Recently, the care of chronic disease has become a worldwide challenge. Although the healthcare domain has begun to adopt new ICT technologies such as the Internet of Things and cloud computing, it is still in its initial phase. In this chapter, the authors conduct a small-scale two-step case study of diabetes care in Blekinge, Sweden. The first step is intended to acquire insight into the actual care situation to improve the original conceptual model. In the second step, we validate the feasibility of the improved model working in real healthcare. The results show that the Internet of Things and cloud computing is acceptable by both healthcare providers and recipients for home-based chronic diseases healthcare with little concerns of security and privacy in the future. In our hybrid cloud model, hospitals and primary healthcare centers could continue using their own exciting databases as private clouds. The best approach for home-based healthcare data is to collect it by connecting the different devices directly and storing and processing them in public clouds. To realize this model in the future, we suggest that a professional IT healthcare education team should be created to support both healthcare providers and recipients. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.

BACKGROUND: Chronic somatic health conditions are a global public health challenge. Being engaged in one's own health management for such conditions is important, and mobile health (mHealth) solutions are often suggested as key to promoting engagement. OBJECTIVE: The aim of this study was to review, critically appraise, and synthesize the available research regarding engagement through mHealth for persons with chronic somatic health conditions. METHODS: An integrative literature review was conducted. The PubMed, CINAHL, and Inspec databases were used for literature searches. Quality assessment was done with the guidance of Critical Appraisal Skills Programme (CASP) checklists. We used a self-designed study protocol comprising 4 engagement aspects-cognitive, behavioral and emotional, interactional, and the usage of mHealth-as part of the synthesis and analysis. RESULTS: A total of 44 articles met the inclusion criteria and were included in the analysis. mHealth usage was the most commonly occurring engagement aspect, behavioral and emotional aspects the second, cognitive aspects the third, and interactional aspects of engagement the least common aspect in the included articles. The results showed that there is a mix of enablers and barriers to engagement in relation to the 4 engagement aspects. The perceived meaningfulness and need for the solution and its content were important to create and maintain engagement. When perceived as meaningful, suitable, and usable, mHealth can support knowledge gain and learning, facilitate emotional and behavioral aspects such as a sense of confidence, and improve interactions and communications with health care professionals. CONCLUSIONS: mHealth solutions have the potential to support health care engagement for persons with chronic somatic conditions. More research is needed to further understand how, by which means, when, and among whom mHealth could further improve engagement for this population. ©Hanna Tuvesson, Sara Eriksén, Cecilia Fagerström. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 24.07.2020.

Knowledge sharing has become an important issue that challenges the efficient healthcare delivery in eHealth system. It also rises as one of the mostdemanding applications with reference to dynamic interactivities among various healthcare actors (e.g. doctors, nurses, patients, relatives of patients). Inthis paper, we suggest an activity theory based ontology model to represent various healthcare actors. The goal of the suggested model is to enhance inte-ractivities among these healthcare actors for conducting more efficient knowledge sharing, which helps to design eHealth system. To validate the feasibilityof suggested ontology model, three typical use cases are further studied. A questionnaire based survey is carried out and the corresponding survey resultsare reported, together with the detailed discussions.

The care of chronic disease has become the main challenge for healthcare institutions around the world. To meet the growing needs of patients, moving the front desk of healthcare from hospital to home is essential. Recently, cloud computing has been applied to healthcare domain; however, adapting to and using this technology effectively for home-based care is still in its initial phase. We have proposed a conceptual hybrid cloud model for home-based chronic disease care, and have evaluated its future feasibility by a case study of diabetes care in Blekinge, Sweden. In this paper, we discuss some possible future opportunities and challenges to apply this cloud model with the huge population for home-based chronic diseases care. To apply this model in practice, a professional IT healthcare education team is needed for both healthcare providers and healthcare recipients. For home-based healthcare, a monitoring system with an automatic alarm to healthcare providers is also necessary in some cases. Also, how to record and integrate excises data through wearable devices in a cloud should be considered. Given the high demand, sharing medical images through the cloud should be another research focus.

The internet based social network has been applied to serve many social functions, such as democratic decision making, knowledge sharing, educa‐ tion, and healthcare. In this paper, we provide a prototype of virtual community designed for home-based chronic diseases healthcare. We studied the concept “community” from the activity theory model in order to design the prototype with a solid theoretical base. Then we conducted a questionnaire from healthcare recipients and interviewed healthcare providers to gather the requirements for the design of the community. With some user stories we described the requirements as use cases for our design and a conceptual prototype is built based on the requirements. This virtual community servers as a shared platform for all the stakeholders who are engaged in the healthcare activity. With this shared community platform, the interoperability problems of current healthcare systems can be moderated

Challenges of improving discharge planning have been an area of concern for many years, including problems related to lack of time for professionals to participate. In a county in South East Sweden, video conferencing was implemented in discharge planning sessions to enable distance participation of the professionals. To examine the implementation process, interviews were conducted with the implementers, who were project leaders, discharge planning coordinators in the hospital, and in home-care. The interviews were analysed qualitatively, using directed content analysis with a deductive approach to a theoretical framework that was composed from theories about implementation processes to be suitable for the healthcare sector, consisting of the factors: implementation objects; implementation actions; actors; users; inner context and outer context. The results of this study are consistent with the framework but with the addition of a new dimension – time, i.e. time to prepare; time to understand; time to run through and time to reflect. It is suggested that implementation frameworks are useful when IT is introduced in healthcare. Framing the implementation process supports the exposure of factors and highlights relationships and states of dependence between those factors which may affect implementation.

This article describes healthcare managers’ experiences of leading the implementation of video conferencing in discharge planning sessions as a new tool in everyday practice. Data collection took place through individual interviews and the interviews were analyzed using qualitative content analysis with an inductive approach. The results indicate that managers identified two distinct leadership perspectives when they reflected on the implementation process. They described a desired way of leading the implementation and communicating about the upcoming change, understanding and securing support for decisions, as well as ensuring that sufficient time is available throughout the change process. They also, however, described how they perceived that the implementation process was actually taking place, highlighting the lack of planning and preparation as well as the need for support and to be supportive, and having the courage to adopt and lead the implementation. It is suggested thatmanagers at all levels require more information and training in how to encourage staff to become involved in designing their everyday work and in the implementation process. Managers, too, need ongoing organizational support for good leadership throughout the implementation of video conferencing in discharge planning sessions, including planning, start-up, implementation, and evaluation. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.

In this commentary of Carsten Sørensen's keynote address and commentary, I argue that it may be the concept of the smart manager—so fundamental to management science—rather than the concept of the smart machine, which is still haunting IS research today. © Scandinavian Journal of Information Systems, 2016.

Aim To describe and obtain a deeper understanding of social challenges and their influence on the implementation process when implementing Information systems in a Swedish health-care organisation. Background Despite positive effects when implementing Information systems in health-care organisations, there are difficulties in the implementation process. Nurses' experiences of being neglected have been dismissed as reasons for setbacks in implementation. Methods An Institutional Ethnography design was used. A deductive content analysis was made influenced by empirically identified social challenges of power, professional identity and encounters. An abstraction was made of the analysis. Results Nineteen nurses at macro, meso and micro levels were interviewed in focus groups. Organisational levels are lost in different ways in how to control the reformation, how to introduce Information systems as reformation strategies and in how to translate new tools and assumptions that do not fit traditional ways of working in shaping professional identities. Conclusion and implication for nurse management Different focus may affect the reformation of health-care organisations and implementation and knowledge processes. An implementation climate is needed where the system standards fit the values of the users. Nursing management needs to be visionary, engaged and work with risk factors in order to reform the hierarchical health-care organisation.

The goal of this paper is to present how citizen-driven design of e-government can be promoted through trans-local cooperation. Our case study consists of the Augment project, which focuses on the design of a mobile service for co-creation of local accessibility. Our approach is action research based in the Scandinavian tradition of Participatory design. Experiences from this project highlight issues concerning how to reconfigure the basis for design of public services. In order to cultivate spaces for citizen-driven design and local innovation, we made iterative use of global collaborations. In the initial phase, influences from R&D cooperation with India provided new spaces for participatory design practices. In the next phase, a proof-of-concept process allowed for broader local stake-holder involvement. In the third phase, the service concept was shared and expanded with partner regions in Europe through exchange of Best Practices. Currently, we are moving towards phase four, the commercialization process. Beyond the iterative design of the mobile service itself, and what trans-local collaboration contributed in this context, we also discuss reconceptualization of innovation as incremental change. We argue that transnational collaboration can be deliberately made use of for leveraging incremental change on a local level and strengthening regional innovation systems and practices.