No abstract

Purpose – The purpose of this paper is to discuss how and to what extent users can become involved in the process of selecting and implementing telecare and telehealth technologies in local health care services. Design/methodology/approach – The discussion is based on data from a project in one local authority in Norway. About 100 persons have participated in focus group interviews where issues regarding new telecare and telehealth technologies for the elderly were discussed. The focus groups involved different groups of product users and stakeholder groups, i.e. “older senior users” (over 65 years), “younger senior users” (55-65 years), relatives, health care professionals and general practitioners (GPs). Findings – Different user groups have different stakes in the technology. It is difficult to involve “older senior users” in the selection process due to their lack of information about potential solutions, while “younger senior users” are more informed and positive towards the introduction of telecare and telehealth technologies. The results also indicate that professionals are ambiguous towards new technologies; on the one hand they expect services to be better, but on the other they are concerned about ethical and working life issues that have not been fully explored as yet. Originality/value – This paper provides an understanding of how different groups of product users and stakeholder groups relate to and can be involved in an expanded implementation process of telecare and telehealth technology which allow older people to remain in their homes for longer.

PurposeThe aim of this article is to study the coordination of comprehensive services for clients with concurrent substance abuse and mental health disorders (dual diagnosis), which is a very complex client group. In order to achieve comprehensive care and treatment, the service providers need to cooperate and coordinate, but the questions here, are how this is done and how appropriate the coordination is.Data and methodsData were collected from group interviews during a 1-day workshop with clients, relatives, and employees from the various services involved.ResultsInformation exchange between the services was generally in writing. Coordination between substance abuse and mental health services was experienced as fragmented. Employees had an unclear perception of the work and expertise of the other service providers involved. There were examples of disparity between the services a municipality could offer and client needs. A coordinator, if available, was emphasized by both clients and service providers as serving an important function in coordination and relationship building.ConclusionPredominantly written communication and unclear division of responsibilities and duties resulted in employees creating stereotypes of each other, both within specialist health services and between specialist and municipal health services. A coordinator was able to coordinate various inputs, often through informal contact, with a view to establishing appropriate services for individual clients. Coordination in interagency meeting points, such as “responsibility teams”, was the most successful solution, but this will involve a greater degree of networking than is common today.

No abstract

The introduction of telecare does not simplify collaboration or improve services; technology does not solve collaboration challenges. Technology limits information to written form, which may not meet the needs of the service provider and user. Collaboration and integration require common strategies and leadership that implements them, including in telecare.