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  • 1.
    Barsaum, Peter
    et al.
    School of Business, Örebro University, Örebro, Sweden .
    Berg, Paul
    School of Business, Örebro University, Örebro, Sweden .
    Hagman, Andreas
    School of Business, Örebro University, Örebro, Sweden .
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Internet of Things Technology for Remote Healthcare: A Pilot Study2016In: Proceedings from The 14th Scandinavian Conference on Health Informatics 2016, Linköping: Linköping University Electronic Press , 2016, Vol. 122, no 122, p. 43-48Conference paper (Other academic)
    Abstract [en]

    One of the latest trends in health informatics is Internet of Things (IoT). IoT consists of various types of technical objects connected to Internet and/or connected to each other, cooperating to reach a common goal. This pilot study explores how chronic patients, potential patients and healthcare personnel (n=100) perceive sensors and implanted sensors as two examples of IoT in remote healthcare. Data was collected through an acceptability questionnaire based on the Unified Theory of Acceptance and Use of Technology (UTAUT) framework using criteria as: performance expectancy; effort expectancy; attitude towards technology; and social influence. The pilot result indicated e.g. a strong acceptance of implants and that external sensors in a treatment requires further work. Differences between men and women were found: acceptance of sensors was preferred by women, and implants by men. In conclusion, IoT could be used to enhance person-centered healthcare, aiming to better engage patients in their treatment, rather than being a passive recipient of a medical intervention.

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

    Norrlandicus är ett ”Living Lab” med syfte att i en verklig testmiljö inom äldreomsorgen testa innovationer i form av produkter, tjänster och arbetssätt för att se om de tillför ett ökat värde i en vård- och omsorgsprocess och om innovationen möter slutanvändarens faktiska behov. En utgångspunkt för Norrlandicus testmetod är Socialstyrelsens riktlinjer om värdegrunder i omsorgen av äldre, om äldres värdighet och välbefinnande.

    På ett äldreboende i Kramfors kommun har SCA Hygiene Products innovation för inkontinensutredning testats. Under tre dygn deltog ett antal utvalda äldre personer i en inkontinensutredning där man använde ny teknik med sensorer i inkontinensskyddet för att samla in information kring tidpunkt och ungefärlig urinmängd av läckage.

    I testet ingår först och främst att utvärdera innovationens användbarhet. Detta sker utifrån personalens användning och uppfattning kring verktyget. Det resultatet kan i viss mån även belysa nyttoeffekter av verktyget i en vård- och omsorgsprocess. Vilka effekter kan innovationen få för den äldre och vilken nytta kan den ge personalen? Enkäter och strukturerade intervjuer har utförts med personal och intervjuer har efter samtycke utförts med de berörda äldre. Användningen har även observerats och Norrlandicus-teamet har deltagit praktiskt i alla testets faser.

    Vårdpersonalens analys av data tillsammans med deras kännedom om personen underlättar för personalen att individanpassa de äldres inkontinensskydd bättre, och att bättre planera in assistans vid toalettbesök. Det ger i detta avseende möjligheter att öka de äldres välbefinnande och värdighet, vilket är i linje med äldreomsorgens nationella riktlinjer. Verktyget har även visat sig kunna förbättra inkontinensvården ur personalens synvinkel. Den information som verktyget ger är mer utförlig än den som fås från dagens utredningsmetod där inkontinensskydden vägs. Det ger stöd i besluten för vilka insatser som personen bör ha samt vilka typer av inkontinensskydd som bör användas. Dessutom slipper personalen momentet med vägning, vilket ökar de hygieniska aspekterna.

    Personalen som deltagit i testet är nöjda med utfallet och skulle gärna använda detta verktyg på rutinbasis vid inkontinensutredningar.

  • 4.
    Cajander, Åsa
    et al.
    Uppsala University, Uppsala, Sweden.
    Grünloh, Christiane
    KTH Royal Institute of Technology, Stockholm, Sweden.
    Lind, Thomas
    Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Designing eHealth Services for Patients and Relatives: Critical Incidents and Lessons to Learn2016In: Proceedings of the NordiCHI '16: The 9th Nordic Conference on Human-Computer Interaction - game changing design, Association for Computing Machinery (ACM), 2016Conference paper (Refereed)
    Abstract [en]

    The number of eHealth services for patients and relatives is rapidly increasing as many countries are launching such services as a means to manage an ageing population, to increase efficiency in healthcare, and to empower patients. However, design and deployment of eHealth services for patients is challenging due to the complex setting and the multitude of affected stakeholders, which in turn make the task of eliciting and managing the needs and requirements equally challenging. Hence, this workshop(1) aims to make use of critical incident analysis as a method for collecting and jointly reflecting on practices, assumptions, and experiences in relation to the design, deployment, and use of eHealth services for patients and relatives. The goal of the workshop is to engage in joint reflection, and to find potential ways forward in relation to critical incidents as well as supporting the shaping and reshaping of eHealth design and development. This full day workshop invites researchers and practitioners to apply/provide their critical reflection in order to derive changed practices and theories about practice. We also especially invite the patients' perspective as this is crucial to achieve successful eHealth services. This workshop provides a venue for challenging the process of eHealth service design and development and is built around a concept of active participation, where the workshop participants will analyse and discuss the critical incidents together.

  • 5.
    Department of Computer and Information Science (IDA) Linköpings Universitet, SE - 581 83 Linköping, Sweden, Vivian
    et al.
    Department of Computer and Information Science (IDA) Linköpings Universitet, Linköping, Sweden.
    Olve, Nils-Göran
    Department of Computer and Information Science Linköping University, Sweden .
    Scandurra, Isabella
    Centre for eHealth, Uppsala University, Sweden; Department of Medical Sciences, Uppsala University, Sweden .
    Koch, Sabine
    Centre for eHealth, Uppsala University, Sweden; Department of Medical Sciences, Uppsala University, Sweden .
    Organizational effects of the use of information and communication technology (ICT) in elderly homecare: a case study2008In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 14, no 3, p. 195-209Article in journal (Refereed)
    Abstract [en]

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

  • 6.
    Engström, Maria
    et al.
    University of Gävle.
    Scandurra, Isabella
    Centre for eHealth, Uppsala University, Uppsala, Sweden.
    Lindqvist, R
    Ljunggren, B
    Koch, Sabine
    Karolinska University.
    Evaluation of OLD@HOME Virtual Health Record: Staff opinions of the system and satisfaction with work2009In: Telemedicine journal and e-health, ISSN 1530-5627, E-ISSN 1556-3669, Vol. 15, no 1, p. 53-61Article in journal (Refereed)
    Abstract [en]

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

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

    Abstract: Patient-accessible electronic health records (PAEHRs) are being implemented at international scale. Comparing policies and systems could allow countries to learn from each other to address global and nation-specific challenges. We compare national PAEHR policy (hard and soft regulation) and services in 10 countries.

    Methods: PAEHR policy and system documentation was gathered from Australia, Denmark, Estonia, Finland, France, the Netherlands, New Zealand, Norway, Sweden and the United States. A basic analytic model for policy analysis was used to delimit our focus to policy content, followed by an inductive thematic analysis across countries, in which we clustered initial themes into a set of categories of PAEHR service “approaches” related to three specific content areas.

    Results: Although all 10 countries ensured some patient rights to access medical records, policies and systems were highly variable, as were the technological processes arising from these. In particular, three policy areas showed great variability. Depending upon country of origin, a patient would encounter differences in: login procedures (security), access to own and other patients’ data during adolescence (user rights), and types of medical data made available to the patient (data sets).

    Conclusions: Individuals encounter very different access rights to their medical data depending on where they live. Countries may be able to develop improved policies by examining how other nations have solved common problems. Harmonizing policies is also an initial step likely to be needed before cross-national PAEHRs could be possible.

  • 8.
    Essén, Anna
    et al.
    SIR (Stockholm School of Economics Institute for Research), Stockholm School of Economics, Stockholm, Sweden; Learning Informatics Management and Ethics Medical Management Center, Karolinska Institutet, Stockholm, Sweden .
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Gerrits, Reinie
    Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands .
    Humphrey, Gayl
    National Institute for Health Innovation, University of Auckland, Auckland, New Zealand .
    Johansen, Monika Alise
    Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, the Artic University of Norway (UIT), Tromsø, Norway .
    Kierkegaard, Patrick
    Innovation, Networks & Knowledge (INK) University of Michigan, Perry Ann Arbor MI, USA.
    Koskinen, Jani
    Information Systems Science, University of Turku, Turku, Finland .
    Liaw, Siaw-Teng
    UNSW Medicine Australia, Sydney, Australia; Academic GP Unit, SW Sydney Local Health District and Ingham Institute, Sydney, Australia .
    Odeh, Souad
    Department of informatics, University Claude Bernad lyon 1, Villeurbanne, France .
    Ross, Peeter
    Tallinn University of Technology (TUT), Department of Health Technologies, Tallinn, Estonia; Diagnostic Clinic, East Tallinn Central Hospital, Tallinn, Estonia .
    Ancker, Jessica S.
    Department of Healthcare Policy & Research, Division of Health Informatics, Weill Cornell Medical College, New York NY, USA .
    Patient Access to Electronic Health Records: Differences Across Ten Countries (vol 7, pg 44, 2018)2018In: Health Policy and Technology, ISSN 2211-8837, E-ISSN 2211-8845, Vol. 7, no 2, p. 224-224Article in journal (Refereed)
  • 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.
    Huvila, Isto
    et al.
    Department of ALM, Uppsala University, Uppsala, Sweden; Information Studies, Åbo Akademi University, Finland.
    Enwald, Heidi
    Information Studies, University of Oulu, Oulu, Finland; Åbo Akademi University, Åbo, Finland.
    Eriksson-Backa, Kristina
    Information Studies, Åbo Akademi University, Åbo, Finland.
    Hirvonen, Noora
    Information Studies, University of Oulu, Oulu, Finland; Åbo Akademi University, Åbo, Finland.
    Nguyen, Hai
    Information Studies, Åbo Akademi University, Åbo, Finland.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Anticipating ageing: Older adults reading their medical records2018In: Information Processing & Management, ISSN 0306-4573, E-ISSN 1873-5371, Vol. 54, no 3, p. 394-407Article in journal (Refereed)
    Abstract [en]

    In spite of the general interest in health information behaviour, there is little earlier research on how older adults, who are still active in working life but approaching retirement, differ from other age groups. A survey with Swedish patients who had ordered and read their medical record was conducted to map the preferences and motivations of older adults (born 1946-1960) ordering a copy of their medical record, and using medical records based e-health and information services in the future. The results do not indicate an obvious linear relationship between age and motivation to use online health information but show several differences between the age groups. Older adults were less interested in communication with their medical doctor by e-mail. Yet, they had searched health information in the Internet during the last week more likely than young. They were more inclined to read medical record to get an overview of their health than young, but less confident that they understood most of the content or turn to their family and friends to seek help than the elderly. When compared to younger adults and elderly people, older adults are the least confident and least motivated to use online health information. It is suggested that older adulthood can be seen as a transitory stage of life when the need of health information increases and engagement with health changes. The results agree with prior research on the potential usefulness of (online) medical records as a way to inform citizens. However, specific provision strategies may be necessary to match the needs and motivations of different age groups.

  • 11.
    Hägglund, Maria
    et al.
    Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden.
    Heinze, Oliver
    Department of Medical Information Systems, Univ. Hospital, Heidelberg, Germany.
    Pobiruchin, Monika
    GECKO Institute for Medicine, Informatics and Economics, Heilbronn University, Heilbronn University, Germany.
    Pohl, Anna-Lena
    Institute for eHealth and Management in HealthCare, Flensburg University, Flensburg, Germany.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Schreiweis, Björn
    Department of Medical Information Systems, Univ. Hospital, Heidelberg, Germany.
    Wiesner, Martin
    Dept. of Medical Informatics, Heilbronn University, Germany.
    Opportunities and Challenges of Consumer-centric eHealth Services: An Interdisciplinary Workshop2016Conference paper (Other academic)
  • 12.
    Hägglund, Maria
    et al.
    Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    A Socio-Technical Analysis of Patient Accessible Electronic Health Records2017In: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 244, p. 3-7Article in journal (Refereed)
    Abstract [en]

    In Sweden, and internationally, there is a movement towards increased transparency in healthcare including giving patients online access to their electronic health records (EHR). The purpose of this paper is to analyze the Swedish patient accessible EHR (PAEHR) service using a socio-technical framework, to increase the understanding of factors that influence the design, implementation, adoption and use of the service. Using the Sitting and Singh socio-technical framework as a basis for analyzing the Swedish PAEHR system and its context indicated that there are many stakeholders engaged in these types of services, with different driving forces and incentives that may influence the adoption and usefulness of PAEHR services. The analysis was useful in highlighting important areas that need to be further explored in evaluations of PAEHR services, and can act as a guide when planning evaluations of any PAEHR service.

  • 13.
    Hägglund, Maria
    et al.
    Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business. APRI eHealth, Själevad, Sweden.
    Does user centred design work in homecare for elderly?: a retrospective on the OLD@HOME case2011In: International Journal of Integrated Care, ISSN 1568-4156, E-ISSN 1568-4156, Vol. 11Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 14.
    Hägglund, Maria
    et al.
    Karolinska University.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Empowering patients and relatives in elderly care by information access2008Conference paper (Refereed)
  • 15.
    Hägglund, Maria
    et al.
    Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden .
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Patients' online access to Electronic Health Records: current status and experiences from the implementation in Sweden2017Conference paper (Refereed)
    Abstract [en]

    The number of eHealth services for patients is rapidly increasing worldwide. This paper describes the status of the currently most important eHealth service for patients in Sweden, the Patient Accessible Electronic Health Record. As many countries are facing an introduction of national eHealth services providing health information to the patients, lessons learned from Sweden may improve the deployment and use of PAEHRs and similar eHealth services also elsewhere. Challenges that remain in Sweden have to do with local differences in the implementation that lead to fragmentation and inequal access to information. Initiatives have been taken to reconcile some of the problems, e.g. an updated national regulatiory framework for PAEHR. To date, evaluations are often performed from a healthcare provider perspective, focusing on aspects that are considered important by healthcare professionals and decision makers. Based on experiences of this nation-wide implementation we argue for the need to also base evaluations of eHealth on the perspective of the patients.

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

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

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

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

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

  • 17.
    Hägglund, Maria
    et al.
    Department of Medical Sciences, Biomedical Informatics and Engineering, Uppsala University, University Hospital, Uppsala, Sweden.
    Scandurra, Isabella
    Department of Medical Sciences, Biomedical Informatics and Engineering, Uppsala University, University Hospital, Uppsala, Sweden.
    Koch, Sabine
    Department of Medical Sciences, Biomedical Informatics and Engineering, Uppsala University, University Hospital, Uppsala, Sweden.
    Integrated Care Plan for Shared Home Care: the technical architecture2005In: Journal on Information Technology in Healthcare, ISSN 1479-649X, Vol. 3, no 5, p. 287-294Article in journal (Refereed)
    Abstract [en]

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

  • 18.
    Hägglund, Maria
    et al.
    Medical Informatics and Engineering, Uppsala University, University Hospital, Uppsala, Sweden.
    Scandurra, Isabella
    Medical Informatics and Engineering, Uppsala University, University Hospital, Uppsala, Sweden.
    Koch, Sabine
    Medical Informatics and Engineering, Uppsala University, University Hospital, Uppsala, Sweden.
    Integrated Care Plan for Shared Home Care: the technical architecture2005In: Telemedicine and eHealth in Recent Years: Meeting the Challenges / [ed] Kioulafas K, Katharaki M, National and Kapodistrian University of Athens , 2005, no 5, p. 377-382Conference paper (Refereed)
  • 19. Hägglund, Maria
    et al.
    Scandurra, Isabella
    Centre for eHealth, Uppsala University, Akademiska sjukhuset, Uppsala, Sweden.
    Koch, Sabine
    Scenarios to Capture Work Processes in Shared Home Care – from analysis to application2010In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 79, no 6, p. 126-134Article in journal (Refereed)
    Abstract [en]

    Background

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

    Method

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

    Results

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

    Conclusion

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

  • 20.
    Hägglund, Maria
    et al.
    Karolinska Institute, Stockholm, Sweden.
    Scandurra, Isabella
    APRI | eHealth, Själevad, Sweden.
    Koch, Sabine
    Karolinska Institute, Stockholm, Sweden.
    Supporting Citizen-centred Care for Seniors: Experiences from Two Swedish Research Projects2012In: 25th International Symposium on Computer-Based Medical Systems (CBMS), 2012 / [ed] Paolo Soda; Francesco Tortorella; Sameer Antani; Mykola Pechenizkiy; Mario Cannataro; Alexey Tsymbal, Rome, Italy: IEEE conference proceedings, 2012, article id 6266377Conference paper (Refereed)
    Abstract [en]

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

  • 21.
    Hägglund, Maria
    et al.
    Dept of Medicial Sciences, Uppsala University, University Hospital, Uppsala, Sweden; Centre for EHealth, Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Dept of Medicial Sciences, Uppsala University, University Hospital, Uppsala, Sweden; Centre for EHealth, Uppsala University, Uppsala, Sweden.
    Koch, Sabine
    Dept of Medicial Sciences, Uppsala University, University Hospital, Uppsala, Sweden; Centre for EHealth, Uppsala University, Uppsala, Sweden.
    User-centred deployment process for ICT in health care teams: experiences from the OLD@HOME project2006In: Ubiquity - Technologies for Better Health in Aging Societies: Proceedings of MIE2006 / [ed] A. Hasman, R. Haux, J. Van der Lei, IOS Press, 2006, p. 167-172Chapter in book (Refereed)
    Abstract [en]

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

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

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

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

  • 22.
    Hägglund, Maria
    et al.
    Dept of Medicial Sciences, Uppsala University, University Hospital, Uppsala, Sweden; Centre for EHealth, Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Dept of Medicial Sciences, Uppsala University, University Hospital, Uppsala, Sweden; Centre for EHealth, Uppsala University, Uppsala, Sweden.
    Koch, Sabine
    Dept of Medicial Sciences, Uppsala University, University Hospital, Uppsala, Sweden; Centre for EHealth, Uppsala University, Uppsala, Sweden.
    Using Scenarios to Capture Work Processes in Shared Home Care2007In: Information Technology in Health Care 2007: Proceedings of the 3rd International Conference on Information Technology in Health Care -- Socio-technical Approaches / [ed] E. Coiera, J.I. Westbrook, J.L. Callen, IOS Press, 2007, p. 233-239Chapter in book (Refereed)
    Abstract [en]

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

  • 23.
    Hägglund, Maria
    et al.
    Department of Medical Sciences, Medical Informatics and Engineering, Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Department of Medical Sciences, Medical Informatics and Engineering, Uppsala University, Uppsala, Sweden.
    Koch, Sabine
    Department of Medical Sciences, Medical Informatics and Engineering, Uppsala University, Uppsala, Sweden.
    Virtual Health Record: User Specific Information Access in a Mobile Work Situation2003In: Article, book review (Refereed)
  • 24.
    Hägglund, Maria
    et al.
    Department of Medical Sciences, Uppsala University, University Hospital, Uppsala, Sweden; Center for eHealth, Uppsala University, Uppsala, Sweden .
    Scandurra, Isabella
    Department of Medical Sciences, Uppsala University, University Hospital, Uppsala, Sweden; Center for eHealth, Uppsala University, Uppsala, Sweden .
    Moström, Dennis
    XLENT Technology AB, Örnsköldsvik, Sweden.
    Koch, Sabine
    Department of Medical Sciences, Uppsala University, University Hospital, Uppsala, Sweden; Center for eHealth, Uppsala University, Uppsala, Sweden .
    Bridging the gap: a virtual health record for integrated home care2007In: International Journal of Integrated Care, ISSN 1568-4156, E-ISSN 1568-4156, Vol. 7Article in journal (Refereed)
    Abstract [en]

    Introduction: The coexistence of different information systems that are unable to communicate is a persistent problem in healthcare and in integrated home care in particular.

    Theory and methods: Physically federated integration is used for design of the underlying technical architecture to implement a mobile virtual health record for integrated home care. A user centered system development approach is followed during design and development of the system.

    Results: A technical platform based on a service-oriented approach where database functionality and services are separated has been developed. This guarantees flexibility with regard to changed functional demands and allows third party systems to interact with the platform in a standardized way. A physically federated integration enables point-of-care documentation, integrated presentation of information from different feeder systems, and offline access to data on handheld devices. Feeder systems deliver information in XML-files that are mapped against an ideal XML schema, published as an interface for integration with the information broker, and inserted into the mediator database.

    Conclusions: A seamless flow of information between both different care professionals involved in integrated home care and patients and relatives is provided through mobile information access and interaction with different feeder systems using the virtual health record.

  • 25.
    Hägglund, Maria
    et al.
    Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Uppsala University, Uppsala, Sweden.
    Moström, Dennis
    Datavis Sverige AB, Örnsköldsvik, Sweden.
    Koch, Sabine
    Uppsala University, Uppsala, Sweden.
    Integration architecture of a mobile virtual health record for shared home care2005In: Connecting Medical Informatics and Bio-Informatics: Proceedings of MIE2005 / [ed] R. Engelbrecht, A. Geissbuhler, C. Lovis, IOS Press, 2005, Vol. 116, p. 340-345Chapter in book (Refereed)
    Abstract [en]

    The coexistence of different information systems that are unable to communicate with each other is a persistent problem in health care in general, and in shared care in particular. This is especially critical when it comes to information access needed at the point of care, e.g. in the patients home. The purpose of this paper is to present the technical architecture of a virtual health record (VHR) that both integrates information from different electronic health records (EHRs) and allows for documenting at the point of care using mobile devices. The VHR supports a seamless information and communication flow between different care providers giving them mobile access to selected patient-oriented information. A service oriented system architecture where database functionality and services are separated has been implemented. This guarantees flexibility with regard to changed functional demands and allows third party systems to interact with the platform in a standardised way. Major requirements for the VHR have been documentation support at the point of care, integrated presentation of the information from different feeder systems, and the possibility of offline access to the data on handheld devices. Therefore, publishing was chosen for the integration design. A patient centred XML schema is published as an interface for integration with the information broker. The feeder systems deliver their information in XML.-files that are mapped against the ideal schema and inserted into the mediator database. The paper describes both an online web application and an offline solution that was implemented on personal digital assistants (PDAs). The system has been introduced in a Swedish home care district with an established fiber-optical network infrastructure connecting all the locations forming the study site.

  • 26.
    Hägglund, Maria
    et al.
    Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden.
    Åhlfeldt, Rose-Mharie
    Institutionen för informationsteknologi, Högskolan i Skövde, Skövde, Sverige.
    Koch, Sabine
    Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden.
    Ålander, Ture
    Department of Public Health and Caring Sciences (IFV), Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Developing and implementing national eHealth services for patients: an interactive exploration of challenges and potential solutions2015In: Digital Healthcare Empowering Europeans: Proceedings of MIE2015 / [ed] Ronald Cornet, Lăcrămioara Stoicu-Tivadar, Alexander Hörbst, Carlos Luis Parra Calderón, Stig Kjær Andersen, Mira Hercigonja-Szekeres, IOS Press , 2015Conference paper (Refereed)
    Abstract [en]

    In this workshop, examples and experiences from ongoing work to develop and implement eHealth services for citizens will be provided. Challenges and potential solutions based on different international contexts will be discussed in interactive sessions. The results will form a report suggesting strategies and activities that could provide potential solutions to the identified challenges.

  • 27.
    Johansson, Niklas
    et al.
    Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business. Uppsala University, Uppsala, Sweden.
    Eriksson, Lena
    Komanco AB, Sweden.
    Sandblad, Bengt
    Uppsala University, Uppsala, Sweden.
    VIHO verksamhetsnära it-stöd i hemtjänst och omsorgsarbete: Aspekter på det framtida arbetet inom äldreomsorgen2005Report (Other academic)
  • 28.
    Koch, Sabine
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Hägglund, Maria
    Karolinska Institutet, Stockholm, Sweden.
    Scandurra, Isabella
    Uppsala University, Uppsala, Sweden.
    Informatics and socio-technical challenges when designing for integrated eCare2014In: Achieving effective integrated e-care beyond the silos / [ed] Ingo Meye, Sonja Muller, Lutz Kubitschke, Hershey PA: IGI Global, 2014, p. 108-134Chapter in book (Refereed)
    Abstract [en]

    The central role of eHealth to enable the successful implementation of integrated care is commonly acknowledged today. This is easier said than done. To provide correct, understandable, and timely information at the point of need and to facilitate communication and decision support for a network of actors with different prerequisites and needs are some of the big challenges of integrated care. This book chapter focuses on the specific challenges related to informatics and socio-technical issues when designing solutions for integrated eCare. Methods for requirements elicitation, evaluation, and system development using user-centred design in collaborative environments involving a variety of stakeholders are presented. Case studies in homecare of older patients, in the care of stroke patients, and regarding citizen eHealth services in general illustrate the application of these methods. Possible solutions and pitfalls are discussed based on the experiences drawn from the case studies. To address the main infor-matics and socio-technical challenges in integrated eCare, namely informatics-supported collaborative work and to provide coordinated continuity for the patient, top-down activities such as health informatics standardization, and bottom-up activities resulting in the definition of concrete patient journey descrip-tions, interaction points, information needs (that can be transformed into standardized data sets), as well as visualization and interaction patterns need to go hand in hand.

  • 29.
    Koch, Sabine
    et al.
    Department of Medical Sciences, Medical Informatics and Engineering, Uppsala University, Uppsala, Sweden.
    Hägglund, Maria
    Department of Medical Sciences, Medical Informatics and Engineering, Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Department of Medical Sciences, Medical Informatics and Engineering, Uppsala University, Uppsala, Sweden.
    Moström, Dennis
    DataVis AB, Örnsköldsvik, Sweden.
    Towards a virtual health record for mobile home care of elderly citizens2004In: MEDINFO 2004: Proceedings of the 11th World Congress on Medical Informatics / [ed] Fieschi, M., Coiera, E., Li, Y.-C.J., Amsterdam: IOS Press, 2004, p. 960-963Chapter in book (Refereed)
    Abstract [en]

    Mobile work situations within home care of the elderly require immediate and ubiquitous access to patient-oriented data. The ongoing Swedish research project “Technical support for Mobile CloseCare” focuses on the development and evalua-tion of work-scenario oriented ICT support for enhanced home care of elderly citizens. The aim of the project is to pro-vide a seamless and consistent information flow between dif-ferent health care providers and to give intuitive access to information services for the elderly and their relatives. For that purpose, different independent software components are connected through a mobile communication platform. Flexible access to prioritized information for different users in different work situations will be given through a virtual health record. In order to obtain both usable and clinically relevant systems, a user centered system development approach is followed. Evaluation of the project results will be based on usability tests and quasi-experimental studies on how system implemen-tation influences quality of care and job- and life satisfaction for care providers, patients and relatives.

  • 30.
    Kolkowska, Ella
    et al.
    Örebro University, Örebro University School of Business.
    Avatare Nöu, Anneli
    SICS Swedish ICT, Kista, Sweden.
    Sjölinder, Marie
    SICS Swedish ICT, Kista, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    To capture the diverse needs of welfare technology stakeholders: Evaluation of a Value Matrix2017In: Human Aspects of IT for the Aged Population. Applications, Services and Contexts: Third International Conference, ITAP 2017, Held as Part of HCI International 2017, Vancouver, BC, Canada, July 9-14, 2017, Proceedings, Part II / [ed] Zhou, Jia & Salvendy, Gavriel, Springer, 2017, p. 404-419Conference paper (Refereed)
    Abstract [en]

    Welfare technology (WT) is often developed with a technical perspective, which does not involve important ethical considerations and different values that come up during the development and implementation of WT within elderly care. This paper presents a study where we have applied an ethical value matrix to support systematic ethical assessments of WT intended for personal health monitoring. The matrix consists of values in a checklist and a number of stakeholders and it is possible to analyze which values are emphasized by which stakeholders. The aim was to assess the matrix and find out how the matrix supports identification of values and interests that drive the various stakeholders in the development and implementation of WT. We have realized that several values specified by different actors as especially important were not included in the matrix and that the values in the matrix did not visualize or enable identification of value conflicts.

  • 31.
    Kolkowska, Ella
    et al.
    Örebro University, Örebro University School of Business.
    Nöu, Anneli Avatare
    SICS Swedish ICT, Kista, Sweden.
    Sjölinder, Marie
    SICS Swedish ICT, Kista, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Socio-Technical Challenges in Implementation of Monitoring Technologies in Elderly Care2016In: Human Aspects of IT for the Aged Population: Healthy and Active Aging, ITAP 2016, Proceedings, Part II, Springer, 2016, p. 45-56Conference paper (Refereed)
    Abstract [en]

    Although new monitoring technologies (MT) supporting aging in place are continuously developed and introduced on the market, attempts to implement these technologies as an integrated part of elderly care often fail. According to the literature, the reason for that may be the prevailing technical focus applied during development and implementation of monitoring technologies in real settings. The aim of this paper was to investigate the socio-technical challenges that arise during implementation of monitoring technologies in elderly care. We used a qualitative case study and semi-structured interviews to investigate socio-technical (S/T) challenges in implementation of monitoring technologies generally and social alarms especially. Based on our findings we suggest a framework for classification of S/T challenges arising during implementation of monitoring technologies in elderly care and in this way this paper contributes to a better understanding of these challenges.

  • 32.
    Kolkowska, Ella
    et al.
    Örebro University, Örebro University School of Business.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Avatare Nöu, Anneli
    RISE SICS, Kista, Sweden.
    Sjölinder, Marie
    RISE SICS, Kista, Sweden.
    Memedi, Mevludin
    Örebro University, Örebro University School of Business.
    A user-centered ethical assessment of welfare technology for elderly2018In: Human Aspects of IT for the Aged Population. Applications in Health, Assistance, and Entertainment / [ed] Jia Zhou, Gavriel Salvendy, Springer, 2018, p. 59-73Conference paper (Refereed)
    Abstract [en]

    Welfare technology (WT) is often developed with a technical perspective, and little consideration is taken regarding the involvement of important ethical considerations and different values that come up during the development and implementation of WT. Safety, security and privacy are significant, as well as the usability and overall benefit of the tool, but to date assessments often lack a holistic picture of the WT as seen by the users. This paper suggests a user-centered ethical assessment (UCEA) framework for WT to be able to evaluate ethical consequences as a part of the user-centered aspects. Building on established methodologies from research on ethical considerations, as well as the research domain of human-computer interaction, this assessment framework joins knowledge of ethical consequences with aspects affecting the “digitalization with the individual in the center”, e.g. privacy, safety, well-being, dignity, empowerment and usability. The framework was applied during development of an interface for providing symptom information to Parkinson patients. The results showed that the UCEA framework directs the attention to values emphasized by the patients. Thus, functionality of the system was evaluated in the light of values and expected results of the patients, thereby facilitating follow-up of a user-centered assessment. The framework may be further developed and tested, but in this study it served as a working tool for assessing ethical consequences of WT as a part of user-centered aspects.

  • 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, ISSN 1438-8871, 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.
    Moström, Dennis
    et al.
    XLENT technology.
    Hägglund, Maria
    Department of Medical Informatics and Engineering, Uppsala University, Uppsala, Sweden.
    Koch, Sabine
    Department of Medical Informatics and Engineering, Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Department of Medical Informatics and Engineering, Uppsala University, Uppsala, Sweden.
    A Case Study of a Service Oriented Architecture (SOA) Implementation using the "Dream Team" Method in Shared Healthcare2006In: Proceedings of ICICTH 2006 / [ed] Kioulafas, K.; Katharaki, M., 2006, p. 241-246Conference paper (Refereed)
  • 35. Rexhepi, Hanife
    et al.
    Grünloh, Christiane
    Cajander, Åsa
    Bildanalys och människa-datorinteraktion, Uppsala universitet, Uppsala, Sweden.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    "Please do not confuse your Google search with my medical degree"?2016In: Designing eHealth Services for Patients and Relatives: NordiCHI 2016 Workshop, WorldPress , 2016Conference paper (Refereed)
  • 36.
    Scandurra, Isabella
    FoU Seniorium, Danderyd, Sweden.
    Hållbara och kvalitetssäkrade kommunikationstjänster i äldreomsorgen2011Report (Other academic)
    Abstract [sv]

    Denna  slutrapport  innehåller  två  delprojekt  i  ett  Vinnova‐finansierat  samverkansprojekt där problemägare,  företag  och  forskare  medverkar  i  skärningspunkten mellan vård och teknik, äldre användare och utvecklare.  Projektet  syftar  till  att  gemensamt  utveckla  och  kvalitetssäkra  hållbara kommunikationstjänster i äldreomsorgen  och  har  beviljats  anslag  från  VINNOVA,  Verket  för  Innovationssystem.  Arbetet  kan  beskrivas  som  en  slags  innovationsupphandling  där  kommuner  och  FoU‐enheter  höjer  sin  beställarkompetens  och  där  företaget  genom  detta  Forska&väx‐projekt  ökar sin kunskap om slutanvändaren i kommunen och genom forskarna får  en  chans  att  stärka  sitt metodologiska  angreppssätt. Syftet med  det  är  att  företaget  InView  AB  tack  vare  ökad  kunskap  om  användarcentrerad utveckling och olika kommuners lokala behov kan öka sin konkurrenskraft.

    Målet var att ta fram ett tjänsteutbud som svarar upp till samhällets behov  av  nya  hållbara  och  kvalitetssäkrade  kommunikationstjänster  i  äldreomsorgen. I detta arbete har användarcentrerade utvecklingsmetoder  varit  centralt,  där  presumtiva  kunder  och  slutanvändare  är  delaktiga  i  processen. Däri består  kvalitetssäkringen, att användaren av  tjänsten görs  delaktig och att de arbetssätt som utvecklats är dynamiska så att lärdomar  byggs in i systemet som görs hållbart med öppna standarder. 

    InView  AB  var  projektägare  i  samverkan  med  representanter  från  FoU  Seniorium,  FoU  Jämt,  Swedish  Institute  of  Computer  Science  (SICS)  med  fallstudier  i  fyra  referens‐kommuner.  Projektarbetet  har  bedrivits  i  åtta  delprojekt; 

    ‐ Metodprojektet, användarcentrerade utvecklingsmetoder och socio‐ tekniska införandemetoder,   ‐ Informationsstrukturprojektet, utveckling av en användbar och  skalbar informationsstruktur,   ‐ Affärsmodellsprojektet, med kommunen som kund till ippi‐tjänsten,   ‐ Jämtlandsprojektet i Berg, service i glesbygd,   ‐ Södertäljeprojektet, hemtjänstverksamhet,   ‐ Täbyprojektet, en träffpunkt för seniora invånare,   ‐ Vallentunaprojektet, ett vård‐ och omsorgsboende, och slutligen   ‐ Teknikprojektet, bestående av utveckling och test av ippi‐systemet.

    Genom ett verksamhetsnära samarbete i de fyra kommunerna med skilda behov och användargrupper har InView och forskarorganisationen i projektet lyft ippi‐plattformens funktionalitet och erhållit värdefulla erfarenheter kring införande av ippi som teknikstöd. Under projektet har ippi vidareutvecklats med sociala kommunikations‐tjänster, vård‐ och omsorgsriktade tjänster och tjänster med fokus på friskvård och hälsa, samt informationstjänster om lokalt aktivitetsutbud. De användarcentrerade utvecklingsmetoderna och socio‐tekniska införandemetoder har varit centrala i projektet och i stort bidragit till projektets lyckade utgång. Affärsmodellen för ippi‐tjänsten med kommunen som kund har utvecklats med argument baserade i Socialtjänstlagstiftningen och bekräftats genom att tre av fyra medverkande kommuner har beslutat att fortsätta i någon form. Dessa kommuner har även agerat referenskommuner och InView har sedan hösten 2009 utökat sitt kundsamarbete till att våren 2011 arbeta med 22 kommuner.

  • 37.
    Scandurra, Isabella
    Örebro University, Örebro University School of Business.
    Patient’s Access to own Electronic Health Record: State of the Art in Sweden2015In: X Jornadas de Sistemas de Información en Salud del Hospital Italiano de Buenos Aires: Health informatics at Hospital Italiano in Buenos Aires, Argentina / [ed] Fernando Plazzotta, Buenos Aires, 2015Conference paper (Other academic)
    Abstract [en]

    In this Key Note, experiences of the introduction of a public eHealth service is discussed: the Patients’ Online Access to their Electronic Health Records. Results from the Swedish pilot project on how access to patient records via Internet affects the development of care for patients as well as for healthcare professionals are presented as well as examples in the form of a live demonstrations of the eHealth service and its ongoing work will be provided. Challenges and potential solutions will be discussed together with the audience. 

  • 38.
    Scandurra, Isabella
    APRI eHealth, Själevad, Sweden.
    Störande eller stödjande?: Om eHälsosystemens användbarhet 20132013Report (Other academic)
  • 39.
    Scandurra, Isabella
    Department of Medical Sciences, Biomedical Informatics and Engineering, Uppsala University, University Hospital, Uppsala, Sweden.
    Visualization and Interaction Design for Ubiquitous Access to Shared Medical Information2005In: Human-computer interaction: INTERACT 2005: IFIP TC13 international conference on Human-computer interaction, 12th-16th September 2005, Rome, Italy: adjunct proceedings / [ed] Buono, Costabile, Paternò & Santoro, Bari: Laterza, Giuseppe , 2005, p. 39-40Conference paper (Refereed)
    Abstract [en]

    The goal of the research work is to develop prototypes for visualization of and interaction with medical information for some specific clinical work situations and to conduct usability tests in order to ensure future guidelines’ validity and reliability. For prototype development user centred system design (UCSD) is used and so far, the specific requirements for applying UCSD in the health care area have been identified. New demands for visualization and interaction design in mobile and shared care considering both the users and the context of use are described.

  • 40.
    Scandurra, Isabella
    et al.
    FoU Seniorium, Danderyd, Sweden.
    Andersson, Pärnilla
    FoU Seniorium, Vallentuna kommun, Vallentuna, Sweden.
    Hållbara kommunikationstjänster i äldreomsorgen, som utvecklats med seniorer i Täby och personal i Vallentuna2011Conference paper (Other (popular science, discussion, etc.))
  • 41.
    Scandurra, Isabella
    et al.
    Örebro University, Örebro University School of Business.
    Blusi, Madeleine
    R&D Department, The Association of Local Authorities in Västernorrland County, Härnösand, Sweden.
    Dalin, Rolf
    R&D Department, The Association of Local Authorities in Västernorrland County, Härnösand, Sweden.
    A Living Lab Method for Innovations to Increase Quality of Life for Elderly: A Pilot Case2015In: Human Aspects of IT for the Aged Population: Design for Aging / [ed] Jia Zhou & Gavriel Salvendy, Heidelberg, Germany: Springer, 2015, Vol. 9193, p. 123-133Conference paper (Refereed)
    Abstract [en]

    A Swedish Living Lab has recently been established offering care organizations a test and evaluation method as an activity in their intrinsic development process. Using the method, innovations for an aging population are assessed, guided by quality criteria as well-being, dignity, value for the elderly and usability.

    This paper describes the method through a pilot test, carried out in November 2014 by the elderly themselves and health and social care staff at a nursing home together with different academic parts in a multidisciplinary test process. The method allows for interaction between innovators and stakeholders as well as potential end-users in the elderly care sector. Simultaneously, the users’ quality aspects are kept in focus when innovations for the aging society are tested.

  • 42.
    Scandurra, Isabella
    et al.
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Blusi, Madeleine
    Mittuniversitetet, Östersund, Sweden.
    Dalin, Rolf
    Mittuniversitetet, Östersund, Sweden.
    Norrlandicus Care Lab: Novel Test Method for Aging Society Innovations2014In: Vetenskapliga papers presenterade vid Vitalis konferens, Svenska Mässan, Göteborg, 8-10 april 2014, Göteborg: Gupea , 2014Conference paper (Refereed)
    Abstract [en]

    Many countries with ageing populations need to work on how to incorporate innovations of different forms into the ongoing process of change in social service, support and care of the elderly. In Sweden, a national initiative to innovate elderly care is taken. Norrlandicus Care Lab (NCL) is a test environment formed as a Living Lab for actors aiming to develop health and social care for elderly through innovation. NCL offers organizations and companies a test and evaluation method as an activity in their intrinsic development process, suited to services, processes and products. The vision is to conceptualize NCL into a European model to forge the challenges of elderly care to progress with new innovative businesses and ideas. Thus, the objective is to create an interdisciplinary open collaboration platform for actors who want to develop longterm care through innovation. Each innovation is assessed in NCL via quality measures from the users’ perspectives. This paper describes the foundation of the novel test method that is the basis for the NCL test process. Testing in NCL will be carried out by elderly themselves, health and social care staff and relatives together with different academic parts in a multidisciplinary test process. Products and services will be evaluated from three perspectives; the “care customer” (elderly or seniors), their relatives and health and social care professionals. There are two main quality criteria that guide the evaluation: quality as stated in the “National Values for Social Care of Elderly” and usability as a function of the innovation and its primary end-users. The expected result from an academic point of view is that the test method as such is validated and measures the contribution of the innovation in terms of “a dignified life for the elderly” as well as the degree of usability of the innovation. Expected results from the innovators and the aging society may vary depending on type of innovation. In Norrlandicus Care Lab, this unique method allows for interaction between innovators and senior stakeholders as well as other primary end-users in the elderly care sector. Thanks to the establishment of this novel method and the support from researchers, the users’ quality aspects are kept in focus when innovations for the aging society are tested in Norrlandicus Care Lab.

  • 43.
    Scandurra, Isabella
    et al.
    APRI-eHealth AB, Örnsköldsvik, Sweden.
    Forsell, Camilla
    Linköping University, Norrköping, Sweden.
    Ynnerman, Anders
    Linköping University, Norrköping, Sweden.
    Ljung, Patrik
    Linköping university, Linköping, Sweden.
    Lundström, Christer
    Linköping university, Linköping, Sweden.
    Persson, Anders
    Linköping university, Linköping, Sweden.
    Advancing the State-of-the-Art for Virtual Autopsies: Initial Forensic Workflow Study2010In: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 160, p. 639-643Article in journal (Refereed)
    Abstract [en]

    There are numerous advantages described of how imaging technology can support forensic examinations. However, postmortem examinations of bodies are mainly performed to address demands which differ from those of traditional clinical image processing. This needs to be kept in mind when gathering information from image data sets for forensic purposes. To support radiologists and forensicclinicians using Virtual Autopsy technologies, an initial workflow study regarding post-mortem imaging has been performed, aiming to receive an improved understanding of how Virtual Autopsyworkstations, image data sets and processes can be adjusted to support and improve conventional autopsies. This paper presents potential impacts and a current forensic Virtual Autopsy workflowaiming to form a foundation for collaborative procedures that increase the value of Virtual Autopsy. The workflow study will provide an increased and mutual understanding of involved professionals. In addition, insight into future forensic workflows based on demands from both forensic and radiologist perspectives bring visualization and medical informatics researchers together to develop and improvethe technology and software needed.

  • 44.
    Scandurra, Isabella
    et al.
    Uppsala university, Uppsala, Sweden.
    Holgersson, Jesper
    Skövde University, Skövde, Sweden.
    Lind, Thomas
    Uppsala university, Uppsala, Sweden.
    Myreteg, Gunilla
    Uppsala university, Uppsala, Sweden.
    Development of Novel eHealth Services for Citizen Use: Current System Engineering vs. Best Practice in HCI.2013In: Human-Computer Interaction – INTERACT 2013 / [ed] Paula Kotzé, Gary Marsden, Gitte Lindgaard, Janet Wesson, Marco Winckler, Springer, 2013, Vol. 8118, p. 372-379Conference paper (Refereed)
    Abstract [en]

    Many new public eHealth Services are now being developed. Often a conventional customer-vendor process is used, where the customer is a public authority, e.g. a county council, and the vendor a commercial actor, e.g. an IT development company. In this case study the engineering process regards a novel eHealth service aiming to provide patients with online access to their electronic health record. A complicating factor in conventional customer-vendor processes for public e-services is that “the future user could be anyone”. In the light of best practice in Human-Computer Interaction, this study examines the joint effort of the customer and vendor when developing novel services for citizen use. The results include delimiting factors, recommendations for public authority customers and proposed new actions for the research agenda.

  • 45.
    Scandurra, Isabella
    et al.
    Uppsala University, Uppsala, Sweden.
    Holgersson, Jesper
    Skövde University, Skövde, Sweden.
    Lind, Thomas
    Uppsala University, Uppsala, Sweden.
    Myreteg, Gunilla
    Uppsala University, Uppsala, Sweden.
    Development of Patient Access to Electronic Health Records as a Step Towards Ubiquitous Public eHealth2013In: European Journal of ePractice, ISSN 1988-625X, E-ISSN 1988-625X, Vol. 20, p. 21-36Article in journal (Refereed)
  • 46.
    Scandurra, Isabella
    et al.
    APRI eHealth, Själevad, Sweden..
    Hägglund, Maria
    A collaborative design method to support integrated care.: An ICT development method containing continuous user validation improves the entire care process and the individual work situation2009In: International Journal of Integrated Care, ISSN 1568-4156, E-ISSN 1568-4156, Vol. 9, no Suppl.Article in journal (Refereed)
    Abstract [en]

    Introduction

    Integrated care involves different professionals, belonging to different care provider organizations and requires immediate and ubiquitous access to patient-oriented information, supporting an integrated view on the care process [1].

    Purpose

    To present a method for development of usable and work process-oriented information and communication technology (ICT) systems for integrated care.

    Theory and method

    Based on Human-computer Interaction Science and in particular Participatory Design [2], we present a new collaborative design method in the context of health information systems (HIS) development [3]. This method implies a thorough analysis of the entire interdisciplinary cooperative work and a transformation of the results into technical specifications, via user validated scenarios, prototypes and use cases, ultimately leading to the development of appropriate ICT for the variety of occurring work situations for different user groups, or professions, in integrated care.

    Results and conclusions

    Application of the method in homecare of the elderly resulted in an HIS that was well adapted to the intended user groups. Conducted in multi-disciplinary seminars, the method captured and validated user needs and system requirements for different professionals, work situations, and environments not only for current work; it also aimed to improve collaboration in future (ICT supported) work processes. A holistic view of the entire care process was obtained and supported through different views of the HIS for different user groups, resulting in improved work in the entire care process as well as for each collaborating profession.

  • 47.
    Scandurra, Isabella
    et al.
    APRI eHealth, Själevad, Sweden.
    Hägglund, Maria
    Karolinska University.
    An ICT development method containing Continuous User Validation improves the entire care process AND the individual work situation2009Conference paper (Refereed)
    Abstract [en]

    Introduction: Integrated care involves different professionals, belonging to different care provider organizations and requires immediate and ubiquitous access to patient-oriented information, supporting an integrated view on the care process.

    Purpose: To present a method for development of usable and work process-oriented information and communication technology (ICT) systems for integrated care.

    Theory and method: Based on Human-computer Interaction Science and in particular Participatory Design, we present a new collaborative design method in the context of health information systems (HIS) development. This method implies a thorough analysis of the entire interdisciplinary cooperative work and a transformation of the results into technical specifications, via user validated scenarios, prototypes and use cases, ultimately leading to the development of appropriate ICT for the variety of occurring work situations for different user groups, or professions, in integrated care.

    Results and conclusions: Application of the method in homecare of the elderly resulted in an HIS that was well adapted to the intended user groups. Conducted in multi-disciplinary seminars, the method captured and validated user needs and system requirements for different professionals, work situations, and environments not only for current work; it also aimed to improve collaboration in future (ICT supported) work processes. A holistic view of the entire care process was obtained and supported through different views of the HIS for different user groups, resulting in improved work in the entire care process as well as for each collaborating profession.

  • 48.
    Scandurra, Isabella
    et al.
    Örebro University, Örebro University School of Business.
    Hägglund, Maria
    Karolinska University, Stockholm, Sweden.
    Developing and implementing national eHealth services for patients: an interactive exploration of challenges and potential solutions2015In: Driving Quality in Informatics: Fulfilling the Promise, 2015Conference paper (Refereed)
    Abstract [en]

    Developing and Implementing National eHealth Services for Patients – An Interactive Exploration of Challenges and Potential Solutions Isabella Scandurra, Informatics, School of Business, Örebro University, Sweden; Maria Hägglund, Health Informatics Centre, Karolinska Institutet, Sweden As a means to address current challenges for and demands on health and social care, e.g. quality of care and patient empowerment, information and communication technologies (ICT) are being used to supply citizens with various health services. One example is to give patients web access to their own electronic health records (EHRs). In this workshop, we will provide examples and experiences from ongoing work in Sweden to develop and implement eHealth services for citizens; SUSTAINS [1] and My Care Pathways [2].The workshop participants will be engaged in interactive discussions regarding challenges and potential solutions based on their experiences from different contexts. The aim of the workshop is twofold: 1. To explore challenges for developing and implementing e-health systems for citizens to access their patient information and other e-health services online. 2. To suggest strategies and activities that could provide potential solutions to the identified challenge. Workshop structure The disposition of the workshop is as follows: a 90 minute session, a 15 minutes break and another 75 minute session. The two sessions will contain both presentations from the workshop organizers and interactive discussions and work in smaller groups to engage all participants and share experiences from different contexts. This disposition requires active participants to generate new ideas and knowledge through discussions and reflections where all participants contribute with their knowledge and understanding of the problem. The topic is expected to engage a lot of people, maybe not only those present at the workshop or at the conference. The workshop organizers will encourage live tweeting during the sessions and invite followers. 

  • 49.
    Scandurra, Isabella
    et al.
    Örebro University, Örebro University School of Business.
    Hägglund, Maria
    Karolinska University.
    How to introduce a mobile ICT system in homecare?: a socio-technical implementation process dis-/ covering staff’s opinions and intention to use ICT2008Conference paper (Refereed)
  • 50.
    Scandurra, Isabella
    et al.
    Centre for EHealth, Uppsala University, University Hospital, Uppsala, Sweden; Dept of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Hägglund, Maria
    Dept of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    Dept of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Koch, Sabine
    Centre for EHealth, Uppsala University, University Hospital, Uppsala, Sweden; Dept of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Heuristic Evaluation Performed by Usability-educated Clinicians: Education and Attitudes2007In: Information Technology in Health Care 2007: Proceedings of the 3rd International Conference on Information Technology in Health Care: Socio-technical Approaches / [ed] E. Coiera, J.I. Westbrook, J.L. Callen, and Jos Aarts, IOS Press, 2007, p. 205-216Chapter in book (Refereed)
    Abstract [en]

    Heuristic evaluation is a usability testing method aiming to improve the user interface design. Traditionally, a panel of experts in usability and human factor issues evaluate and judge the compliance of computer software according to recognized usability principles, the heuristics. In this paper, we investigate clinicians' attitudes towards learning and performing a heuristic evaluation and present the procedure of educating the healthcare staff and their accomplishment of the evaluation. 18 clinicians were recruited for a 2-hours education and filled in a post-education questionnaire regarding their opinions of the evaluation method when applied by clinicians. Six of the clinicians participated later in a heuristic evaluation of a web-based virtual health record,Their time spent for evaluation and analysis of results was approximately four hours each. Opinions from the six "clinical evaluators" were gathered in an post-evaluation form and compared to the post-education questionnaire. The results of 18 clinicians indicate that there is an interest in learning and participating in such evaluations. Our interpretation is that it is feasible to educate healthcare staff to perform rapid usability inspections to locate usability defects and additionally emphasize the domain specific problems residing in health information systems.

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