The second day of this week’s summer school was spent at Uppsala University in Gustavianum – one of the University’s oldest buildings. This was a lecture intense day, with many interesting areas covered and apart from researchers from Uppsala Univeristy, there was also a physician, an IT-strategist and a manager among the speakers!
The first half of this day was focused on patient accessible electronic health records. Benny Eklund, IT strategist at Uppsala county council, started out by discussing some of the highlights from the winding journey towards establishing patient accessible electronic health records in Sweden. Among other things he mentioned important enablers, barriers and success factors. He also brought up the contrast between the medical professionals’ fears and the patients’ overall positive response towards the possibilities that the system can give. Benny also demoed Journalen.
The next two talks, about the professionals’ perspective and the patients’ perspective, were related to the contrast that Benny brought up. Christiane Grünloh (see picture above) and Åsa Cajander brought up the professionals’ perspective and I presented the patients’ perspective in the form of results from the national patient survey I have been writing about before on this blog. Common issues raised by doctors were e.g. that they see the record as their work tool (primarily for communication among medical professionals, not with patients), that the workflow can be disrupted (patients see results before they do), and that workload increases (more calls, etc.). When it comes to patients the results are a lot more positive regarding attitudes and possibilities. I will write more about results from the survey when those results are published.
After lunch Birgitta Wallgren, who has had different manager positions at Uppsala University Hospital for years, talked about work with a new surgical planning system. She made several important points and I will only bring up a few here. One of the main points was that you need to know as well as respect the organization structure if you want to make a change, conduct studies, etc. If you just pick someone in the middle of the organization it will not work – you need to locate the right manager. In this case she managed to gather 19 medical professionals at various levels one day a week during 4 months! That is quite impressive! Another point related to the workflow. She emphasised several times that it is of utmost importance to take the workflow into account when designing new systems – this was the first thing they did when they started to work towards the new surgical planning system the talk focused on (they also mapped out the work process they wanted to have – this is not necessarily the same as the current one). Based on the results they started designing a system which was adapted to the target workflow. The 19 medical professionals mentioned above made sure that the team was on the right track.
The last speaker was Gunnar Enlund, chief physician at Uppsala University Hospital. He discussed practical consequences of IT-systems in an operating theater. One of his first pictures showed (a simplified) chart with available IT-systems and how they depended on each other. That chart was very complex! He also campared the situation long ago (one doctor for each patient) to the situation today (often over 100 medical professionals per patient). This highlights the importance of 1) designing for working teams and 2) designing systems that are usable for different teams in different parts of the care process. He also brought up several examples of how IT-systems can cause stress. One key problem, which was in focus during the end of the talk was that of integration. Quite often the same information needs to be registered in two different systems, since values entered in one system are not automatically copied! This certainly doesn’t save time! They have been working on this issue for quite some time, but they currently don’t have a working solution for the integration problem.
Before I end this post I also want to mention today’s lunch break which included a guided tour between some of the important buildings close to Gustavianum (like the cathedral and University library) and Gustavianum itself! Unfortunately I could not take an active part in the guiding activity, but my colleagues from Uppsala University presented one builing and two famous Swedes each. It was a very nice and well organized activity!