This week I submitted several texts, related to different studies and activities I have been working with during the last couple of years. Last Monday, I finally submitted the first version of the journal article presenting the first findings from the observation/interview/survey study at Uppsala University Hospital! The article focuses on the survey part and contains several interesting results (some of them surprising) about how the work of healthcare professionals has been affected by patient accessible electronic health records. Now, Åsa Cajander and I just have to wait for the peer review reports! I will write more about this study when the peer-review process has been completed.
Last Thursday, I submitted the last corrections to the proofs for the overview article about the large national patient survey which several researchers within the DOME consortium have worked with. Within a few days the article will be published open access! The article will present the very first results from the follow-up work about long-term effects (for patients) of patient accessible electronic health records in Sweden. A press release has already been prepared and my next blog post will probably focus on that. I really wonder what effects that press release will have, since the last one we published was picked up by several media sites!
Last Friday, I also submitted the last correction to the post-conference report for Uppsala Health Summit, where the results from all workshops are presented. Next week, that report will be sent to layout editors and I will of course write a blog post about it when it has been published online.
This has been quite a productive week for me, but several important things will happen during the next couple of weeks as well, so stay tuned!
The blog picture is my own – I took from the ferry while going from Öregrund to Gräsö Yesterday.
In my last blog post I wrote about an article on “threats and violence for staff and patient accessible electronic health records”, which was recently published in Cogent Psychology. Earlier this week a press release about the study was published on the Uppsala University media web. Since research on patient accessible electronic health records (PAEHRs) should be of interest to most of us, we thought it would be interesting and important to reach out with our results to the public in this way, and we were of course hoping that someone would pick up the news.
After less than one week, articles based on our press release have been published at the following places (at this point, all the articles we have found are in Swedish):
- Forskning.se published an article, Nätjournaler ökar rädslan för hot och våld, which was a re-organized version of our original press release. Forskning.se is an online resource, where results from publicly funded research are communicated to the public.
- Ciennce.se published an article with the same name, Nätjournaler ökar rädslan för hot och våld. The editor actually emailed me and asked me to write a summary of the study, so this particular popular science article is written by me and Åsa Cajander. Ciennce.se is a venue where scientists get the opportunity to write short, popular science, summaries about their published studies.
- Dagens medicin published an article, Uppsala inför e-journal i psykiatrin, which actually took the results from our study a bit further. They connected our study to the current work with implementation of psychiatry records online in Region Uppsala! They interviewed both Åsa Cajander and the person in charge of the implementation process at Uppsala University Hospital, Åsa Törnkvist. As one of the researchers following this implementation process, I can without hesitation verify that the concerns of healthcare professionals has been taken seriously.
- SVT Nyheter published an article, E-journaler ökar oron för hot och våld inom vården, which again took the results from our study a bit further. Even in this case they interviewed Åsa Cajander and they also interviewed a representative from the Swedish Association of Health Professionals in Uppsala! Once again, they also connected our results to the ongoing implementation of psychiatry records online in Region Uppsala.
I have never before seen this kind of interest in a study I have been working on! Not only did different media sites publish versions of our press release, but they also conducted new interviews and investigations based on the results we published. I think it’s safe to say that this would not have happened if we hadn’t published that initial press release last Tuesday. I think there is an important lesson to be learned here – it’s important to write both popular science and scientific version of our studies, especially when the research concerns as all as is the case with PAEHRs (we are all patients and/or relatives of patients, right?). We will definitely continue to write press releases about our studies and the next one, about the patients’ attitudes towards and experiences with PAEHRs, will be published very soon on the Uppsala University media web!
In summary, we can conclude that, yeah, someone picked up the news! 🙂
Last Friday, an article written by Ulrika Åkerstedt, Åsa Cajander, me and Ture Ålander was published in the open access journal Cogent Psychology. The article, “On threats and violence for staff and patient accessible electronic health records”, presents results from a survey study conducted with healthcare professionals from an emergency department and a psychiatric department, respectively. Patients at the emergency department could access their electronic health records online since about a year back, while patients at the psychiatry department did not yet have this access. The study showed that 40% of the participating healthcare professionals believed that risks of threats and violence increase after launch of patient accessible electronic health records (PAEHRs). The study did not show any correlation with more (self-reported) instances of threats and violence.
You can of course read more in the open access article, which you can find here.
Early this morning a press release was published, which introduced the study and linked to the article. This is the very first time I have taken part in work that has been announced in that way! You can read the press release (in Swedish) here.
Here is the article’s abstract:
Does patient accessible electronic health records (PAEHR) result in increased risk of threats and violence? This study was conducted one year after launching PAEHR in Uppsala to examine whether staff whose patients had gained access to the patient portal perceived greater risks of threats and violence, and were exposed to more threats and violence, than those whose patients had not yet gained access. A total of 174 (35%) professionals responded to a web survey. 83 were from the emergency department, whose patients had online electronic health record access, and 91 were from the psychiatric department, whose patients had not. 40% of all participating professionals believed that risks of threats and violence increase after launch. The results did not support a correlation with more incidents of threats and violence, and only one respondent reported that patient access had played any significant negative role in relation to an incident.
Very soon, another press release will be published about the DOME consortium’s work on PAEHRs, so stay tuned for more!! 🙂
Those who follow my blog regularly have probably realized that I haven’t made any new posts during the last couple of months. I took a break from the blog since I needed a few weeks of 100% vacation and I also had several writing and analysis tasks going on in parallel. The fact is that I wanted to do as much as possible before my position as postdoc at Uppsala University ended last Thursday! I will of course write a blog post where I summarize my time at Uppsala University. I still, however, have quite a few things left to do, especially when it comes to writing papers, so I will continue to work closely with my colleagues in the HTO group at Uppsala University as well as in the DOME consortium.
During my period off the blog quite a few things have happened. Two journal articles were accepted and one of them was actually published open access last week! One is about threats and violence in relation to patient accessible electronic health records (PAEHRs) and the other is an overview paper about the national patient survey (focusing on Swedish patients’ attitudes towards and experiences with PAEHRs), which I have written about many times before on this blog. Both of these articles are expected to draw a lot of attention, so they will be announced in press releases! The first of these releases might go online already on Monday. Aside from working on press releases and dealing with copyediting issues for these two articles I also finalized a draft of the first journal article about results from the extensive interview/observation/survey study at Uppsala University Hospital. The article, which covers the survey part, will be submitted very soon. I also wrote major parts of two journal articles where we compare patient groups from the national patient survey and smaller parts on some other papers related to that study. Last, I also worked on two grant applications – one about patient accessible psychiatry records and one about technology support for better inclusion of visually impaired pupils in primary school. So, a lot of things have been written during these last months and I will of course write individual blog posts about all of these articles/applications.
Aside from writing I have also completed a preliminary analysis of the interviews with physicians in the interview/observation/survey study at Uppsala University Hospital. We definitely have some interesting results and very soon we will meet in the project group to discuss the results and how to move forward. I will of course get back to this work in other posts during the autumn.
From next week I will write blog posts more regularly and I will most probably start with a post about the upcoming press release!
(In case you were wondering – I took the above picture during my last visit to Öland)
As I wrote in an earlier blog post, two papers on which I was a co-author were presented in parallel sessions during the first day of the Medical Informatics Europe (MIE) conference. Luckily, Åsa Cajander and I managed to switch rooms, after our presentation, before Maria Hägglund started hers. Maria’s presentation of the paper “Timing It Right – Patients’ Online Access to Their Record Notes in Sweden” was also about work performed within the DOME consortium, but it focused more on the patient accessible electronic health records system (Journalen) as such and on when new information is presented for the patients to see.
Maria started off by giving a thorough overview of Journalen as well as the national patient portal where patients e.g. can, apart from logging in to Journalen, contact care providers electronically, book times and check as well as renew medication prescriptions. As can be seen in the blog picture above, Sweden’s independent regions are responsible for healthcare and as a consequence there are some differences regarding e.g. which health record systems are used and what policies are followed when it comes to information presented in Journalen.
After introducing Journalen and the national patient portal, Maria continued by discussing the Swedish National Regulatory Framework and especially the part concerning when patients get access to new information (e.g. lab results or visit notes). The big issue here is that each independent region or healthcare provider can make a choice (electable paragraphs) if they want to give patients immediate access to new information or not. The alternative is to use a two weeks delay. The different providers and regions can also choose whether or not patients get access to unsigned notes/results. The obvious consequence of the electable paragraphs is differences between different county councils, regarding when patients get access to information in Journalen.
Towards the end, Maria also revealed what the patients say about waiting times. Results from the national patient survey show that the majority of patients want to see new information in Journalen within a day and only about 20% think that a two week waiting period would be ok. This is interesting to relate to the fact that the majority of the county councils have chosen to use a delay period of two weeks for unsigned notes (in the survey, the patients were informed about that new information presented in Journalen within a day will most probably not yet be signed by a physician, but they still wanted quick access).
If you want to know more about this study, you can find the open access full paper here.
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.
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!