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  • 1.
    Bai, Guohua
    Blekinge Institute of Technology, Faculty of Computing, Department of Creative Technologies.
    An Organic View of Prototyping in Information System Development2014In: 2014 IEEE 17th International Conference on Computational Science and Engineering (CSE) / [ed] Liu, X; ElBaz, D; Hsu, CH; Kang, K; Chen, W, ChengDu: IEEE, 2014, Vol. Article number 07023844, p. 1814-1818Conference paper (Refereed)
    Abstract [en]

    This paper presents an organic view of prototyping for managing dynamic factors involved in evolutionary design of information systems (IS). Those dynamic factors can be caused by, for example, continuing suggestions from users, changes in the technologies, and users-designers learning related stepwise progresses. Expanding the evolutionary prototyping to ‘start small and grow’, the organic view of prototyping proposes two prerequisites to do so, namely 1) a sustainable and adaptive ‘embryo’ – an organic structure of the future system, and 2) an embedded learning and feedback management that the actors of the system (users, designers, decision makers, administrators) can communicate with each other. An example of eHealth system design demonstrates how the prerequisites can be implemented.

  • 2.
    Berner, Jessica
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Psychosocial, Socio-Demographic and Health Determinants in Information Communication Technology Use by Older-Adults2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of the thesis was to investigate factors influencing ICT use by older-adults. A selection of psycho-social, socio-demographic and health determinants were investigated with Internet use. Data were collected through questionnaires (Studies I-III) and interviews (Study IV). Univariate and multivariate analyses were conducted, investigating Internet use as a dichotomous variable, with the aforementioned factors. The results indicated that psycho-social determinants did not affect older-adults’ Internet use (Study I). Scoring higher on the personality traits openness and extraversion did not affect whether the older adults started to use the Internet (Study II). However, well-being increased for some frail older-adults when using the tablet computer and connected to the Internet (Study IV). Some socio-demographic determinants affected Internet use. Being younger in age was a strong contributing factor in all four studies whether the older-adult would use the Internet. Higher education influenced Internet use (Study I & III), correlated with living in a rural or urban setting (Study III); yet education was not influencing whether they would start to use the Internet. Living alone was correlated with Internet use, especially if the older-adult lived in an urban setting (Study III). Functional disability and household economy did not affect Internet use. Finally, the health determinants on Internet use were quite strong. Normal cognitive functioning influenced whether older-adults would start to use the Internet (Study II). The older-adult living in an urban environment, would use the Internet if they had normal cognitive functioning (Study III). It was noted also from Study IV that the learning to use the Tablet PC and Skype took longer for older people and more repetition was needed. Being frail was a strong factor whether the older-adult would use the Internet. They would not want to learn or try to use the technology if they were too ill (Study IV). The findings show only a small increase (7.7%) in Internet use by older-adults over time. The indicators of non-use are: higher in age, lower educated, living alone or rurally, lower cognition and frailty. There are two different profiles of rural and urban Internet users. These determinants along with an understanding of the use of technology, and a good support system, are a few pillars in ICT adoption by older-adults. As ICT continues to develop as a means to provide better health care, it will be important to take into account the abovementioned indicators. In certain cases Internet use is not a given, which continues to exclude older-adults. Part of healthy aging is social participation; therefore being connected and included in the digital society is important. Alternative and not only one design solutions should be explored in health care and by organisations, so as to cater to the heterogeneity of the aging population.

  • 3. Beyene, Ayne A.
    et al.
    Welemariam, Tewelle
    Persson, Marie
    Blekinge Institute of Technology, Faculty of Computing, Department of Computer Science and Engineering.
    Lavesson, Niklas
    Blekinge Institute of Technology, Faculty of Computing, Department of Computer Science and Engineering.
    Improved concept drift handling in surgery prediction and other applications2015In: Knowledge and Information Systems, ISSN 0219-1377, Vol. 44, no 1, p. 177-196Article in journal (Refereed)
    Abstract [en]

    The article presents a new algorithm for handling concept drift: the Trigger-based Ensemble (TBE) is designed to handle concept drift in surgery prediction but it is shown to perform well for other classification problems as well. At the primary care, queries about the need for surgical treatment are referred to a surgeon specialist. At the secondary care, referrals are reviewed by a team of specialists. The possible outcomes of this review are that the referral: (i) is canceled, (ii) needs to be complemented, or (iii) is predicted to lead to surgery. In the third case, the referred patient is scheduled for an appointment with a surgeon specialist. This article focuses on the binary prediction of case three (surgery prediction). The guidelines for the referral and the review of the referral are changed due to, e.g., scientific developments and clinical practices. Existing decision support is based on the expert systems approach, which usually requires manual updates when changes in clinical practice occur. In order to automatically revise decision rules, the occurrence of concept drift (CD) must be detected and handled. The existing CD handling techniques are often specialized; it is challenging to develop a more generic technique that performs well regardless of CD type. Experiments are conducted to measure the impact of CD on prediction performance and to reduce CD impact. The experiments evaluate and compare TBE to three existing CD handling methods (AWE, Active Classifier, and Learn++) on one real-world dataset and one artificial dataset. TBA significantly outperforms the other algorithms on both datasets but is less accurate on noisy synthetic variations of the real-world dataset.

  • 4.
    Eriksén, Sara
    et al.
    Blekinge Institute of Technology, Faculty of Computing, Department of Creative Technologies.
    Lundberg, Jenny
    Blekinge Institute of Technology, Faculty of Engineering, Department of Applied Signal Processing.
    Georgsson, Mattias
    Blekinge Institute of Technology, Faculty of Computing, Department of Creative Technologies.
    Nilsson, Lina
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Hofflander, Malin
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Borg, Christel
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Transforming Healthcare Delivery: ICT Design for Self-Care of Type 2 Diabetes2014Conference paper (Refereed)
    Abstract [en]

    In this position paper we present an on-going case study where the aim is to design and implement mobile technologies for self-care for patients with type 2 diabetes. The main issue we are addressing in this paper is how to bridge clinical and non-clinical settings when designing self-care technologies. Usability, User Experience and Participatory Design are central aspects of our research approach. For designing with and for patients in home settings and everyday life situations, this approach has so far not been problematic. However, when it comes to designing with and for user groups located within a large healthcare organization, in a highly institutionalized clinical setting, the situation is different. We have recently introduced the Health Usability Maturity Model (UMM) to our project partners as a potential tool for bringing usability and participa-tory design issues to the fore as strategic assets for transforming healthcare delivery with ICT.

  • 5.
    Georgsson, Mattias
    et al.
    Blekinge Institute of Technology, Faculty of Computing, Department of Creative Technologies.
    Weir, Charlene
    Staggers, Nancy
    Revisiting Heuristic Evaluation Methods to Improve the Reliability of Findings2014Conference paper (Refereed)
    Abstract [en]

    The heuristic evaluation (HE) method is one of the most common in the suite of tools for usability evaluations because it is a fast, inexpensive and resource-efficient process in relation to the many usability issues it generates. The method emphasizes completely independent initial expert evaluations. Inter-rater reliability and agreement coefficients are not calculated. The variability across evaluators, even dual domain experts, can be significant as is seen in the case study here. The implications of this wide variability mean that results are unique to each HE, results are not readily reproducible and HE research on usability is not yet creating a uniform body of knowledge. We offer recommendations to improve the science by incorporating selected techniques from qualitative research: calculating inter-rater reliability and agreement scores, creating a codebook to define concepts/categories and offering crucial information about raters' backgrounds, agreement techniques and the evaluation setting.

  • 6.
    Hofflander, Malin
    et al.
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Nilsson, Lina
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Borg, Christel
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Eriksén, Sara
    Blekinge Institute of Technology, Faculty of Computing, Department of Creative Technologies.
    Video Conference as a Tool to Enable Participation in Discharge Planning – Experiences From Implementers about the Implementation Process2014Conference paper (Refereed)
    Abstract [en]

    The problems and challenges that arise in the task of improving discharge planning have been an area of concern for many years, including problems related to the lack of time for professionals to participate. In a county council area in South East Sweden, video conferencing was implemented in discharge planning sessions to enable distance participation. As part of a larger research study of the implementation process, interviews were conducted with two of the implementers. The interviews were analysed qualitatively, using directed content analysis with a deductive approach to considering a framework developed by Nilsen et al. The results of this study are consistent with the actual framework but with the addition of time, i.e. time to prepare, time to understand, time to run through and time to reflect. Further research is proposed to focus more on leadership during the implementation process and its influence on the meaning of time.

  • 7.
    Hofflander, Malin
    et al.
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Nilsson, Lina
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Eriksén, Sara
    Blekinge Institute of Technology, Faculty of Computing, Department of Creative Technologies.
    Borg, Christel
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Framing the Implementation Process of Video Conferencing in Discharge Planning: According to Staff Experience2016In: Informatics for Health and Social Care, ISSN 1753-8157, E-ISSN 1753-8165, Vol. 41, no 2, p. 192-209Article in journal (Refereed)
    Abstract [en]

    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.

  • 8.
    Larsson, Madelene
    Blekinge Institute of Technology, School of Computing.
    Traceability in Healthcare Innovation Maintaining the Relations Between Needs and Solutions2013Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Healthcare is an important arena for improvement and innovation by the use of e-health solutions. But many obstacles exist, such as insufficiency in interoperability and usability. One reason for this problematic situation is that the development process has been inadequate. Swedish healthcare serves under regulations for public procurement. Hence, almost every e-health solution has to be procured to prevent an orientation towards illegal direct award of contracts. Specifying requirements that explain what the customer and users needs and why, is one of the most critical parts of that process. The customer gets what asked for, but often the requirements are on a high level of interpretation and not explicit or traceable enough. This prevents interoperability and usability from being a vital part of the prioritizing activity. Today knowledge about requirement processes and traceability is fragmented, and often more based on ideal models than on practical, real life experiences. The aim of this work is therefore to understand how traceability is managed and how it can be improved. I investigate who is most suitable to perform the “traceability activity” and, maybe even more important, the skill needed to fulfil that task. With a practice-based and ethnographical approach several studies have been conducted in different healthcare settings in Sweden, all closely connected to the design- and development process in e-health projects. The research shows that traceability maintains the relation between needs and solutions by providing a reality check for every step in the procurement and development. To accomplish that, requirements must be made explicit and interpretable for different stakeholders. The actors best suited for this “traceability activity” must have a holistic approach and know how to identify needs and relate them to the context. This demands a domain-specific knowledge about the healthcare setting and understanding how the organisation works practically and politically. It is crucial to also be skilled at usability, design, development and procurement. In addition, implementing IT in healthcare cannot be separated from business development. I argue that it is time to update the way healthcare development is managed and by whom. First, healthcare management must pay more attention on usability and the crucial role that healthcare professionals have as change leaders and needfinders to strengthening existing initiatives. Second, the design community must match existing initiatives and roles in healthcare with the designers’ special knowledge to support innovation and design processes.

  • 9.
    Nilsson, Lina
    et al.
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Eriksén, Sara
    Blekinge Institute of Technology, Faculty of Computing, Department of Creative Technologies.
    Borg, Christel
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Social Challenges When Implementing Information Systems in Everyday Work in a Nursing Context2014In: Computers, Informatics, Nursing, ISSN 1538-2931, E-ISSN 1538-9774, Vol. 32, no 9, p. 442-450Article in journal (Refereed)
    Abstract [en]

    Implementation of information systems in healthcare has become a lengthy process where healthcare staff (eg, nurses) are expected to put information into systems without getting the overall picture of the potential usefulness for their own work. The aim of this study was to explore social challenges when implementing information systems in everyday work in a nursing context. Moreover, this study aimed at putting perceived social challenges in a theoretical framework to address them more constructively when implementing information systems in healthcare. Influenced by institutional ethnography, the findings are based on interviews, observations, and written reflections. Power (changing the existing hierarchy, alienation), professional identity (calling on hold, expert becomes novice, changed routines), and encounter (ignorant introductions, preconceived notions) were categories (subcategories) presented in the findings. Social Cognitive Theory, Diffusion of Innovations, organizational culture, and dramaturgical analysis are proposed to set up a theoretical framework. If social challenges are not considered and addressed in the implementation process, it will be affected by nurses’ solidarity to existing power structures and their own professional identity. Thus, implementation of information systems affects more aspects in the organization than might have been intended. These aspects need to be taken in to account in the implementation process.

  • 10.
    Olander, Ewy
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Olsen, Anders
    Optimus-modellen stärker egenmakt och trygghet med bibehållen vårdkvalitet.2012In: Vasculär medicin, ISSN 2000-3188, Vol. 28, no 2, p. 85-89Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    Sammanfattning: Hypertoni är en vanligt förkommande riskfaktor för hjärt-kärl sjukdomar. Internationellt genomförs alltfler blodtrycksmätningar i hemmet. En utvärderingsrapport av SBU fastställer att hemblodtrycksmätning kan vara lika tillförlitlig som traditionell blodtrycksmätning om patienten har tillräcklig kunskap och fungerande utrustning. Denna artikel beskriver en pilotstudie av en ny modell för blodtrycksbehandling med blodtrycksskola, hemblodtrycksmätning och individuell support. Syftet var att undersöka deltagarnas erfarenheter av Optimus-modellen och dess betydelse för deltagarnas egenmakt och hälsobildning i blodtrycksrelaterade frågor, samt om blodtrycksvärdena förändrades vid hemblodtrycksmätning. Studien skall ge underlag för vidare modellutveckling och långsiktiga studier av modellens värde ur ett patient-, hälso- och sjukvårds- samt hälsoekonomiskt perspektiv. Studien omfattade patienter med högt blodtryck som deltog i ny form av blodtrycksbehandling enligt Optimus-modellen med blodtrycksskola, hemblodtrycksmätning och individuellt support. Datamaterialet bestod av blodtrycksprotokoll med hemblodtrycksvärden registrerade av deltagarna, två deltagarenkäter som bearbetades kvantitativt och kvalitativt samt två uppföljningssamtal i respektive deltagargrupp. Resultatet visar att Optimus-modellen stärkte deltagarnas helhetsförståelse för faktorer som påverkar deras hälsa och blodtryck, trygghetskänsla vid HBTM samt möjligheterna att ha kontroll och ta ansvar för sitt blodtryck och hälsotillstånd. Studien visar att Optimus-modellen har potential att kunna skapa det underlag med kunskap, färdigheter och trygghet för blodtrycksmätning som behövs enligt SBU för att HBTM skall kunna genomföras på ett tillförlitligt sätt. Studien visar också att modellen stödjer den utveckling av egenmakt (empowerment) och hälsobildning som hälsopolitiska dokument och riktlinjer framhåller som angelägen i insatser som avser att stödja människors förändring till mer hälsofrämjande livsstilar och att förebygga hjärt- kärlsjukdomar samt en mer hälsofrämjande hälso- och sjukvård.

  • 11.
    Schenkman, Bo N.
    et al.
    Blekinge Institute of Technology, School of Management.
    Nilsson, Mats E.
    Blind and sighted individual´s thresholds for ordinary pitch, repetition pitch and loudness.2013Conference paper (Other academic)
    Abstract [en]

    The perceived pitch and loudness of sounds change as they fuse with reflections from nearby objects. Blind people use both sources of information, with dominance for the use of pitch. We studied if their better performance as compared to sighted can be related to the ability to discriminate tone frequency, repetition pitch and loudness. Only loudness discrimination differed between blind and sighted persons.

  • 12. Thuemmler, Christoph
    et al.
    Fricker, Samuel
    Blekinge Institute of Technology, School of Computing.
    Mival, Oli
    Benyon, David
    Buchanan, William
    Paulin, Alois
    Fiedler, Markus
    Koops, Bert-Jaap
    Kosta, Eleni
    Grottland, Astrid
    Norms and Standards in Modular Medical Architectures2013Conference paper (Refereed)
    Abstract [en]

    Recent Internet of Things (IoT) research has been aiming at interoperability of devices and the integration of sensor networks. The Future Internet – Private Public Partnership (FI-PPP) has created a whole array of different purpose-oriented modules with defined specifications, better known as Generic Enablers. This article gives an overview of legal, ethical and technical norms and standards to be considered when planning, developing and implementing modular medical architectures, integrating the Internet of Things (IoT) and Generic Enablers (GEs) in cutting edge, latest generation medical data networks.

  • 13. Tümmler, Christoph
    et al.
    Mival, Oli
    Lim Jumelle, Ai Keow
    Holanec, Ivo
    Fricker, Samuel
    Blekinge Institute of Technology, Faculty of Computing, Department of Software Engineering.
    A Social Technological Aligment Matrix2014Conference paper (Refereed)
    Abstract [en]

    This paper refers to the term “implementation” as the process of integrating a new technology into established workflows. Especially in health care this has proven to be a very critical phase and many large-scale projects have failed on this very last mile. Although strategies such as requirements engineering, co-designing and user interaction design have been proposed to reduce the risk of end-user rejection and subsequently project failur. There is still no tool to analyze, predict and quantify user acceptance and identify critical areas which might be addressed before the start of the implementation phase in order to reduce resistance and increase the effectiveness and efficiency.

  • 14. Yang, Geng
    et al.
    Li, Xie
    Mäntysalo, Matti
    Zhou, Xiaolin
    Pang, Zhibo
    Xu, Li Da
    Kao-Walter, Sharon
    Blekinge Institute of Technology, School of Engineering, Department of Mechanical Engineering.
    Chen, Qiang
    Zheng, Lirong
    A Health-IoT Platform Based on the Integration of Intelligent Packaging, Unobtrusive Bio-Sensor and Intelligent Medicine Box2014In: IEEE Transactions on Industrial Informatics, ISSN 1551-3203, E-ISSN 1941-0050, Vol. 10, no 4, p. 2180-2191Article in journal (Refereed)
    Abstract [en]

    In-home healthcare services based on the Internet-of-Things (IoT) have great business potential; however, a comprehensive platform is still missing. In this paper, an intelligent home-based platform, the iHome Health-IoT, is proposed and implemented. In particular, the platform involves 1) an open-platform-based intelligent medicine box (iMedBox) with enhanced connectivity and interchangeability for the integration of devices and services, 2) intelligent pharmaceutical packaging (iMedPack) with communication capability enabled by passive radio-frequency identification (RFID) and actuation capability enabled by functional materials, and 3) flexible and wearable bio-medical sensor device (Bio-Patch) enabled by the state-of-the-art inkjet printing technology and system-on-chip. The proposed platform seamlessly fuses IoT devices (e.g., wearable sensors, intelligent medicine packages, etc.) with in-home healthcare services (e.g., telemedicine) for an improved user experience and service efficiency. The feasibility of the implemented iHome Health-IoT platform has been proven in field trials.

  • 15. Zheng, Zhibo Pang
    et al.
    Zheng, Lirong
    Tian, Junzhe
    Kao-Walter, Sharon
    Blekinge Institute of Technology, Faculty of Engineering, Department of Mechanical Engineering.
    Dubrova, Elena
    Chen, Qian
    Design of a terminal solution for integration of in-home health care devices and services towards the Internet-of-Things2015In: Enterprise Information Systems, ISSN 1751-7575, E-ISSN 1751-7583, Vol. 9, no 1, p. 86-116Article in journal (Refereed)
    Abstract [en]

    In-home health care services based on the Internet-of-Things are promising to resolve the challenges caused by the ageing of population. But the existing research is rather scattered and shows lack of interoperability. In this article, a business-technology codesign methodology is proposed for cross-boundary integration of in-home health care devices and services. In this framework, three key elements of a solution (business model, device and service integration architecture and information system integration architecture) are organically integrated and aligned. In particular, a cooperative Health-IoT ecosystem is formulated, and information systems of all stakeholders are integrated in a cooperative health cloud as well as extended to patients’ home through the inhome health care station (IHHS). Design principles of the IHHS includes the reuse of 3C platform, certification of the Health Extension, interoperability and extendibility, convenient and trusted software distribution, standardised and secured electrical health care record handling, effective service composition and efficient data fusion. These principles are applied to the design of an IHHS solution called iMedBox. Detailed device and service integration architecture and hardware and software architecture are presented and verified by an implemented prototype. The quantitative performance analysis and field trials have confirmed the feasibility of the proposed design methodology and solution.

  • 16. Zhi, Tao
    et al.
    Zhang, Xia-Jun
    Zhao, He-Ming
    Kulesza, Wlodek J.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Applied Signal Processing.
    Noise reduction in whisper speech based on the auditory masking model2010Conference paper (Refereed)
    Abstract [en]

    This paper presents the issue of whispered speech enhancement. Based on multi-band spectral subtraction method where the introduced musical residual noise occurs, the proposed approach performs parametric subtraction according to the WSS (Whispered Sensitive Scale) method that is particular for whispered speech processing and auditory masking model. The algorithm is characterized by a tradeoff mechanism between the amount of the whispered speech distortion, noise reduction, and the level of musical residual noise, which are determined by appropriate adjusting the subtraction parameters. Compared with traditional subtractive-type algorithms, the proposed method results in a significant reduction of musical residual noise. Finally, objective and subjective evaluations are implemented illustrating the improvements over traditional subtractive-type algorithms.

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