and the same goes for those who are not working/have worked in healthcare (p=0.007). An effect of disease groups was also found, showing that diabetes patients in particular, want to receive bad news through the PAEHR.

  • 40.
    Rexhepi, Hanife
    et al.
    University of Skövde, Sweden.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Huvila, Isto
    Uppsala University, Sweden; Åbo Akademi University, Finland.
    Åhlfeldt, Rose-Mharie
    University of Skövde, Sweden.
    Do you want to receive bad news through your patient accessible electronic health record? A national survey on receiving bad news in an era of digital health2021In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 27, no 3, article id 14604582211035817Article in journal (Refereed)
    Abstract [en]

    Despite the fact that patient accessible electronic health records (PAEHRs) have been around for many years in several countries, there is a lack of research investigating patient's preferences for receiving bad news, including through PAEHRs. Little is also known about the characteristics of the patients who prefer to receive bad news through the PAEHR in terms of, for example medical diagnosis, age and educational level. This study, based on a national patient survey in Sweden (N = 2587), investigated this. Results show that, generally, receiving bad news by reading in the PAEHR is still among the least preferred options. Additionally, a higher proportion of men want to receive bad news in the PAEHR compared to women (p = 0.001), and the same goes for those who are not working/have worked in healthcare (p = 0.007). An effect of disease groups was also found, showing that diabetes patients in particular, want to receive bad news through the PAEHR.

  • 41.
    Sahlin Åkerstedt, Ulrika
    et al.
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Cajander, Åsa
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Moll, Jonas
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Ålander, Ture
    Department of Public Health and Caring Sciences, Uppsala University Hospital, Uppsala, Sweden.
    On threats and violence for staff and patient accessible electronic health records2018In: Cogent Psychology, E-ISSN 2331-1908, Vol. 5, no 1, article id 1518967Article in journal (Refereed)
    Abstract [en]

    Does patient accessible electronic health records (PAEHR) result in increased risk of threats and violence? This study was conducted one year after launching PAEHR in Uppsala to examine whether staff whose patients had gained access to the patient portal perceived greater risks of threats and violence, and were exposed to more threats and violence, than those whose patients had not yet gained access. A total of 174 (35%) professionals responded to a web survey. 83 were from the emergency department, whose patients had online electronic health record access, and 91 were from the psychiatric department, whose patients had not. 40% of all participating professionals believed that risks of threats and violence increase after launch. The results did not support a correlation with more incidents of threats and violence, and only one respondent reported that patient access had played any significant negative role in relation to an incident.

  • 42.
    Thangavel, Gomathi
    et al.
    Örebro University, Örebro University School of Business.
    Memedi, Mevludin
    Örebro University, Örebro University School of Business.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Hedström, Karin
    Örebro University, Örebro University School of Business.
    Management of social isolation and loneliness in Parkinson’s disease: Design principles2023In: ICIS 2023 Proceedings, AIS eLibrary , 2023, article id 2169Conference paper (Refereed)
    Abstract [en]

    Persons with Parkinson’s disease (PwPs) may have difficulty participating in social activities due to motor and non-motor symptoms that may lead to social isolation and loneliness. This paper addresses how to manage social isolation and loneliness among PwPs using digital solutions. Information and Communication Technologies (ICT) have the potential to address social isolation and loneliness, but there are no current solutions that specifically target these issues among PwPs. In this paper, we present an ongoing project based on design science research (DSR) combined with a user-centered approach to identify challenges, requirements, and design objectives. The empirical work includes data from interviews and focus groups with PwPs and healthcare professionals. Based on the empirical material, we formulated design principles on identified challenges and requirements, which were instantiated into a high-fidelity prototype. This initial cycle serves as a foundation for ongoing improvements and evaluations in a continuous DSR process.

  • 43.
    Wistrand, Kai
    et al.
    Örebro University, Örebro University School of Business.
    Moll, Jonas
    Örebro University, Örebro University School of Business.
    Hatakka, Mathias
    Örebro University, Örebro University School of Business.
    Andersson, Annika
    Örebro University, Örebro University School of Business.
    Improving Writing Skills Among Information Systems Students: Guidelines for Incorporating Communication Components in Higher Education2020In: 2020 IEEE Frontiers in Education Conference (FIE), IEEE, 2020, article id 9274074Conference paper (Refereed)
    Abstract [en]

    Students in Engineering, Computer science and Information systems often experience problems when writing the final examination theses. This paper reports on two cases, applying different strategies, with the ambitions to improve the students’ possibilities to write, evaluate and verbally present scientific reports. The first strategy presented concerns using a specific course and the second strategy involves a revision of an entire programme. Using constructive alignment and curriculum theory the two strategies are compared with the purpose of extrapolating specific and general guidelines for how to incorporate scientific communication components in engineering programmes.

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