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  • 1.
    Eriksen, Sara
    et al.
    Blekinge Tekniska Högskola, Fakulteten för datavetenskaper, Institutionen för kreativa teknologier.
    Georgsson, Mattias
    Blekinge Tekniska Högskola, Fakulteten för datavetenskaper, Institutionen för kreativa teknologier.
    Hofflander, Malin
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Nilsson, Lina
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa. Blekinge Inst Technol, Karlskrona, Sweden..
    Lundberg, Jenny
    Lund Univ, Dept Design Sci, Lund, Sweden..
    Health in Hand: Putting mHealth Design in Context2014Ingår i: 2014 IEEE 2ND INTERNATIONAL WORKSHOP ON USABILITY AND ACCESSIBILITY FOCUSED REQUIREMENTS ENGINEERING (USARE), 2014, s. 36-39Konferensbidrag (Refereegranskat)
    Abstract [en]

    Wireless technologies, cloud computing and connectivity have enabled mobile services that extend the coverage of health services, resulting in a branch of eHealth now commonly referred to as mHealth. However, at least in Sweden, where the healthcare sector is heavily institutionalized and regulated, mHealth has so far mainly evolved in the form of applications for support of healthy life-style and self-management of chronic diseases, implemented outside of the firewalls of traditional healthcare delivery environments. In this paper we present an on-going Indo-Swedish research and development project in which we are putting mHealth design into context both from a patient's perspective and from the perspective of a healthcare team working within a professional healthcare organization. Our research approach is inspired by the Scandinavian tradition of Participatory Design of ICT and informed by studies of how to measure usability, user experience and impact of mHealth interventions. The involved research teams are multi-disciplinary, including researchers from engineering, computing and health sciences. The project includes, on the Swedish side, a partner from the public healthcare sector, three SME:s and an industrial partner who is currently providing Electronic Patient Record and other healthcare information system solutions and who is interested in developing mobile solutions for healthcare professionals. We are currently in the process of collaborative articulation and specification of problems, goals and requirements within the framework of the first Swedish case study of the project, focused on mobile support for patients with diabetes type 2 and their healthcare teams.

  • 2.
    Eriksén, Sara
    et al.
    Blekinge Tekniska Högskola, Fakulteten för datavetenskaper, Institutionen för kreativa teknologier.
    Lundberg, Jenny
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för tillämpad signalbehandling.
    Georgsson, Mattias
    Blekinge Tekniska Högskola, Fakulteten för datavetenskaper, Institutionen för kreativa teknologier.
    Nilsson, Lina
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Hofflander, Malin
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Borg, Christel
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Transforming Healthcare Delivery: ICT Design for Self-Care of Type 2 Diabetes2014Konferensbidrag (Refereegranskat)
    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.

  • 3.
    Fagerström, Cecilia
    et al.
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Tuvesson, Hanna
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Axelsson, Lisa
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Nilsson, Lina
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    The role of ICT in nursing practice: An integrative literature review of the Swedish context2017Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, s. 434-448Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The Swedish healthcare system employs information and communication technologies (ICT) in nursing practice to meet quality-, security- and efficiency-related demands. Although ICT is integrated with nursing practices, nurses do not always feel that they are convenient to use it. We need to improve our knowledge of the role of ICT in healthcare environments and so we decided to complement existing experience of how ICT influences nursing practice. Aim: This study aimed to review and synthesise the available literature on the role of ICT in nursing practice in Swedish healthcare settings. Method: To consolidate previous studies based on diverse methodologies, an integrative literature review was carried out. Three databases were used to search for literature, 20 articles met the inclusion criteria. Results: The literature review indicates that ICT integration into nursing practice is a complex process that impacts nurses’ communication and relationships in patient care, working conditions, and professional identities and development. Nurses are found to express ambiguous views on ICT as a usable service in their everyday practice since it impacts both positively and negatively. Discussion and conclusion: Although ICT cannot replace physical presence, it can be considered a complementary service that gives rise to improved patient care. However, nonverbal communication cues may be missed when ICT is used as mediating tool and ICT can be limiting because it is not always designed to meet nurse and patient needs. The meaning of an encounter appears to change when ICT is used in nursing practice, not only for patient relationships but also for interpersonal communication.

  • 4.
    Hofflander, Malin
    et al.
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Lina, Nilsson
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Sara, Eriksén
    Blekinge Tekniska Högskola, Sektionen för datavetenskap och kommunikation.
    Christel, Borg
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Discharge planning: Narrated by nursing staff in primary healthcare and their concerns about using video conferencing in the planning session – An interview study2013Ingår i: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 3, nr 1, s. 88-98Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background/Objective: This paper sets out to describe experience-based reflections on discharge planning as narrated by nursing staff in primary healthcare, along with their concerns about how the introduction of video conferencing might influence the discharge planning situation. Methods: Interviews were conducted with nursing staff working at a primary healthcare centre in South East Sweden. Each interview took place was conducted on a one-to-one basis in dialogue form, using open questions and supported by an interview guide. It was then analysed using a phenomenological hermeneutic method. Participants were eligible for the study if they had given their informed consent and if they worked with discharge planning and home-based healthcare provision. In total, 10 of the 30 persons working at the primary healthcare centre participated in the study. Results: It was found that nursing staff in primary healthcare regarded the planning session as stressful, time-consuming and characterised by a lack of respect between nursing staff at the hospital and nursing staff in primary healthcare. They also described uncertainty and hesitation about using video conferences where patients might probably be the losers and nursing staff the winners. Conclusions: It is suggested that there is a need for improvement in communication and understanding between nursing staff at the hospital and nursing staff in primary healthcare in order to develop discharge planning. There is also a need for the nursing staff in primary healthcare to obtain more information about how Information Technology (IT) solutions could support their work and help them to find ways to collaborate.

  • 5.
    Hofflander, Malin
    et al.
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Nilsson, Lina
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Borg, Christel
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Eriksén, Sara
    Blekinge Tekniska Högskola, Fakulteten för datavetenskaper, Institutionen för kreativa teknologier.
    Video Conference as a Tool to Enable Participation in Discharge Planning – Experiences From Implementers about the Implementation Process2014Konferensbidrag (Refereegranskat)
    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.

  • 6.
    Hofflander, Malin
    et al.
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Nilsson, Lina
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Eriksén, Sara
    Blekinge Tekniska Högskola, Fakulteten för datavetenskaper, Institutionen för kreativa teknologier.
    Borg, Christel
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Framing the Implementation Process of Video Conferencing in Discharge Planning: According to Staff Experience2016Ingår i: Informatics for Health and Social Care, ISSN 1753-8157, E-ISSN 1753-8165, Vol. 41, nr 2, s. 192-209Artikel i tidskrift (Refereegranskat)
    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.

  • 7.
    Hofflander, Malin
    et al.
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Nilsson, Lina
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Eriksén, Sara
    Blekinge Tekniska Högskola, Fakulteten för datavetenskaper, Institutionen för kreativa teknologier.
    Borg, Christel
    Healthcare managers’ experiences of leading the implementation of video conferencing in discharge planning sessions: An interview study2016Ingår i: Computers, Informatics, Nursing, ISSN 1538-2931, E-ISSN 1538-9774, Vol. 34, nr 3, s. 108-115Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 8.
    Nilsson, Lina
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Social Challenges when Implementing Information Systems in a Swedish Healthcare Organization2014Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    When the Swedish National IT Strategy for Health and Social Care was introduced in 2006, intensive work started in implementing Information Systems (IS) in Swedish healthcare organizations. To follow up on the requests for more research with a combined socio-technical focus on challenges, the overall aim of this thesis was to identify social challenges when implementing IS in a Swedish healthcare organization. Furthermore, the aim was to understand the impact of identified social challenges when implementing IS in this context by putting them in an interdisciplinary Applied Health Technology theoretical framework. Institutional ethnography and phenomenological hermeneutics influenced the study design. Study 1 aimed to investigate different meanings of accessibility when implementing Health Information Technology in everyday work practice. The results indicate that accessibility depends on working routines, social structures and patient relationship. When an IT strategy and interaction in everyday work use the same word in different ways there will be consequences. Study 2 sets out to describe experience-based reflections on discharge planning as narrated by nursing staff in primary healthcare, along with their concerns about how the introduction of video conferencing might influence the discharge planning situation. It was found that there is a need for improvement in communication and understanding between nursing staff at the hospital and in primary healthcare. The aim of study 3 was to explore social challenges when implementing IS in everyday work in a nursing context. Power (changing the existing hierarchy, alienation), Professional identity (calling on hold, expert becomes novice, changed routines), and Encounter (ignorant introductions, preconceived notions) were categories presented in the findings. The aim of study 4 was to explore and obtain a deeper understanding of how identified social challenges have an influence on the implementation process of IS, based on healthcare staff’s experiences on micro, meso and macro levels of Swedish Healthcare organizations. It was found that the challenges were related to the steps of putting into practice, making IS a part of everyday work routine and establishing an identity in the implementation process. In the thesis’s discussion, social challenges when implementing IS in Swedish healthcare organizations and how they might be met and dealt with constructively are further reflected upon in relation to the interdisciplinary theoretical framework and as possible consequences of the modernity-era. This thesis contributes to the starting up of a discussion of how ingrained professional characteristics are important to feel secure of being part of an established profession. If the characteristics are questioned, the whole professional performance is threatened. One consequence of this insight is the reinforcement of the realization that a basic understanding of IS and IS implementation processes in healthcare organizations needs to be integrated in to the construction of professional identity of nurses already from the start in nursing education.

  • 9. Nilsson, Lina
    et al.
    Borg, Christel
    Hofflander, Malin
    Eriksén, Sara
    PD 3.1 to the rescue: Challenges for Participatory Design in a health care context2010Konferensbidrag (Refereegranskat)
    Abstract [en]

    A National Strategy for E-health has been introduced in Swedish county councils. The strategy indicates that health care needs to become more accessible. To generate usable and sustainable e- Health solutions in Swedish health care, Participatory Design (PD) was introduced as a working method in an e-Health project in the south of Sweden. The project has met with opposition; e-health solutions are not exactly what Swedish health care wanted at the same time as different arenas within the health care organization have difficulties understanding each other. The aim of this study is to find work methods that result in applicable, usable, and sustainable ICT- solutions in every day work within Swedish health care. The study suggests that a modification of third generation of PD may be one way to the challenges PD has come across in the health care context.

  • 10.
    Nilsson, Lina
    et al.
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Eriksen, Sara
    Blekinge Tekniska Högskola, Fakulteten för datavetenskaper, Institutionen för kreativa teknologier.
    Borg, Christel
    Linneaus Univ, SWE.
    The influence of social challenges when implementing information systems in a Swedish health-care organisation2016Ingår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, nr 6, s. 789-797Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 11.
    Nilsson, Lina
    et al.
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Eriksén, Sara
    Blekinge Tekniska Högskola, Fakulteten för datavetenskaper, Institutionen för kreativa teknologier.
    Borg, Christel
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Social Challenges When Implementing Information Systems in Everyday Work in a Nursing Context2014Ingår i: Computers, Informatics, Nursing, ISSN 1538-2931, E-ISSN 1538-9774, Vol. 32, nr 9, s. 442-450Artikel i tidskrift (Refereegranskat)
    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.

  • 12.
    Nilsson, Lina
    et al.
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Hofflander, Malin
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    What if it was like a departure lounge at an airport?: eHealth for healthcare staff in a Swedish healthcare organization, a participatory design study2016Ingår i: Studies in Health Technology and Informatics, IOS Press, 2016, Vol. 225, s. 923-924Konferensbidrag (Refereegranskat)
    Abstract [en]

    EHealth is implemented in everyday work practice as a tool to improve accessibility and patient participation as well as healthcare efficiency. The aim of this study was to explore healthcare staff’s experiences and ideas about how eHealth ought to be designed to be a useful tool in everyday work practice in a Swedish healthcare organization. Healthcare staff (n= 7) at the micro level in a Swedish healthcare organization, participated in four Participatory Design workshops about eHealth design. eHealth could be a more useful and efficient tool in everyday work practice if it were designed more purposefully for its local setting and intended users, like the information system in ’a departure lounge of an airport’. Including healthcare staff in design discussions concerning eHealth tools for everyday work practice may improve the efficiency of eHealth as an everyday tool and support for healthcare staff.

  • 13.
    Nilsson, Lina
    et al.
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Hofflander, Malin
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Eriksén, Sara
    Blekinge Tekniska Högskola, Sektionen för datavetenskap och kommunikation.
    Borg, Christel
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    The importance of interaction in the implementation of information technology in health care: A symbolic interactionism study on the meaning of accessibility2012Ingår i: Informatics for Health and Social Care, ISSN 1753-8157, E-ISSN 1753-8165, Vol. 37, nr 4, s. 277-290Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A challenge when groups from different disciplines work together in implementing health information technology (HIT) in a health-care context is that words often have different meanings depending upon work practices, and definition of situations. Accessibility is a word commonly associated with HIT implementation. This study aimed to investigate different meanings of accessibility when implementing HIT in everyday work practice in a health-care context. It focused on the perspective of nurses to highlight another view of the complex relationship between HIT and information in a health-care context. This is a qualitative study influenced by institutional ethnographic. District nurses and student nurses were interviewed. The results indicate that when implementing HIT accessibility depends on working routines, social structures and patient relationship. The findings of the study suggest that interaction needs to take on a more important role when implementing HIT because people act upon words from the interpreted meaning of them. Symbolic interactionism is proposed as a way to set a mutual stage to facilitate an overall understanding of the importance of the meaning of words. There is a need for making place and space for negotiation of the meaning of words when implementing HIT in everyday work practice.

  • 14.
    Olander, Ewy
    et al.
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Nilsson, Lina
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Applied Health Technology – a New Research Discipline at Blekinge Institute of Technology2009Konferensbidrag (Refereegranskat)
    Abstract [sv]

    Sedan våren 2008 har Blekinge Tekniska Högskola ett nytt forskningsämne i Tillämpad hälsoteknik. Ämnet har utvecklats i samarbete mellan Sektionen för hälsa och Sektionen för teknik. I den allmänna studieplanen för utbildning på forskarnivå i Tillämpad hälsoteknik understryks värdet av såväl mångvetenskaplig som tvärvetenskaplig ansats med fokus på hur vårdvetenskap, folkhälsovetenskap och klinisk medicin kan förenas med forskningsområden inom teknik. Uppbygganden av forskargrupper och forskarutbildning pågår. Tillämpad hälsoteknik svarar mot ett alltmer, nationellt och internationellt uttalat samhällsbehov av teknikutveckling inom såväl hälsofrämjande och förebyggande insatser som inom hälso- och sjukvård samt omsorg.

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