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Web-based Knowledge Portals in Swedish Healthcare: Overview and Challenges
University of Skövde, School of Humanities and Informatics. University of Skövde, The Informatics Research Centre.ORCID iD: 0000-0001-8957-9853
University of Skövde, The Informatics Research Centre. University of Skövde, School of Humanities and Informatics.ORCID iD: 0000-0003-0740-4123
2012 (English)In: Scandinavian Conference on Health Informatics 2012 / [ed] Daniel Karlsson, Johan Gustav Bellika, Pia Britt Elberg, Mariann Fossum, Gert Galster, Gunnar Hartvigsen, Sabine Koch, Gunilla Nilsson, Linköping University Electronic Press, 2012, p. 9-12Conference paper, Published paper (Refereed)
Abstract [en]

Healthcare organizations are increasingly becoming dependent on knowledge management activities to improve the quality of care, to maintain a high level of efficiency and innovation as well as to flexibly adapt to raid change. Utilizing knowledge management support systems - e.g. Internet based knowledge portals - to manage medical information and healthcare knowledge aimed to support the full spectrum of knowledge needs has become an important issue for all healthcare professionals. This paper reports on the main findings from analyzing the characteristics and challenges of 15 Swedish knowledge portals containing healthcare information. The analysis is based on inspection of the portals and interviews with their owners. The main challenges found concern fragmentation of knowledge, structuring of knowledge content, usability, interaction and resources for maintaining knowledge content. Future successful development and use of knowledge portals to disseminate healthcare knowledge depend on addressing these challenges, which requires portal owners to have a long-term strategy as well as a systematic way of working.

Place, publisher, year, edition, pages
Linköping University Electronic Press, 2012. p. 9-12
Series
Linköping Electronic Conference Proceeding, ISSN 1650-3686 ; 70
Keywords [en]
Knowledge management, knowledge portal
National Category
Computer and Information Sciences
Research subject
Technology
Identifiers
URN: urn:nbn:se:his:diva-6914ISBN: 978-91-7519-758-6 OAI: oai:DiVA.org:his-6914DiVA, id: diva2:577054
Conference
Scandinavian Conference on Health Informatics 2012, October 2–3, Linköping, Sverige
Available from: 2012-12-14 Created: 2012-12-14 Last updated: 2018-06-14Bibliographically approved
In thesis
1. Improving healthcare information systems: A key to evidence based medicine
Open this publication in new window or tab >>Improving healthcare information systems: A key to evidence based medicine
2015 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Delivering good quality care is a complex endeavor that is highly dependent on patient information and medical knowledge. When decisions about the care of a patient are made, they must, as far as possible, be based on research-derived evidence rather than on clinical skills and experience alone. Evidence based medicine (EBM) is the conscientious and judicious use of current best evidence in conjunction with clinical expertise as well as patient values and preferences to guide healthcare decisions. Following the principles of EBM, healthcare practitioners are required to formulate questions based on patients’ current clinical status, medical history, values and preferences, search the literature for answers, evaluate the evidence for its validity and usefulness, and finally apply the information to the patient. Information systems play a crucial role in the practice of evidence based medicine, by allowing healthcare practitioners to access clinical evidence and information about the patients’ health as they formulate their patient-care strategies. However, current information systems solutions are far from this perspective for various reasons. One of these reasons is that existing information systems do not support a seamless flow of patient information along the patient process. Due to interoperability issues, healthcare practitioners cannot easily exchange patient information from one information system to another and from one healthcare practitioner to another. Consequently, vital information that is stored in separate information systems and which could present a clear and complete picture of the patient cannot be easily accessed. All too often, units have to operate without knowledge of the problems addressed by other healthcare practitioners from other units, the services provided, medications prescribed, or preferences expressed in those previous situations. The practice of EBM is further complicated by current information systems that do not support practitioners in their search and evaluation of current evidence in everyday clinical care.

Based on a qualitative approach, this work aims to find solutions for how future healthcare information systems can support the practice of EBM. By combining existing research on process orientation, knowledge management and evidence based medicine with empirical data, a number of recommendations have been initiated. These recommendations aim to support healthcare managers, IT–managers and system developers in the development of future healthcare information systems, from a process-oriented and knowledge management perspective. By following these recommendations, it is possible to develop information systems that facilitate the practice of evidence based medicine, and improve patient engagement.

Place, publisher, year, edition, pages
Skövde: University of Skövde, 2015. p. 80
Series
Dissertation Series ; 7
Keywords
Process orientation, Knowledge management, Healthcare, Evidence based medicine
National Category
Information Systems
Identifiers
urn:nbn:se:his:diva-11019 (URN)978-91-981474-7-6 (ISBN)
Presentation
2015-06-15, G207, Högskolan i Skövde, Skövde, 12:45 (English)
Opponent
Supervisors
Available from: 2015-06-10 Created: 2015-06-09 Last updated: 2018-01-11Bibliographically approved
2. BRIDGING THE INFORMATION GAP: Supporting Evidence-Based Medicine and Shared Decision-Making through Information Systems
Open this publication in new window or tab >>BRIDGING THE INFORMATION GAP: Supporting Evidence-Based Medicine and Shared Decision-Making through Information Systems
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Practicing evidence-based medicine (EBM) and shared decision-making (SDM)along the patient process is important in today's healthcare environment, as thesemodels of care offer a way to improve quality and safety of care, patient satisfaction,and reduce costs. EBM is the conscientious and judicious use of current best medicalevidence in conjunction with clinical expertise. It also includes taking into accountpatient values and preferences to guide decisions about the care of individual patients.SDM offers a process that guides how a healthcare professional (e.g., a physicianor a nurse) and a patient jointly can participate in a decision after incorporatingthe body of evidence (the options, benefits and harms) and considering the patient'svalues and preferences.

The degree to which healthcare professionals can practice EBM and SDM is dependentupon the availability of information about the patient (e.g., medical diagnosis,therapies as well as laboratory and administrative information) and medical evidence(such as medical guidelines). Patient information is a prerequisite for making decisionsabout the care of individual patients and it is evidence-based medicalknowledge, clinical expertise as well as patient values and preferences that guidethese decisions. Moreover, for patients to be able to communicate values and preferencesas well as participate effectively in their own care, they need to have a basicunderstanding of their condition and treatment options, and the consequences ofeach. Hence, they need access to the same information streams—in "patientaccessible"form—as their physician(s) and care team throughout their journey (process)in healthcare. However, making the right decisions about the care of individualpatients at the right time and place is a challenge for healthcare professionals. Due tointeroperability issues, existing information systems do not support a seamless flowof patient information along the patient process. Healthcare professionals are thereforeunable to easily access up-to-date information about the patient at the right timeand place. The situation is complicated further by the fragmentation of medical evidencein different repositories and its presentation by diverse providers, each withunique ideas about how information should be organized and how search enginesshould function. Limited or no access to relevant patient information and the bestmedical evidence about the benefits and risks of treatment options can result inflawed decisions and, more seriously, the suffering of patients. The situation also affectsSDM. If patients are not informed about their health condition, treatment options,benefits and risks or not given high quality information, e.g., becausehealthcare professionals do not have access to the best evidence, patients will be unIIable to assess 'what it is important to them', or they will make inadequate decisionsabout key issues. Consequently, it is almost impossible to practice EBM and SDM ineveryday clinical care.

For EBM and SDM to serve their purpose, healthcare professionals and patients needinformation systems that provide quick and trouble-free access to all-round information.They also need information systems that can influence the patient/physicianrelationship and facilitate their pursuance of shared goals in the healthcare process,taking into account both illness and personal experience. Hence, based on a qualitativeapproach, this thesis proposes recommendations regarding the redesign of futurehealthcare information systems in ways that will facilitate, rather than hinder,the access to relevant information. One important recommendation identified is thatfuture healthcare information systems must support the core characteristics of EBMand SDM, in an integrated manner, and using the one without the other is notenough. However, such support requires the adoption of a process view on informationsystem development based on the patient's process. A process-oriented approachwith supporting information systems is thus vital for the support of an evidence-based practice where the patient is an important and active collaborator.Moreover, the challenges identified with regard to information system support arenot exclusively technical. Organizational culture, and the attitudes of healthcare professionalsto patient involvement are some of the biggest challenges facing healthcareorganizations.

Place, publisher, year, edition, pages
Göteborg: BrandFactory AB, 2018
Series
Dissertation Series ; 19 (2018)
National Category
Information Systems
Research subject
Information Systems
Identifiers
urn:nbn:se:his:diva-15210 (URN)978-91-984187-1-2 (ISBN)
Public defence
2018-05-22, Skövde, 13:00 (English)
Opponent
Available from: 2018-06-12 Created: 2018-05-31 Last updated: 2018-06-14Bibliographically approved

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Krasniqi, HanifePersson, Anne

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