DOME · eHealth · Medical Records Online

Seminar about the history of patient accessible electronic health records in Sweden

A few months ago I participated in a very interesting session in the seminar series “Current challenges in biomedical information technology” at Uppsala University. The invited speaker was Benny Eklund, IT Strategist, Uppsala county council. Benny’s work and initiatives – starting about 20 years ago – is probably the main reason why we have patient accessible electronic health records in most county councils in Sweden today (the few ones remaining will allow access before we leave 2017). See link to the filmed presentation below!

Åsa Cajander, who has collaborated with Benny for years introduced him before he began his presentation. As she reveals in the introduction students in one of her courses, “IT in society” played a very important role when they, during one of the course rounds, investigated future possibilities for medical records online in Sweden (a topic provided by Benny). The students’ work resulted in a white paper, which was presented in Brussels! Their work certainly helped in attracting necessary funding.

During the session Benny talked mostly about the early history of patient accessible electronic health records in Sweden, like e.g. important decisions made, the many barriers encountered as well as identified enablers and functions included. After listening to the talk it became more clear to me than before that there were many bumps in the road towards the system in use today. I really recommend you to watch the video – I’m convinced that the barriers and enablers brought up to discussion are relevant in many other countries as well where similar systems have been or are about to be introduced.

Link to presentation

 

 

DISA · DOME · eHealth · Interact · Medical Records Online

Another visit from Germany and a lot of good progress!

Christiane_besök2

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!

 

Academic writing · communication · Council · DOME · eHealth · Pedagogical development · Pedagogy

Recently applied for an associate professorship in implementation research

Last Sunday, I finally submitted an application for a position as associate professor in implementation research (didn’t have much of a choice since that was the last day to submit)! One positive outcome, apart from the obvious, is that I really had to think through what different roles I have and how I can make use of them. Since I have not written about all of them on this blog, I will list the different roles I came up with here (some of them will have follow-ups in more focused posts):

  • Researcher in multimodal communication and interactionI have already written about my thesis and quite a few other blog posts about haptics as an interaction modality. My main focus in this role has been to study how different modality combinations affect collaboration and communication in collaborative virtual environments
  • E-health researcherI have already written quite a lot about the studies I have been leading, regarding patient accessible electronic health records, since I stared my postdoc. What I have not yet written about is my earlier contact with healthcare – a quite intense collaboration with physicians at the Gastro department at Karolinska institutet during about two years of my doctoral studies. I will definitely write about that project later on.
  • Pedagogical development researcherA role I have not written that many posts about yet. During an extended period of time I e.g. took part in a study about Twitter use in a higher education course. I will come back to this when a paper has gone through the review process.
  • TeacherAnother role I haven’t written that much about. My teaching has focused on written and verbal communication in engineering sciences, haptics and human-computer interaction. I will definitely come back with blog posts on this topic, especially when it comes to master’s thesis supervision – my favorite teacher role.
  • Software developerI have not written that much about this role either, since it was quite a while ago that I actually developed an application. My focus in this case has been on haptic interfaces and haptic collaborative functions.
  • Member of eHealth councilThis is the newest role, which I wrote a blog post about a while ago – I represent “Education” and “patients” in the eHealth council at the The National Board of Health and Welfare.
  • Research network memberI have written about the DOME consortium several times, but I have not yet written about my participation in the “Nordic Network for ICT and Disabilities”, which specializes in assistive technology for people with deafblindness. I will introduce that network more thoroughly in its own blog post.
  • PatientI am a regular patient since more than a decade ago, and I have already used that in my own research on eHealth at e.g. conferences. This is why I add it as a “role” in this list. There will be plenty of blog posts from the patient’s perspective on this blog – that’s for sure!
  • BloggerNo comment…  🙂

I might have missed a few roles, but I think these are the big ones at least for the moment. As I said earlier, not all these are relevant for the position in implementation research but I started thinking about all of them as I was writing the quite extensive application. Writing this type of application forces you to really think about what you have done and what types of roles you have taken, and I really found it rewarding to reflect on this.

Earlier when I had written these kinds of applications I let them rest in peace and just waited for the decision, but this time I’m not going to leave what I wrote behind me and just hope for the best. This time, I will try to transform my sketched research ideas into funding applications as soon as possible. There will surely be more posts about that process!

DISA · DOME · Medical Records Online · National patient survey

Workshop day with DOME researchers

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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!

 

DOME · eHealth · Medical Records Online · National patient survey · Vitalis

A very successful session about patient accessible electronic health records at Vitalis 2017!

Samlingsbild

I recently got back home to Stockholm again, after three great days at the 2017 version of Vitalis (Senska mässan) in Gothenburg. As I wrote in this blog post, several researchers from the DOME consortium and representatives from Inera and SALAR (Swedish Association of Local Authorities and Regions) were presenting during a 1.5 hours session May 26. We are all very pleased with the outcome and I will try to summaize the main points below (all presentations were in Swedish).

Introduction of the speakers and DOME

DOMEpresentation

The whole session was introduced by Isabella Scandurra, who gave a quick overview. As a part of this introduction every one of the 10 ten persons who should talk during the session, came up on stage and presented themselves shortly. After the introduction, Åsa Cajander presented the history behind the DOME consortium and Patient Accessible Electronic Health Records (PAEHR) in Sweden. The image above show the current partners; Uppsala University, University of Skövde, Örebro University, Karlstad University, Royal Institute of Technology and Karolinska Institutet.

Role play!!

Role_play

After the introduction a role play was carried out between Isabella and Åsa (see picture above). Isabella played the physician (with the 1177.se scarf!) and Åsa the patient and the idea was to present an ideal scenario where Journalen (a PAEHR system in Sweden) was used as a focus in the communication during a patient visit. Unfortunately, Journalen is not used in that way today – it’s seldom mentioned during visits and some example comments from physicians, from earlier interview studies, showed that they were not enthusiastic. Nevertheless, this was a very good way of illustrating the intended use of Journalen, and comments from the audience show that this part of our session was very appreciated.

The national patient survey

Enkät2

Hanife Rexhepi and I were next in line! We presented a collection of results from the large national patient survey. Hanife started by introducing the rationale behind the survey and its basic building blocks, after which I described some demographic results (e.g. that most respondents were from Uppsala and Skåne, that most of them were highly educated and that women were in majority). I also discussed general attitudes, which are very positive as shown in the image above, importance of different information types and common reasons for using Journalen. Hanife then ended with some more results, e.g. stating that the respondents understand most of the contents in Journalen, and a summary.

Journalen for children

Barn

After Hanife’s and my performance it was time for Maria Pettersson from Inera and Martin Price from SALAR to get up on stage and talk about Journalen for children. As it is today, parents can access their child’s PAEHR until the child turns 13 and the child itself then gets automatic access to Journalen from the day he/she turns 16. There is currently a gap, 13-16, where no one gets automatic access. It is, however, possible for the child and/or a parent to apply for direct access. Maria’s introduction (illustrated in the image above) brought this up, as well as how security in that age group can be tackled. Martin then continued with results from studies performed with parents and children, highlighting key aspects regarding e.g. usage, risks, access by parents vs. children and understandability. Quite a few audio recordings with interesting quotes were played during this presentation.

Journalen is the key – for the one who is sick

Jenny

The last presentation was held by Jenny Juremalm from Inera and focused on comments from patients who use Journalen (when logged in to Journalen, there is a possibility to contact Inera and comment on Journalen and how it is being used). In the picture above, there is a summary about why patients want to use Journalen. Most of the points coincide with results from the national patient survey. Access to test results was very high up on the list. It is good that “being in control” and “better communication with care” are also at the top on the list. The facts that all county councils have not yet introduced Journalen (at the end of 2017 everyone should have joined, though) and that different information is shown in different county councils were also brought up to discussion. Increasing the use and taking care in listening to experiences from patients and medical professionals were among the points we need to focus on for the future.

Sneak peek panel and mentometer

Mentometer

The last part consisted of a “sneak peek panel” lead by Rose-Mharie Åhlfeldt, where two of our Ph.D. students from the HTO group at Uppsala University, Ida Löscher and Diane Golay, presented the newly started DISA (The effects of digitalization on the work environment of nurses) project. Åsa presented some preliminary results from the Interact submission about interviews with nurses that I mentioned here and Isabella presented the newly started PACESS (patient-centred assessment of patients’ online access to electronic health records) project.

At the very end, the audience was given the possibility to submit questions to the panel through a mentometer solution. Most of those questions were directed to Maria and Jenny from Inera. In fact, the audience was invited to interact through mentometer after each presentation – a few questions, relevant to the respective presentations, were presented and everyone could see a live presentation of the results as they were pouring in! The mentometer activities were also lead by Rose-Mharie. In the image above the question “How many years will it take until Journalen is used for communication between care professionals and patients?”, and we can see that 5 years won in this case. Isabella, Åsa and Rose-Mharie, shown in the image, are also the three researchers forming the managing team of the DOME consortium.

Short sum up

We were all pleased with our session and the audience also gave very positive comments on several of the presentations! So, I guess it is safe to label our session a success. It was very fun to be a part of this and I especially liked the varying presentation modes (text, diagrams, audio recordings, role play…) and the mentometer interaction with the audience. In fact, we got quite a lot of information from the audience in this way and we may use it for a publication later on! I am very sorry the event is over and I look forward to next year’s version of Vitalis, which will also be held in parallel with the Medical Informatics Europe (MIE) conference in Gothenburg. We will most certainly be back with several submissions to MIE and presentations at Vitalis next year!

DOME · eHealth · Medical Records Online · National patient survey · Vitalis

DOME researchers presenting at Vitalis next week!

DOMEatVitalis

Next week on Wednesday DOME researchers will host a 1.5 hours session about patient accessible electronic health records (PAEHR) in Sweden, just before lunch at Vitalis! Many different topics will be covered such as;

  • The history behind the DOME consortium and PAEHR in Sweden (“Journalen”)
  • Results from studies with medical professionals
  • Results from the national patient survey
  • Medical records online for children
  • Opinions from users of Journalen
  • Preliminary results from ongoing studies

I have discussed our national patient survey in earlier blog posts and during the second DOME presentation slot Hanife Rexhepi and I will present some concrete results from that study! We will, among other things, present basic demographic data, usage behavior and attitudes towards different aspects of Journalen. Later on during the spring there will also be a journal manuscript submitted, but the presentation at Vitalis will be the first occasion where results from the study are presented in public!

Åsa Cajander (coordinator of the DOME consortium) and Isabella Scandurra will present some history and a few results from studies with medical professionals and Rose-Mharie Åhlfeldt will lead the “sneak peak” session where a few new projects within DOME and some preliminary results from ongoing studies are discussed.

Apart from researchers within DOME, a few people from Inera (the company behind Journalen) – Maria Pettersson and Jenny Juremalm – and Martin Price from Uppsala county council will present results on medical records online for children and opinions from users.

I think this will be a great opportunity for us to reach out with our results and also a great opportunity for others to learn about DOME and the status of and attitudes towards patient accessible electronic health records in Sweden. I hope that many will show up and listen to us!

 

 

 

 

DOME · eHealth · Grant application · Medical Records Online · National patient survey

Looking back at first part of 2017

Uggla

Since we are now approaching Easter, I will take a look back at the quite busy first quarter of this year. I really don’t have a good summary picture, so I will go with a tawny owl (kattuggla) instead, which I photographed at my countryside last Easter (a couple has been occupying that hole for years).  🙂

Leading large research studies in eHealth

Quite a lot of my time has been devoted to working with (and leading) the two large eHealth studies I introduced here and here. At the end of January the ethical application for the observation/interview/survey study at Uppsala University hospital was sent in and a couple of weeks ago it was finally approved. I’m currently recruiting participants for the observation and interview activities, described here. In parallel I have been working, together with colleagues from several Swedish universities, on analyzing the results from the national patient survey and drafting a first publication about the study. We are still writing, but the current plan is to submit a journal manuscript before May is over.

Writing research grant applications

This is the first year that I have been working very actively with research grant applications and I must say I have really enjoyed it! For one of the applications, to the Swedish Research Council, I was the main applicant. I wrote most of the text and also assembled a group of researchers from four Swedish Universities who I thought would complement each other perfectly in carrying out the planned project. You can read more about this particular application here. I really learned a lot from this experience, so I definitely think I have gained something from this application process even if our proposed project is not funded. And if it is not – I will just assemble the team once again and give it another try!

The other application I have been working on is an EU grant application aiming at developing a kind of health coach to be used both in Sweden and Uganda – thus this application is within the eHealth area. The grant writing process was led by Meena Daivadanam from Uppsala University/Karolinska Institutet who is also the main applicant. Åsa Cajander and I will play key roles in the “technical component”, since we are the only IT people among the co-applicants. Apart from Sweden, researchers from Finland, Belgium, Uganda and Australia. The application was submitted two days ago – let’s see if we get lucky!  🙂

Conferences

In the middle of March we had a traditional DOME consortium conference, this time in Skövde. I really enjoyed going there to meet all people that I work with in my studies in real life (normally we have regular Skype meetings, but that is not the same thing of course). It was also especially interesting to meet Bridget Kane again – the newest addition to the DOME consortium. We had referenced each other’s studies on multidisciplinary medical team meetings (this article is an example) quite a few times before we met at a conference at the end of last year! More can be read about the DOME conference in this blog post.

During these days I’m also preparing a presentation which Hanife Rexhepi and I will have at Vitalis, April 26. We are going to present preliminary findings from the national patient survey! I’m really looking forward to going to that conference and presenting with Hanife!

Apart from going to conferences I have also been working with conference papers. In a blog post from last year I wrote about a workshop where I participated as a patient. All participants eventually gathered again to write a paper about the workshop, but we recently got notified that the first attempt was unsuccessful. We will now try another conference, after taking the reviewer comments on the first version into account. I really like the fact that workshop participants actually forms a kind of research group and stay in contact, writing papers and so on! In parallel, I’m also writing on another conference paper about medical health records from the nurse’s perspective. And if that wasn’t enough I’m also writing on a full paper, about experiences from a recently held HCI course, for a pedagogical Conference.

Pedagogical courses

I have already written blog posts about a course on supervising oral presentations and a course on activating students, which I took during March. They required a lot of effort and time, but I really learned a lot from them. I’m currently also taking a pedagogical course on grading criteria, examination and feedback, which I will write more about after the last course day.

Teaching

Apart from research, I have also done some teaching in a basic course in human-computer interaction. Specifically, I have been responsible for reading seminars. I also managed to squeeze in a guest lecture on design of advanced medical information systems and analysis Tools.

Ok, I think that was all. The first part of the spring term has been great and now I’m really looking forward to the second half – the part of spring where we will conduct our large eHealth study at Uppsala University hospital!!

 

Happy Easter!