DISA · DOME · eHealth · Medical Records Online

New article published about the effects of patient accessible electronic health records on the work environment of oncology healthcare professionals!

Health Informatics Journal

Yesterday, the first journal article based on the large observation/interview/survey study about the effects of patient accessible electronic health records (PAEHRs) on oncology healthcare professionals was finally published in Health Informatics Journal! The article, “Oncology health-care professionals’ perceived effects of patient accessible electronic health records 6 years after launch: A survey study at a major university hospital in Sweden”, focuses on a survey covering  questions about effects of PAEHR on contacts with patients, documentation practices and care quality as well as supposed effects for patients. The survey was handed out to physicians and nurses by the heads of all departments at Uppsala University Hospital that were associated with blood and tumor diseases. This, in part, explains the unusually high response rate of around 72%. I led the data collection and analysis of this study and wrote the article together with Åsa Cajander at my former department at Uppsala University.

In the article we present several results, related to the areas mentioned above, from one of the first large follow-up studies in Sweden about clinician-perceived effects of PAEHR several years after launch of the system. Some of the key results are:

  • Oncology care professionals believe that it is generally a good idea to give patients access to their medical records through the PAEHR
  • There is a small effect regarding increased patient contacts, like e.g. more phone calls and longer visits
  • The strongest identified effect (although, still fairly small) concerns documentation practices. Especially, the respondents experienced that they are more restrictive in their notes now. This effect mostly concerns other conditions than cancer, like obesity and mental illness
  • The majority of the respondents do not see that the care has become safer as an effect of patients accessing the PAEHR
  • There were very few significant differences between the answers from physicians and nurses

The article is published open access here, where you can find more results and details about the study. As has been the case for our earlier eHealth studies published lately, a press release has also been published by Uppsala University about this new study. You can find the press release (in Swedish) here. Let’s see how the new travels this time around!

Here is the article’s abstract:

Patient accessible electronic health records have been launched in many countries, and generally, health-care professionals have had strong initial concerns related to the areas patient contact, documentation practices and quality of care. Especially, oncology care was discussed in media when launching patient accessible electronic health records in Sweden. However, few studies have investigated clinician-perceived effects several years after the launch. A survey covering these areas, as well as supposed effects for patients, was distributed to oncology health-care professionals 6 years after the launch of patient accessible electronic health records and answered by N = 176. Results show that patient accessible electronic health records have had small effects within the covered areas, and that the area most affected was documentation practices. Very few significant differences could be found between physicians and nurses. A comparison with results from interviews and surveys conducted shortly after the launch of patient accessible electronic health records clearly indicates that the experienced negative effects are not as big as originally feared.

In parallel with the work on the recently published survey study, a larger research group, also consisting of researchers from the DOME consortium, continues working with interviews with the oncology care professionals at Uppsala University Hospital. Thus, we will also provide you with more qualitative results on this topic.

DISA · DOME · eHealth · Popular science

Time to write a new book chapter!

Långe Jan

Quite a while ago I joined a group, as a co-author, that submitted a book chapter proposal (abstract) for a (hopefully) forthcoming book on gendered norms at work. I’m certainly not a gender expert, but I do have a lot of experience from studying effects of technology in the healthcare area, which is the book’s focus area. Last, week, I got a confirmation email that the book proposal had been accepted by the publisher and that it was time to start writing the chapters!

The chapter will be based on experiences from interviews and observation studies at Uppsala University Hospital, like e.g. the observation/interview/survey study on the Oncology department which I have written about before. There are quite a few interesting results from the latest studies performed at the hospital, which can be problematized from a gender perspective. I will not give any more details about the chapter before I know how the review process will be carried out.

This is the second book chapter I’m involved in. I write about my first ever book chapter here. That chapter was published in the Swedish popular science book “Digitalisering av högre utbildning” [Digitalization of higher education], which is now used in the teacher education at some universities. I’m not sure how the new book on gendered norms at work will be used, but I’m sure it will give us an opportunity to reach a wider audience than we do with our journal and conference papers.

The first draft should be submitted in the beginning of March, and about one month after that I should know a lot more about what happens with the book chapter.

I couldn’t really find a blog image that matches the content of this post, so once again I have used one of my own nature pictures – this time from my last trip to Öland.

conference · DISA · DOME · eHealth · Medical Records Online · National patient survey

Two papers submitted to Medical Informatics Europe 2020!


During August and September I have been working on two papers for the annual conference Medical Informatics Europe, together with colleagues from Uppsala University and University of Skövde, respectively. Next year’s version of the conference will be held in Geneva, Switzerland, April 28 – May 1. I will mention the papers briefly in this blog post, since they are not subject to a blind review. I will write more about them in later posts when they have (hopefully) been accepted. I’m the main author of both papers.

Both papers are based on data that were gathered while I was working as a postdoctoral researcher at Uppsala University. One of the papers, written together with Åsa Cajander from Uppsala University, is based on interview results from the large interview/survey/observation study on patient accessible electronic health records (PAEHRs) presented in this blog post. In this paper we focus on the effect of PAEHR on nurses’ work.

The other paper, written together with Hanife Rexhepi from University of Skövde, is based on results from the national patient survey which I introduced in this blog post. The focus in this case is on the effect of PAEHR on communication with medical professionals and on involvement in the care process.

This is the second time I contribute with papers to a MIE conference – the first time was in 2018 when MIE was held in parallel with Vitalis. That time around I was co-author of two papers and responsible for a workshop. I wrote about the presentation of one of the papers, also focusing on the effect of PAEHR on nurses’ work, in this blog post. In this blog post I write about the presentation of the other paper, focusing on differences between county councils/regions in Sweden when it comes to access to information in the PAEHR. You can read about our workshop, on the use of patient data for diagnoses and treatment of cancer, in this blog post.

I really enjoyed attending the MIE conference last time, and I’m positive it will be a nice experience this time around as well. The deadline for full paper (5 pages) submissions was recently postponed until October 15, so there is still time to submit research contributions to the conference!


conference · DISA · DOME · eHealth · Medical Records Online · Vitalis

Today’s presentation at Medical Informatics Europe was successful!


As I mentioned in yesterday’s blog post, Åsa Cajander and I had a presentation to carry out at the Medical Informatics Europe conference today. We got 11 minutes to present (which is a really short time if you want to describe a study and its results in a good way) and we were done after 11.03 minutes! I started with presenting myself, Åsa and the DOME consortium (the image above, taken by our colleague Hanife Rexhepi, is from that phase of the presentation) and then moved on to introduce Journalen, the patients accessible electronic health record system in Sweden, and the interview study with nurses. Åsa then continued by going through the four main themes that were found during the analysis (themes related to the effect of Journalen on the nurses’ work environment and their communication with patients); “Altered contacts”, “Increased workload”, “Creates uncertainty” and “Requires new knowledge”. You can read more about these themes and results related to them in the paper which you can find a direct DOI link to here.

I concluded by highlighting some important take-away messages from the study:
• The enhanced communication, which Journalen is perceived to give, is key to shared decision making!
• Both nurses and physicians see a risk with patients accessing unsigned notes and increased workload when patients request clarifications
• There is an identified need to educate both medical professionals and patients in how to use systems like Journalen

Usually, after you have presented something at a conference, you can relax for a bit but that wasn’t the case for Åsa and me. A few rooms away, our DOME colleague Maria Hägglund presented the study Timing It Right – Patients’ Online Access to Their Record Notes in Sweden in a session parallel to ours. Luckily, we managed to switch rooms in time for her presentation. I will write a separate post about that later.

Tomorrow, I will be presenting again – this time at Vitalis. The same goes for several other DOME colleague as well as representatives from Inera. After a nice dinner with several colleagues from Uppsala University and DOME, Hanife and I had a test run of our presentation, which will take the form of a role-play contrasting physicians’ and patients’ views on Journalen. That will be an interesting experience! We have two hours (13:00-15:00 in room A5) with several short presentations using different presentation modes as well as Mentimeter questions for the audience. If you are at Vitalis and are interested in Journalen and similar health record systems, I can really recommend that session.

conference · DISA · DOME · eHealth · Medical Records Online · Vitalis

Getting ready to present at Medical Informatics Europe!


Those who follow my blog have probably noticed that I have not posted anything since the end of March. This is mostly due to an episode of my autoimmune disease. I will write more about that in a later blog post, since my situation could actually have become a lot worse if it hadn’t been for me being able to access my medical records, and most importantly test results, online before the physician had a chance to contact me about changes.

Right now, I’m actually in Gothenburg, getting ready for my first presentation at the Medical Informatics Europe conference tomorrow! As I already wrote in an earlier blog post one of the paper that I co-authored, “Medical Records Online for Patients and Effects on the Work Environment of Nurses”, is scheduled for the last afternoon session. More specifically the session will take place 15:30-17:00. If you are at the conference you will be able to listen to the presentation, which Åsa Cajander and I will hold together, in room F5.

All MIE papers are published Open Access and you can find a post-print version of the paper here. If you follow this link you will find electronic versions of all papers presented during the conference.

I’m really looking forward to this combined MIE/Vitalis conference which I think will be very interesting and it’s also great that many colleagues are joining. Several colleagues from the HTO group at Uppsala University are here and I actually just got back from a dinner with Åsa Cajander, Diane Golay and Christiane Grünloh. Tomorrow several others will join both from the HTO group and the DOME consortium. Tomorrow, I will probably also be back with another post on how the presentation went as well as on our preparations for Wednesday’s DOME session at Vitalis!


DISA · DOME · eHealth · Interact · Medical Records Online

Another visit from Germany and a lot of good progress!


Christiane Grünloh, who came from Germany to visit as a few weeks ago (see this blog post), came back to us this week. The main reason for her visit was once again to work with us in the large eHealth studies which I’m currently leading. As always, it was nice to have her with us and we got a lot of things done during these few days. First of all, we got several interviews done for this study. I will not discuss results here, since it is too early in the process and nothing has been analyzed, but after these days I’m sure that the study will give a lot of new insight. I also learned that Christiane is a very talented interviewer! It was obvious that she is a good active listener and that she can create a nice atmosphere during the interviews.

While Christiane was here, we also discussed about possibilities for writing CHI-papers and I think we came up with some really good ideas. I will try two write one related to mediated communication and haptic feedback and one, together with other researchers in DOME, related to eHealth. We also discussed ideas for submissions to other conferences. I will of course write more about this in future blog posts.

We also had progress when it came to accepted papers. A while ago I wrote a blog post about some papers being submitted to Interact. Yesterday we learned that one of them, a method paper about a workshop the DOME consortium hosted last autumn, had been conditionally accepted! I will write more about it when we have a final answer after resubmit. This also means that Christiane will get funding for visiting the conference in Mumbai, which in turn means that we (Åsa Cajander, Christiane and I) can submit a prepared workshop paper to the same conference (I will write another post about that if the WS contribution gets accepted)! The other paper we sent to Interact, about nurses’ views on patient accessible electronic health records, did not get accepted this time. But, we do have a plan for the future of that paper.

So, we had a lot of good progress this week and I hope we will have more of these weeks ahead of us!


DISA · DOME · Medical Records Online · National patient survey

Workshop day with DOME researchers


This week, Christiane Grünloh (Ph.D. student from KTH and one of the researchers within the DOME consortium) is visiting Uppsala University to work mostly with the oncology interview study but also the national patient survey. Today, Gunilla Myreteg and Maria Hägglund, also from DOME, joined us. In the picture above we are looking at and discussing the current interview template (from left to right: me, Christiane, Gunilla and Maria). It was very nice to work together in this small group – normally we are spread out and communicate only via Skype.

Christiane, Maria and I started out by going through the interview questions once again, since we have not yet conducted any of the interviews with physicians at the oncology department. We did some updates and piloted the interview with Gunilla when she arrived. We are not sure, but hopefully we can do the first interview(s) tomorrow.

During the last hour we also discussed what was needed to be able to finalize an overview article about the national patient survey. It should not take long before we have a manuscript ready!

We ended the day with a nice dinner at an Italian restaurant in Uppsala, where more persons, mostly from the HTO group at Uppsala University, also joined. Even though we did not spend the entire day writing on the overview article for the national patient survey as we planned from the beginning, we still had a very productive day. Hope we will all meet again soon!


DISA · DOME · eHealth · Medical Records Online

A new eHealth research adventure is about to start!


The ethics application I wrote about quite a while ago, regarding a new large observation/interview/survey study conducted by DOME researchers, has now finally been approved! This means that a new eHealth research adventure will now begin for the research team (presented here)! The following parts are planned for this study:

·         Five full-day observations with nurses at different divisions of the Oncology department at Uppsala University hospital. The focus here is on use of technology in the daily activities

·         Interviews with 20 physicians and 20 nurses at the Oncology department, focusing on how patients’ access to electronic health records has affected the work environment and means of communication.

·         A short survey handed out to physicians and nurses, focusing on attitudes towards patient accessible electronic health records.

This will be one of the largest follow-up studies on the effects of patient accessible electronic health records in Sweden to date, so, needless to say, I’m very excited about being able to start the work now!!!

I will continue to write blog posts with updates about the ongoing work, but I will not give out any detailed results until they are published. Stay tuned!  🙂


DISA · DOME · eHealth · Medical Records Online

The team behind a new large study on electronic health records in Sweden


In my last blog post I wrote about the application for ethical review, concerning a new large interview/survey/observation study with doctors and nurses at Akademiska Sjukhuset in Uppsala. The study, which will focus on how patient access to their medical records online has affected the work environment for physicians and nurses, will probably start during March. Since we are currently waiting for the results from the ethical review, this seems like a good time to introduce the team members behind the study.

The study is part of the DOME consortium, which collects researchers with a common interest in online electronic health records and their effects on patients and medical staff. The researchers come from different universities in Sweden. DISA (The effects of digitalization on the work environment for nurses) is a newly started project within the DOME consortium and the study I’m leading is the first study carried out within that project.

As many as 8 researchers and 2 medical doctors are behind this study;

Uppsala University:

  • Jonas Moll (In case you don’t realize whose blog you are reading – this is me! 🙂. I’m postdoc in Human-Computer Interaction at the IT-department and I lead this study)  [Researchgate]
  • Åsa Cajander (An associate professor in Human-Computer Interaction at the IT-department, who is the main responsible for the study and also the leader of DISA and the DOME-consortium)  [Blog] [Twitter] [Researchgate]
  • Isto Huvila (A professor in Information Studies at the ALM department)  [Blog] [Twitter] [Researchgate]


Uppsala University Hospital (Akademiska Sjukhuset):

  • Gustaf Hedström (A medical doctor with a Ph.D. degree in Oncology, at the department of Immunology, Genetics and Pathology)  [Researchgate]
  • Ingrid Glimelius (A medical doctor with a Ph.D. degree in Oncology, at the department of Immunology, Genetics and Pathology)  [Researchgate]


Karolinska Institutet:

  • Maria Hägglund (A researcher in Health Informatics with a Ph.D. degree in Medical Informatics, at the department of Learning, Informatics, Management and Ethics)  [Blog] [Twitter] [Researchgate]


Royal Institute of Technology:

  • Christiane Grünloh (A Ph.D. student in Human-Computer Interaction at the School of Computer Science and Communication)  [Twitter] [Researchgate]


University of Skövde:

  • Rose-Mharie Åhlfeldt (An associate professor in Computer Science at the IT-institution)  [Twitter] [Researchgate]
  • Hanife Rexhepi (A Ph.D. student in Information Technology at the IT-department)  [Twitter][Researchgate]


Örebro University:

  • Gunilla Myreteg (An associate professor in Business Economics at the School of Business)  [Researchgate]


The group introduced briefly above is highly multi-disciplinary, which I am sure will prove to be valuable for the study. Stay tuned for more!  🙂