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Åhlfeldt, Rose-MharieORCID iD iconorcid.org/0000-0002-8607-948X
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Publications (10 of 70) Show all publications
Huvila, I., Moll, J., Enwald, H., Hirvonen, N., Åhlfeldt, R.-M. & Cajander, Å. (2019). Age-related differences in seeking clarification to understand medical record information. Paper presented at ISIC Information Behaviour Conference, OCT 09-11, 2018, Krakow, POLAND. Information research, 24(1), Article ID isic1834.
Open this publication in new window or tab >>Age-related differences in seeking clarification to understand medical record information
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2019 (English)In: Information research, ISSN 1368-1613, E-ISSN 1368-1613, Vol. 24, no 1, article id isic1834Article in journal (Refereed) Published
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.

Keywords
health, patient, participation, care
National Category
Information Studies Health Care Service and Management, Health Policy and Services and Health Economy Information Systems, Social aspects
Research subject
Information Systems
Identifiers
urn:nbn:se:his:diva-16742 (URN)000461468700018 ()
Conference
ISIC Information Behaviour Conference, OCT 09-11, 2018, Krakow, POLAND
Available from: 2019-04-04 Created: 2019-04-04 Last updated: 2019-06-10Bibliographically approved
Huvila, I., Hirvonen, N., Enwald, H. & Åhlfeldt, R.-M. (2019). Differences in Health Information Literacy Competencies Among Older Adults, Elderly and Younger Citizens. In: Serap Kurbanoğlu, Sonja Špiranec, Yurdagül Ünal, Joumana Boustany, Maija Leena Huotari, Esther Grassian, Diane Mizrachi, Loriene Roy (Ed.), Information Literacy in Everyday Life: 6th European Conference, ECIL 2018, Oulu, Finland, September 24–27, 2018, Revised Selected Papers (pp. 136-143). Springer, 989
Open this publication in new window or tab >>Differences in Health Information Literacy Competencies Among Older Adults, Elderly and Younger Citizens
2019 (English)In: Information Literacy in Everyday Life: 6th European Conference, ECIL 2018, Oulu, Finland, September 24–27, 2018, Revised Selected Papers / [ed] Serap Kurbanoğlu, Sonja Špiranec, Yurdagül Ünal, Joumana Boustany, Maija Leena Huotari, Esther Grassian, Diane Mizrachi, Loriene Roy, Springer, 2019, Vol. 989, p. 136-143Chapter in book (Refereed)
Abstract [en]

To address the research gap on age-based differences in health information literacy (HIL), we investigated how younger (born 1960–) and older adults (1946–1960), and elderly citizens (–1945) differed from each other by their HIL competencies. Data were collected with an online survey of patients using the Swedish national electronic health record system. Altogether, 2,587 users responded. One-way ANOVA with post hoc tests revealed several differences between the groups: younger adults were less likely to value health information than older adults; older adults and elderly were least likely to compare information from multiple sources and had trouble in determining health information needs; older adults were most likely to have trouble understanding health terminology and the elderly to have difficulties in understanding medicinal package labels. The study shows that HIL is not necessarily improving or declining but adapting to challenges of advanced age. © 2019, Springer Nature Switzerland AG.

Place, publisher, year, edition, pages
Springer, 2019
Series
Communications in Computer and Information Science, ISSN 1865-0929, E-ISSN 1865-0937 ; 989
Keywords
elderly, health information literacy, older adults, young, computer science, computers, elderly citizens, electronic health record systems, health informations, multiple source, online surveys, health
National Category
Gerontology, specialising in Medical and Health Sciences Information Systems, Social aspects
Research subject
Information Systems
Identifiers
urn:nbn:se:his:diva-16704 (URN)10.1007/978-3-030-13472-3_13 (DOI)2-s2.0-85062276821 (Scopus ID)978-3-030-13471-6 (ISBN)978-3-030-13472-3 (ISBN)
Available from: 2019-03-18 Created: 2019-03-18 Last updated: 2019-06-05Bibliographically approved
Iwaya, L., Fischer-Hübner, S., Åhlfeldt, R.-M. & Martucci, L. A. (2019). Mobile Health Systems for Community-Based Primary Care: Identifying Controls and Mitigating Privacy Threats. JMIR mhealth and uhealth, 7(3), 1-16, Article ID e11642.
Open this publication in new window or tab >>Mobile Health Systems for Community-Based Primary Care: Identifying Controls and Mitigating Privacy Threats
2019 (English)In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 7, no 3, p. 1-16, article id e11642Article in journal (Refereed) Published
Abstract [en]

Background: Community-based primary care focuses on health promotion, awareness raising, and illnesses treatment and prevention in individuals, groups, and communities. Community Health Workers (CHWs) are the leading actors in such programs, helping to bridge the gap between the population and the health system. Many mobile health (mHealth) initiatives have been undertaken to empower CHWs and improve the data collection process in the primary care, replacing archaic paper-based approaches. A special category of mHealth apps, known as mHealth Data Collection Systems (MDCSs), is often used for such tasks. These systems process highly sensitive personal health data of entire communities so that a careful consideration about privacy is paramount for any successful deployment. However, the mHealth literature still lacks methodologically rigorous analyses for privacy and data protection.

Objective: In this paper, a Privacy Impact Assessment (PIA) for MDCSs is presented, providing a systematic identification and evaluation of potential privacy risks, particularly emphasizing controls and mitigation strategies to handle negative privacy impacts.

Methods: The privacy analysis follows a systematic methodology for PIAs. As a case study, we adopt the GeoHealth system, a large-scale MDCS used by CHWs in the Family Health Strategy, the Brazilian program for delivering community-based primary care. All the PIA steps were taken on the basis of discussions among the researchers (privacy and security experts). The identification of threats and controls was decided particularly on the basis of literature reviews and working group meetings among the group. Moreover, we also received feedback from specialists in primary care and software developers of other similar MDCSs in Brazil.

Results: The GeoHealth PIA is based on 8 Privacy Principles and 26 Privacy Targets derived from the European General Data Protection Regulation. Associated with that, 22 threat groups with a total of 97 subthreats and 41 recommended controls were identified. Among the main findings, we observed that privacy principles can be enhanced on existing MDCSs with controls for managing consent, transparency, intervenability, and data minimization.

Conclusions: Although there has been significant research that deals with data security issues, attention to privacy in its multiple dimensions is still lacking for MDCSs in general. New systems have the opportunity to incorporate privacy and data protection by design. Existing systems will have to address their privacy issues to comply with new and upcoming data protection regulations. However, further research is still needed to identify feasible and cost-effective solutions.

Place, publisher, year, edition, pages
CANADA: JMIR PUBLICATIONS, 2019
Keywords
mobile health, mHealth, data security, privacy, data protection, privacy impact assessment, public health
National Category
Computer Sciences
Research subject
Information Systems
Identifiers
urn:nbn:se:his:diva-16707 (URN)10.2196/11642 (DOI)000463345300001 ()30892275 (PubMedID)2-s2.0-85064505109 (Scopus ID)
Available from: 2019-03-20 Created: 2019-03-20 Last updated: 2019-07-10Bibliographically approved
Kävrestad, J., Åhlfeldt, R.-M., Nohlberg, M., Johani, K. & Kowalski, S. (2019). Spiraling out in control: A Video Cartesian Dialectic on a Socio-technical Approach to Teaching Privacy, Information- and Cyber Security (PICS). In: Stewart Kowalski, Peter Bednar, Alexander Nolte, Ilia Bider (Ed.), Socio-Technical Perspective in IS Development 2019: Proceedings of the 5th International Workshop on Socio-Technical Perspective in IS Development (STPIS 2019) co-located with 27th European Conference on Information Systems (ECIS 2019). Paper presented at 5th International Workshop on Socio-Technical Perspective in IS Development (STPIS 2019) co-located with 27th European Conference on Information Systems (ECIS 2019) Stockholm, Sweden, June 10, 2019 (pp. 153-155). , 2398
Open this publication in new window or tab >>Spiraling out in control: A Video Cartesian Dialectic on a Socio-technical Approach to Teaching Privacy, Information- and Cyber Security (PICS)
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2019 (English)In: Socio-Technical Perspective in IS Development 2019: Proceedings of the 5th International Workshop on Socio-Technical Perspective in IS Development (STPIS 2019) co-located with 27th European Conference on Information Systems (ECIS 2019) / [ed] Stewart Kowalski, Peter Bednar, Alexander Nolte, Ilia Bider, 2019, Vol. 2398, p. 153-155Conference paper, Poster (with or without abstract) (Refereed)
Series
CEUR Workshop Proceedings, E-ISSN 1613-0073 ; 2398
Keywords
education, spiral learning, curriculum, information security
National Category
Other Computer and Information Science
Research subject
Information Systems
Identifiers
urn:nbn:se:his:diva-17453 (URN)2-s2.0-85069459247 (Scopus ID)
Conference
5th International Workshop on Socio-Technical Perspective in IS Development (STPIS 2019) co-located with 27th European Conference on Information Systems (ECIS 2019) Stockholm, Sweden, June 10, 2019
Available from: 2019-07-18 Created: 2019-07-18 Last updated: 2019-08-12
Rexhepi, H., Åhlfeldt, R.-M., Cajander, Å. & Huvila, I. (2018). Cancer Patients’ Attitudes and Experiences of Online Access to their Electronic Medical Records: A Qualitative Study. Health Informatics Journal, 24(2), 115-124
Open this publication in new window or tab >>Cancer Patients’ Attitudes and Experiences of Online Access to their Electronic Medical Records: A Qualitative Study
2018 (English)In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 24, no 2, p. 115-124Article in journal (Refereed) Published
Abstract [en]

Patients’ access to their online medical records serves as one of the cornerstones in the efforts to increase patient engagement and improve healthcare outcomes. The aim of this paper is to provide in-depth understanding of cancer patients’ attitudes and experiences of online medical records, as well as an increased understanding of the complexities of developing and launching e-Health services. The study result confirms that online access can help patients prepare for doctor visits and to understand their medical issues. In contrast to the fears of many physicians the study shows that online access to medical records did not generate substantial anxiety, concerns or increased phone calls to the hospital

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Electronic medical records, medical information, patient access, patient empowerment
National Category
Information Systems, Social aspects
Research subject
Humanities and Social sciences; Information Systems
Identifiers
urn:nbn:se:his:diva-12806 (URN)10.1177/1460458216658778 (DOI)000432068300001 ()27440056 (PubMedID)2-s2.0-85046829118 (Scopus ID)
Available from: 2016-08-22 Created: 2016-08-22 Last updated: 2019-01-22Bibliographically approved
Åhlfeldt, R.-M., Nohlberg, M., Söderström, E., Lennerholt, C. & van Laere, J. (2018). Current Situation Analysis of Information Security Level in Municipalities. Journal of Information System Security, 14(1), 3-19
Open this publication in new window or tab >>Current Situation Analysis of Information Security Level in Municipalities
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2018 (English)In: Journal of Information System Security, ISSN 1551-0123, E-ISSN 1551-0808, Vol. 14, no 1, p. 3-19Article in journal (Refereed) Published
Abstract [en]

Municipalities manage a significant part of society's services, and hence they also handle a vast amount of information. A municipality's activities include managing a significant part of society's services, and municipalities’ supply and management of information are, therefore, critical for society in general, and also for achieving the municipalities’ own operational goals. However, research shows weaknesses in the municipalities' work on information security, and there is a need to study and identify the current level of security.

This paper presents the result from a GAP analysis mapping the current situation of Swedish municipalities' for systematic information security work, based on the demands made on municipalities from both research and social perspectives. The result shows that the information security level regarding the systematic security work is generally low, and that there is a need to implement adapted tools for Information Security Management Systems in order to support municipalities.

Keywords
Information Security, Information Security Management Systems, Municipality
National Category
Computer and Information Sciences
Research subject
Information Systems
Identifiers
urn:nbn:se:his:diva-16354 (URN)
Available from: 2018-11-02 Created: 2018-11-02 Last updated: 2019-02-08Bibliographically approved
Åhlfeldt, R.-M., Nohlberg, M., Söderström, E., Lennerholt, C. & van Laere, J. (2018). Current Situation Analysis of Information Security Level in Municipalities. In: Gurpreet Dhillin, Spyridon Samonas (Ed.), Proceedings of the Annual Information Institute Conference: . Paper presented at 17th Annual Security Conference, Las Vegas, March 26, 2018 - March 28, 2018. The Information Institute
Open this publication in new window or tab >>Current Situation Analysis of Information Security Level in Municipalities
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2018 (English)In: Proceedings of the Annual Information Institute Conference / [ed] Gurpreet Dhillin, Spyridon Samonas, The Information Institute , 2018Conference paper, Published paper (Refereed)
Abstract [en]

Municipalities manage a significant part of society's services, and hence also handle a vast amount of information. A municipality's activities include managing a significant part of society's services, and the municipality's supply and management of information are, therefore, critical for society in general, but also for achieving the municipality's own operational goals. However, investigations show weaknesses in the municipalities' work on information security, and there is a need to study and identify the current level of security. This paper presents the result from a GAP analysis mapping the Swedish municipalities current situation for systematic information security work, based on the demands made on municipalities from both research and social perspectives. The result shows that the information security level regarding systematic security work is generally low and that there is a need for adapted tools for Information Security Management Systems in order to support municipalities.

Place, publisher, year, edition, pages
The Information Institute, 2018
National Category
Information Systems
Research subject
INF303 Information Security; Information Systems
Identifiers
urn:nbn:se:his:diva-16755 (URN)978-1-935160-19-9 (ISBN)
Conference
17th Annual Security Conference, Las Vegas, March 26, 2018 - March 28, 2018
Available from: 2019-04-08 Created: 2019-04-08 Last updated: 2019-07-08Bibliographically approved
Iwaya, L., Fischer-Hübner, S., Åhlfeldt, R.-M. & Martucci, L. (2018). mHealth: A privacy threat analysis for public health surveillance systems. In: B Kane, J Hollmen, C McGregor, P Soda (Ed.), 2018 IEEE 31st International Symposium on Computer-Based Medical Systems (CBMS), (2018): . Paper presented at 31st IEEE International Symposium on Computer-Based Medical Systems, CBMS 2018; Karlstad; Sweden; 18 June 2018 through 21 June 2018 (pp. 42-47). IEEE
Open this publication in new window or tab >>mHealth: A privacy threat analysis for public health surveillance systems
2018 (English)In: 2018 IEEE 31st International Symposium on Computer-Based Medical Systems (CBMS), (2018) / [ed] B Kane, J Hollmen, C McGregor, P Soda, IEEE , 2018, p. 42-47Conference paper, Published paper (Refereed)
Abstract [en]

Community Health Workers (CHWs) have been usingMobile Health Data Collection Systems (MDCSs) for supportingthe delivery of primary healthcare and carrying out public healthsurveys, feeding national-level databases with families’ personaldata. Such systems are used for public surveillance and to managesensitive data (i.e., health data), so addressing the privacy issuesis crucial for successfully deploying MDCSs. In this paper wepresent a comprehensive privacy threat analysis for MDCSs,discuss the privacy challenges and provide recommendationsthat are specially useful to health managers and developers. Weground our analysis on a large-scale MDCS used for primarycare (GeoHealth) and a well-known Privacy Impact Assessment(PIA) methodology. The threat analysis is based on a compilationof relevant privacy threats from the literature as well as brainstormingsessions with privacy and security experts. Among themain findings, we observe that existing MDCSs do not employadequate controls for achieving transparency and interveinability.Thus, threatening fundamental privacy principles regarded asdata quality, right to access and right to object. Furthermore, itis noticeable that although there has been significant research todeal with data security issues, the attention with privacy in itsmultiple dimensions is prominently lacking.

Place, publisher, year, edition, pages
IEEE, 2018
Series
IEEE Symposium on Computer-Based Medical Systems, ISSN 1063-7125, E-ISSN 2372-9198
Keywords
mHealth, privac, data protection, threat analysis, mHealth data collection system, public healthcare
National Category
Computer and Information Sciences
Research subject
INF303 Information Security; Information Systems
Identifiers
urn:nbn:se:his:diva-16431 (URN)10.1109/CBMS.2018.00015 (DOI)2-s2.0-85050971478 (Scopus ID)978-1-5386-6061-4 (ISBN)
Conference
31st IEEE International Symposium on Computer-Based Medical Systems, CBMS 2018; Karlstad; Sweden; 18 June 2018 through 21 June 2018
Available from: 2018-11-24 Created: 2018-11-24 Last updated: 2019-02-08Bibliographically approved
Hägglund, M., Moll, J., Åhlfeldt, R.-M. & Scandurra, I. (2018). Timing It Right: Patients' Online Access to Their Record Notes in Sweden. In: Adrien Ugon, Daniel Karlsson, Gunnar O. Klein, Anne Moen (Ed.), Building Continents of Knowledge in Oceans of Data: The Future of Co-Created eHealth. Proceedings of MIE2018. Paper presented at Medical Informatics Europe, MIE2018, Gothenburg, Sweden, April 24-26, 2018 (pp. 336-340). IOS Press, 247
Open this publication in new window or tab >>Timing It Right: Patients' Online Access to Their Record Notes in Sweden
2018 (English)In: Building Continents of Knowledge in Oceans of Data: The Future of Co-Created eHealth. Proceedings of MIE2018 / [ed] Adrien Ugon, Daniel Karlsson, Gunnar O. Klein, Anne Moen, IOS Press, 2018, Vol. 247, p. 336-340Conference paper, Published paper (Refereed)
Abstract [en]

In Sweden, and internationally, there is an ongoing debate about the effects of national implementations of Patient Accessible Electronic Health Records (PAEHRs). The purpose of this paper was to describe the current situation in Sweden and compare this with the expectations on reasonable waiting time for information access of users of the Swedish PAEHR. Data were collected from publicly available resources regarding current implementation in the 21 county councils, contrasted with patient experiences, gathered from a national online survey. The results indicate that patients have high expectations on immediate access to information, while this varies greatly in implementation across Sweden.

Place, publisher, year, edition, pages
IOS Press, 2018
Series
Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365
Keywords
Patient portals, Electronic health records, Health Information Exchange, Patient Accessible EHR
National Category
Information Systems
Research subject
Information Systems
Identifiers
urn:nbn:se:his:diva-15113 (URN)10.3233/978-1-61499-852-5-336 (DOI)2-s2.0-85046538091 (Scopus ID)978-1-61499-851-8 (ISBN)978-1-61499-852-5 (ISBN)
Conference
Medical Informatics Europe, MIE2018, Gothenburg, Sweden, April 24-26, 2018
Available from: 2018-05-02 Created: 2018-05-02 Last updated: 2018-09-03
Åhlfeldt, R.-M., Nohlberg, M. & Söderstöm, E. (2017). Länsstyrelsernas förutsättningar att stödja kommuner gällande informationssäkerhet. Stockholm: Myndigheten för samhällsskydd och beredskap
Open this publication in new window or tab >>Länsstyrelsernas förutsättningar att stödja kommuner gällande informationssäkerhet
2017 (Swedish)Report (Other academic)
Abstract [sv]

En studie har genomförts av Högskolan i Skövde på uppdrag av Myndigheten för Samhällsskydd och beredskap (MSB) med syfte att kartlägga länsstyrelsernas faktiska möjligheter att samordna och stödja kommunernas arbete avseende informationssäkerhet. Arbetet har även inkluderat hur länsstyrelserna arbetar med att samordna och stödja kommunernas arbete avseende informationssäkerhet. Kartläggningen genomfördes hos sju utvalda länsstyrelser under perioden oktober 2016 till januari 2017 genom intervjuer av representanter från varje länsstyrelse.

Resultatet visar att länsstyrelserna behöver ett tydligt uppdrag med tillhörande mandat och resurser för att ha förutsättningar att kunna samordna och stödja kommunerna i deras informationssäkerhetsarbete. Detta anser de involverade länsstyrelserna saknas i nuläget. Dessutom visar resultatet på att det finns omfattande kompetensbrist inom informationssäkerhetsområdet. Kompetensbristen finns såväl i det interna arbetet som i det externa arbetet ut mot kommunerna, allt från ledningsnivå till operativ nivå. Det finns även behov av tydligare roller både strategiskt och operativt för att sätta igång arbetet och möjliggöra en tydligare överblick. Detta behövs för att ge förutsättningar till länsstyrelserna för att kunna samordna och stödja länsstyrelserna i informationssäkerhetsarbetet relaterat till kris och höjd beredskap men även för att erhålla en strategisk helhetssyn på informationssäkerhetsarbetet utifrån ett samhällsperspektiv.

Place, publisher, year, edition, pages
Stockholm: Myndigheten för samhällsskydd och beredskap, 2017. p. 29
Keywords
informationssäkerhet, krisberedskap
National Category
Information Systems
Research subject
Information Systems
Identifiers
urn:nbn:se:his:diva-13655 (URN)978-91-7383-729-3 (ISBN)
Projects
LISAK - Länsstyrelsernas förutsättningar att stödja kommuner gällande informationssäkerhet
Funder
Swedish Civil Contingencies Agency
Available from: 2017-06-08 Created: 2017-06-08 Last updated: 2018-01-13Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8607-948X

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