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  • 1.
    Alklind Taylor, Anna-Sofia
    et al.
    Högskolan i Skövde, Institutionen för kommunikation och information. Högskolan i Skövde, Forskningscentrum för Virtuella system.
    Backlund, Per
    Högskolan i Skövde, Institutionen för kommunikation och information. Högskolan i Skövde, Forskningscentrum för Virtuella system.
    Engström, Henrik
    Högskolan i Skövde, Institutionen för kommunikation och information. Högskolan i Skövde, Forskningscentrum för Virtuella system.
    Johannesson, Mikael
    Högskolan i Skövde, Institutionen för kommunikation och information. Högskolan i Skövde, Forskningscentrum för Virtuella system.
    Krasniqi, Hanife
    Lebram, Mikael
    Högskolan i Skövde, Institutionen för kommunikation och information. Högskolan i Skövde, Forskningscentrum för Virtuella system.
    Acceptance of Entertainment Systems in Stroke Rehabilitation2009Inngår i: Proceedings of IADIS Game and Entertainment Technologies 2009 (GET 2009), IADIS Press , 2009, s. 75-83Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Game-based tools for rehabilitation of different types of physical and cognitive impairments are becoming more and more popular. By introducing an element of fun, these systems aim at increasing patients' motivation to train and, from a further perspective, improve recovery rates. There is, however, a question whether such tools will be fully accepted by the intended target group. Earlier work on user acceptance has mainly focused on utility systems, i.e. systems used mainly in the work place. However, people use systems for different reasons and that makes it difficult to apply the same principles on systems with the main purpose to entertain. Serious games have characteristics from both utility and entertainment systems, which makes it interesting to study the acceptance of these kinds of systems. In this study, we have developed a home-based entertainment system for stroke rehabilitation, with focus on rehabilitation of motor impairments. By analysing the gaming behaviour and interview responses of five stroke patients, we investigate factors influencing user acceptance of this specific type of system. The results show that current models of acceptance are not sufficient to fully explain acceptance of serious games in general and serious games for rehabilitation in particular. Besides well-known factors, such as perceived usefulness, perceived ease-of-use and perceived enjoyment, other, more specific, factors also play a vital role in the acceptance of the system.

  • 2.
    Cajander, Åsa
    et al.
    Uppsala University, Uppsala, Sweden.
    Grünloh, Christiane
    KTH Royal Institute of Technology, Sweden / CUAS Cologne University of Applied Sciences, Gummersbach, Germany.
    Rexhepi, Hanife
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Worlds Apart - Doctors’ Technological Frames and Online Medical Records2015Inngår i: INTERACT 2015 adjunct proceedings: 15th IFIP TC.13 International Conference on Human-Computer Interaction 14 to 18 September 2015, Bamberg, Germany / [ed] Christoph Beckmann & Tom Gross, Bamberg: University of Bamberg Press , 2015, s. 357-367Konferansepaper (Fagfellevurdert)
    Abstract [en]

    The ability of individuals to access and use their online medical records serves as one of the cornerstones of national efforts to increase patient empowerment and improve health outcomes. However, the launch of online medical records in Uppsala County, Sweden, has been criticized by the medical profession and the local doctors’ union. The aim of this paper is therefore to present the results from an exploratory study where interviews with two oncologists are analysed and discussed based on the theory of Technological Frames and Patient Empowerment. The results indicate that medical doctors have different assumptions and perspectives that affect their use of technology and how they view patient empowerment in everyday clinical work.

  • 3.
    Gruenloh, Christiane
    et al.
    KTH Royal Institute of Technology, Stockholm, Sweden / TH Köln, Gummersbach, Germany.
    Haslwanter, Jean D. Hallewell
    FH Oberösterreich, Wels, Austria / TU Wien, Vienna, Austria.
    Kane, Bridget
    Karlstad University Business School, Karlstad, Sweden.
    Lee, Eunji
    SINTEF ICT, Oslo, Norway.
    Lind, Thomas
    Uppsala University, Sweden.
    Moll, Jonas
    Uppsala University, Sweden.
    Rexhepi, Hanife
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Scandurra, Isabella
    Örebro University, Sweden.
    Using Critical Incidents in Workshops to Inform eHealth Design2017Inngår i: Human-Computer Interaction – INTERACT 2017: 16th IFIP TC 13 International Conference Mumbai, India, September 25–29, 2017 Proceedings, Part I / [ed] Regina Bernhaupt, Girish Dalvi, Anirudha Joshi, Devanuj K. Balkrishan, Jacki O'Neill, Marco Winckler, Cham: Springer, 2017, s. 364-373Konferansepaper (Fagfellevurdert)
    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.

  • 4.
    Grünloh, Christiane
    et al.
    School of Computer Science and Communication, KTH Royal Institute of Technology, Stockholm, Sweden / Institute of Informatics, Technische Hochschule Köln, University of Applied Sciences, Gummersbach, Germany.
    Myreteg, Gunilla
    Department of Business Studies, Uppsala University, Uppsala, Sweden.
    Cajander, Åsa
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Rexhepi, Hanife
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    "why do they need to check me?" patient participation through ehealth and the doctor-patient relationship: Qualitative study2018Inngår i: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 20, nr 1, artikkel-id e11Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Roles in the doctor-patient relationship are changing and patient participation in health care is increasingly emphasized. Electronic health (eHealth) services such as patient accessible electronic health records (PAEHRs) have been implemented to support patient participation. Little is known about practical use of PAEHR and its effect on roles of doctors and patients. Objective: This qualitative study aimed to investigate how physicians view the idea of patient participation, in particular in relation to the PAEHR system. Hereby, the paper aims to contribute to a deeper understanding of physicians' constructions of PAEHR, roles in the doctor-patient relationship, and levels and limits of involvement. Methods: A total of 12 semistructured interviews were conducted with physicians in different fields. Interviews were transcribed, translated, and a theoretically informed thematic analysis was performed. Results: Two important aspects were identified that are related to the doctor-patient relationship: roles and involvement. The physicians viewed their role as being the ones to take on the responsibility, determining treatment options, and to be someone who should be trusted. In relation to the patient's role, lack of skills (technical or regarding medical jargon), motives to read, and patients' characteristics were aspects identified in the interviews. Patients were often referred to as static entities disregarding their potential to develop skills and knowledge over time. Involvement captures aspects that support or hinder patients to take an active role in their care. Conclusions: Literature of at least two decades suggests an overall agreement that the paternalistic approach in health care is inappropriate, and a collaborative process with patients should be adopted. Although the physicians in this study stated that they, in principle, were in favor of patient participation, the analysis found little support in their descriptions of their daily practice that participation is actualized. As seen from the results, paternalistic practices are still present, even if professionals might not be aware of this. This can create a conflict between patients who strive to become more informed and their questions being interpreted as signs of critique and mistrust toward the physician. We thus believe that the full potential of PAEHRs is not reached yet and argue that the concept of patient empowerment is problematic as it triggers an interpretation of "power" in health care as a zero-sum, which is not helpful for the maintenance of the relationship between the actors. Patient involvement is often discussed merely in relation to decision making; however, this study emphasizes the need to include also sensemaking and learning activities. This would provide an alternative understanding of patients asking questions, not in terms of "monitoring the doctor" but to make sense of the situation.

  • 5.
    Hedström, Karin
    et al.
    Örebro University.
    Jäger, Kerstin
    Högskolan i Skövde, Institutionen för teknik och samhälle.
    Krasnizi, Hanife
    Högskolan i Skövde, Forskningscentrum för Informationsteknologi. Högskolan i Skövde, Institutionen för kommunikation och information.
    Linderoth, Henrik
    Högskolan i Skövde, Institutionen för teknik och samhälle.
    Nohlberg, Marcus
    Högskolan i Skövde, Forskningscentrum för Informationsteknologi. Högskolan i Skövde, Institutionen för kommunikation och information.
    Persson, Anne
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Åhlfeldt, Rose-Mharie
    Högskolan i Skövde, Forskningscentrum för Informationsteknologi. Högskolan i Skövde, Institutionen för kommunikation och information.
    Vårdens framtida informationssystem - Vision i form av en demonstrator: Slutrapport.2010Rapport (Annet (populærvitenskap, debatt, mm))
  • 6.
    Krasniqi, Hanife
    et al.
    Högskolan i Skövde, Institutionen för kommunikation och information. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Persson, Anne
    Högskolan i Skövde, Forskningscentrum för Informationsteknologi. Högskolan i Skövde, Institutionen för kommunikation och information.
    Web-based Knowledge Portals in Swedish Healthcare: Overview and Challenges2012Inngår i: 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, s. 9-12Konferansepaper (Fagfellevurdert)
    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.

  • 7.
    Krasniqi, Hanife
    et al.
    Högskolan i Skövde, Institutionen för kommunikation och information. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Åhlfeldt, Rose-Mharie
    Högskolan i Skövde, Institutionen för kommunikation och information. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Persson, Anne
    Högskolan i Skövde, Institutionen för kommunikation och information. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Patients' Experiences of Communicating with Healthcare - an Information Exchange Perspective2011Inngår i: Proceedings of the 15th International Symposium on Health Information Management Research (ISHIMR 2011) / [ed] Bath, P. A., Mettler, T., Raptis, D. A. & Sen, B. A., University of Zurich , 2011, s. 241-251Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Aims: To explore on how patients experience the information exchange with healthcare organizations and how this relates to the six areas that constitute good quality care.Method: A qualitative approach inspired by Grounded Theory was adopted. Seven interviews with patients were carried out in the homes of patients.Conclusion: Healthcare does not always meet the requirements of Health and Medical Services Act with regard to good quality health. An effective exchange of information between health professionals and patients was found as a key issue for creating the conditions for good quality care.

  • 8.
    Moll, Jonas
    et al.
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Rexhepi, Hanife
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Cajander, Åsa
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
    Grünloh, Christiane
    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 School of Business, Örebro, Sweden.
    Åhlfeldt, Rose-Mharie
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Patients’ Experiences of Accessing Their Electronic HealthRecords: National Patient Survey in Sweden2018Inngår i: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 20, nr 11, artikkel-id e278Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 9.
    Rexhepi, Hanife
    Högskolan i Skövde, Institutionen för informationsteknologi.
    BRIDGING THE INFORMATION GAP: Supporting Evidence-Based Medicine and Shared Decision-Making through Information Systems2018Doktoravhandling, med artikler (Annet vitenskapelig)
    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.

  • 10.
    Rexhepi, Hanife
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Improving healthcare information systems: A key to evidence based medicine2015Licentiatavhandling, med artikler (Annet vitenskapelig)
    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.

  • 11.
    Rexhepi, Hanife
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Information Systems for the Practice of Evidence-Based Medicine and Shared Decision Making2016Inngår i: Proceedings of the 10th European Conference on Information Systems Management: The University of Ebora, Portugal, 8-9 September 2016 / [ed] Paulo Silva, Rui Quaresma, António Guerreiro, Academic Conferences and Publishing International Limited, 2016, s. 258-270Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Evidence-based medicine (EBM) and shared decision making (SDM) are both essential for the quality of healthcare. Using information systems to support EBM and SDM has been proposed as one of the important initiatives to significantly improve quality of care. They play a crucial role by allowing healthcare practitioners to access information and clinical evidence while formulating their patient care strategies. They can also create new opportunities for patients to participate actively in their care. However, current information systems solutions are far away from this perspective for various reasons.  The aim of this paper is to present and illustrate how a prototype visualization of a process support system (PSS) can enhance the communication and collaboration among healthcare providers and patients by improving the access to patient information and medical knowledge, in so doing support the practice EBM and SDM. An important conclusion from this research is that a process support as the one described in this paper can reshape the practice of EBM and SDM.

  • 12.
    Rexhepi, Hanife
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Process oriented information systems: A key to evidence based medicine2015Inngår i: IADIS International Journal on Computer Science and Information System, ISSN 1646-3692, E-ISSN 1646-3692, Vol. 10, nr 1, s. 64-79Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The primary and basic component of healthcare is information. Being a healthcare practitioner involves using medical knowledge and patient information to deliver the best possible care. When decisions about the care of the patient are made they must as far as possible be based on research-derived evidence rather than on clinical skills and experience alone. This decision process is complex as evidence is infrequently available in a form that can be acted upon at the time decisions must be made. The aim of this paper is to present and illustrate how a prototype visualization of a process support system can support the availability of relevant medical knowledge in a way which seamlessly integrates with healthcare practitioners work practice, and thereby enables healthcare practitioners to work in accordance with EBM. An important conclusion from this research is that a process support as the one described in this paper can reshape the practice of EBM.

  • 13.
    Rexhepi, Hanife
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Supporting evidence based medicine: A prototype for future healthcare information systems2015Inngår i: Information Systems 2015: Proceedings of the 8th IADIS International Conference, 2015, s. 185-195Konferansepaper (Fagfellevurdert)
    Abstract [en]

    The primary and basic component of healthcare is information. Being a healthcare practitioner involves using medical knowledge and patient information to deliver the best possible care. When decisions about the care of the patient are made they must as far as possible be based on research-derived evidence rather than on clinical skills and experience alone. This decision process is complex as evidence is infrequently available in a form that can be acted upon at the time decisions must be made. The aim of this paper is to present and illustrate how a prototype visualization of a process support system can support the availability of relevant medical knowledge in a way which seamlessly integrates with healthcare practitioners work practice, and thereby enables healthcare practitioners to work in accordance with EBM. An important conclusion from this research is that a process support as the one described in this paper can reshape the practice of EBM

  • 14.
    Rexhepi, Hanife
    et al.
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Cajander, Åsa
    Uppsala Universitet.
    Åhlfeldt, Rose-Mharie
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Huvila, Isto
    Uppsala Universitet.
    Cancerpatienter och användningen av journal via nätet2015Rapport (Annet vitenskapelig)
    Abstract [sv]

    I tre år har patienter i landstinget i Uppsala kunnat läsa sina journaler via nätet och haft tillgång till en rad eHälsotjänster såsom att följa remisser, se läkemedelslista och den lista med namn på vårdpersonal som använt deras journal. Att patienter skulle kunna fara illa när de får svåra besked via sin journal på nätet var en av många farhågor som Uppsala Allmänna Läkarföreningen (UAL) hade när projektet med direktåtkomst sjösattes hösten 2012 inom ramen för ett EU-projekt, SUSTAINS. Andra farhågor som UAL hade gällde att patienterna inte skulle förstå texten i journalen, och att de skulle bli oroade utan att ha möjlighet att fråga någon vårdpersonal om t ex provsvar. För att ta reda på patientens upplevelser av och förväntningar på e-tjänsten ”Min journal” genomfördes en intervjustudie med 30 cancerpatienter på Onkologen, Akademiska sjukhuset i Uppsala som en del av det Vinnovafinansierade DOME-projektet. Resultatet av intervjuerna ger en bra bild av varför patienter läser sin journal och använder eHälsotjänster samt varför man väljer att inte läsa sin journal. Bland annat framgår av resultatet att en stor majoritet av patienterna är positiva till tjänsten och upplever att det finns en nytta med att kunna läsa sin journal. Bland annat tycks tillgången till journalen förbättra möjligheten till förberedelser inför ett läkarbesök och öka tryggheten och delaktigheten i den egna vården. Även de patienter som inte har erfarenheter av att läsa sin journal via nätet ser en viktig nytta med tjänsten. Vidare upplever några patienter en oro över att obehöriga ska få tillgång till informationen. Det finns dock en underliggande förväntan hos samtliga patienter att e-tjänsten håller hög säkerhetsnivå. Av studien kan man dra slutsatsen att det finns ett behov av att studera hur e-tjänsten ”Min journal” kan länkas med övriga eHälsotjänster som ett led i att effektivisera tillgången till information.

  • 15.
    Rexhepi, Hanife
    et al.
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Persson, Anne
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Challenges to Implementing IT Support for Evidence Based Practice Among Nurses and Assistant Nurses: A Qualitative Study2017Inngår i: Journal of Electronic Commerce in Organizations, ISSN 1539-2937, E-ISSN 1539-2929, Vol. 15, nr 2, s. 61-76Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    When practitioners make decisions as well as treat and care for patients they interpret patient specific information according to evidence based medical knowledge. This process is complex as evidence is infrequently available in a form that can be acted upon at the time decisions must be made. The aim of this paper is to (1) explore how primary, secondary and municipality care in Sweden work with the process of managing knowledge, (2) explore how nurses and assistant nurses experience availability of medical knowledge when and where they need it and (3) conditions for developing a coherent IT-based knowledge portal for different areas of knowledge bases in healthcare. The results show significant deficiencies in the knowledge management process of the participating organizations. The knowledge management processes are not embedded in business processes, activities and relationships, which cause major difficulties for practitioners to keep up with the latest medical evidence.

  • 16.
    Rexhepi, Hanife
    et al.
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Persson, Anne
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Worlds Apart - IT Support Strategies for Evidence Based Medicine Meet Reality2016Inngår i: Proceedings of the 9th IADIS International Conference on Information Systems, 2016, 9–11 April, Vilamoura, Algarve, Portugal / [ed] Miguel Baptista Nunes, Pedro Isaías, Philip Powell, IADIS Press, 2016, s. 3-10Konferansepaper (Fagfellevurdert)
    Abstract [en]

    When practitioners make decisions as well as treat and care for patients they interpret patient specific information according to evidence based medical knowledge. This process is complex as evidence is infrequently available in a form that can be acted upon at the time decisions must be made. The aim of this paper is to (1) explore how primary, secondary and municipality care in Sweden work with the process of managing knowledge, (2) explore how healthcare practitioners’ experience, availability of medical knowledge when and where they need it and (3) conditions for developing a coherent IT-based knowledge portal for different areas of knowledge bases in healthcare. The results show significant deficiencies in the knowledge management process of the participating organizations. The knowledge management processes are not embedded in business processes, activities and relationships, which cause major difficulties for practitioners to keep up with the latest medical evidence.

  • 17.
    Rexhepi, Hanife
    et al.
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Åhlfeldt, Rose-Mharie
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Cajander, Åsa
    Department of Information Technology, Uppsala University.
    Huvila, Isto
    Department of ALM, Uppsala University.
    Cancer Patients’ Attitudes and Experiences of Online Access to their Electronic Medical Records: A Qualitative Study2018Inngår i: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 24, nr 2, s. 115-124Artikkel i tidsskrift (Fagfellevurdert)
    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

  • 18.
    Rexhepi, Hanife
    et al.
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Åhlfeldt, Rose-Mharie
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Cajander, Åsa
    Uppsala University, Department of Information Technology, Uppsala, Sweden.
    Huvila, Isto
    Uppsala University, Department of ALM, Åbo Akademi University, Finland.
    Cancer Patients’ Attitudes and Experiences of Online Medical Records2015Inngår i: Proceedings of the 17th International Symposium on Health Information Management Research – ISHIMR 2015, 2015, s. 19-25Konferansepaper (Fagfellevurdert)
    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 therefore 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 eHealth 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.

  • 19.
    Rexhepi, Hanife
    et al.
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Åhlfeldt, Rose-Mharie
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Persson, Anne
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Challenges and Opportunities with Information System Support for Healthcare Processes: a Healthcare Practitioner Perspective2015Inngår i: Proceedings of the 8th IADIS International Conference Information Systems 2015, IS 2015, 2015, s. 61-69Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Healthcare processes require the cooperation of different healthcare providers and medical disciplines. In such an environment, the quality and safety of care rely heavily on the ability to exchange information from one software to another, and from one person to another. However, information systems that support a seamless flow of information along healthcare processes are not broadly used in healthcare environments. Usually, healthcare organizations have their own autonomously developed information systems that do not support the cooperation of different organizational units and medical disciplines. This has led to the fragmentation of the patients’ information in proprietary heterogeneous systems across healthcare organizations. The aim of this paper is to: (1) explore how healthcare practitioners´ in Sweden experience information system support in their daily work activities, and (2) present and illustrate how key design principles of a process support system prototype can support healthcare practitioners in their work practice. An important conclusion from this research is that a process support as the one described in this paper creates new opportunities to organize and coordinate healthcare

  • 20.
    Rexhepi, Hanife
    et al.
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Åhlfeldt, Rose-Mharie
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Persson, Anne
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Towards effective and efficient information system support for healthcare processes: A healthcare practitioner perspective2015Inngår i: IADIS International Journal on Computer Science and Information System, ISSN 1646-3692, E-ISSN 1646-3692, Vol. 10, nr 1, s. 80-96Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Healthcare processes require the cooperation of different healthcare providers and medical disciplines. In such an environment, the quality and safety of care rely heavily on the ability to exchange information from one software to another, and from one person to another. However, information systems that support a seamless flow of information along healthcare processes are not broadly used in healthcare environments. Usually, healthcare organizations have their own autonomously developed information systems that do not support the cooperation of different organizational units and medical disciplines. This has led to the fragmentation of the patients’ information in proprietary heterogeneous systems across healthcare organizations. The aim of this paper is to: (1) explore how healthcare practitioners´ in Sweden experience information system support in their daily work activities, and (2) present and illustrate how key design principles of a process support system prototype can support healthcare practitioners in their work practice. An important conclusion from this research is that a process support as the one described in this paper creates new opportunities to organize and coordinate healthcare.

  • 21.
    Åhlfeldt, Rose-Mharie
    et al.
    Högskolan i Skövde, Institutionen för kommunikation och information. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Persson, Anne
    Högskolan i Skövde, Forskningscentrum för Informationsteknologi. Högskolan i Skövde, Institutionen för kommunikation och information.
    Krasniqi, Hanife
    Högskolan i Skövde, Institutionen för kommunikation och information. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Wåhlander, Kalle
    Visuera Integration AB, Sankt Erikssgatan 117, SE-113 43 Stockholm.
    Supporting Active Patient and Healthcare Collaboration - A Prototype for Future Healthcare Information Systems2013Inngår i: Proceedings of the 16th International Symposium on Health Information Management Research (ISHIMR 2013). Halifax, June 26-28 2013 / [ed] Sibte, Abidi and Bath, 2013, s. 13-23Konferansepaper (Fagfellevurdert)
    Abstract [en]

    This paper presents and illustrates the main features of a proposed process oriented approach for patient information distribution in future healthcare information systems by using a prototype of a process support system. The development of the prototype was based on Visuera method which includes five various steps. The results indicate that a visualised prototype is a suitable tool for illustrating both the opportunities and constraints of future ideas and solutions in eHealth. The main challenges for developing and implementing a fully functional process support system are both on a technical and organisational/management level.

  • 22.
    Åhlfeldt, Rose-Mharie
    et al.
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Persson, Anne
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Rexhepi, Hanife
    Högskolan i Skövde, Institutionen för informationsteknologi. Högskolan i Skövde, Forskningscentrum för Informationsteknologi.
    Wåhlander, Kalle
    Visuera Integration AB, Sweden.
    Supporting Active Patient and Health Care Collaboration: A Prototype for Future Health Care Information Systems2016Inngår i: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 22, nr 4, s. 839-853Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This article presents and illustrates the main features of a proposed process-oriented approach for patient information distribution in future health care information systems, by using a prototype of a process support system. The development of the prototype was based on the Visuera method, which includes five defined steps. The results indicate that a visualized prototype is a suitable tool for illustrating both the opportunities and constraints of future ideas and solutions in e-Health. The main challenges for developing and implementing a fully functional process support system concern both technical and organizational/management aspects.

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