Supporting citizen-centered care for seniors - experiences from two Swedish research projects

Hägglund, Maria; Scandurra, Isabella; Koch, Sabine

doi:10.1109/cbms.2012.6266377

Cited by 3 publications

(1 citation statement)

References 18 publications

(18 reference statements)

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“…Most of the county councils and regions use one EHR system throughout hospitals, primary care and psychiatric care, which means the patient records are available in the entire region. Elderly care is however, the responsibility of municipalities, falls under a different legislation [5], and often uses separate EHR systems [6]- [8]. Private healthcare providers may also use different systems which means the information access can be limited, even though many regions have an agreement with private actors, which allows information exchange [4].…”

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confidence: 99%

Failed implementation of mobile access to electronic health records in homecare: a qualitative study

Hagstedt

Hvitfeldt

Hägglund

2021

Preprint

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BACKGROUNDDigitalization could optimize healthcare; however, many eHealth projects are unsuccessful. By analyzing reasons for unsuccessful eHealth implementation, we could gain important knowledge on how to achieve successful digitalization in primary care and homecare.The aim of this study is to describe the implementation process of a tablet computer with an mHealth app that provides mobile access to the electronic health record (EHR) in homecare in order to understand reasons for unsuccessful implementations of mHealth interventions, as well as potential success factors.METHODSA tablet computer with mobile access to the EHR was implemented in 4 primary care centers and one municipality home care organization in Sweden. Focus groups, interviews and observations were used to evaluate how the implementation affects the work of the healthcare professionals. Qualitative content analysis informed by the Consolidated Framework for Implementation Research was used to analyze the implementation process and interpret the results.RESULTSThe implementation of the eHealth application was unsuccessful, mainly because the application did not fully support the users’ needs, but also due to immature technology and unstable infrastructure. Outcome of the intervention was dependent on context and user engagement. Users who had been involved in the development were more positive, despite missing functions, whereas those who had not been involved struggled to adopt the mobile tool. Development of the mHealth app and the subsequent implementation process was lengthy which affected user engagement negatively. The implementation process was insufficient and use of the application was affected by poor readiness for implementation. Users perceived lack of leadership engagement and questioned available resources dedicated to the implementation, in terms of resources and training.CONCLUSIONSThe functionality of mHealth must support users’ needs, be sufficiently integrated with existing eHealth ecosystems, and all aspects of the implementation process must be met to ensure success. Premature implementations may cause change fatigue and become a barrier for future implementation projects. In order to achieve the potential of mHealth, we have to ensure that sufficient resources are allocated to design and development, evaluation and feasibility studies and support and engagement during the implementation of mHealth in the future.

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Failed implementation of mobile access to electronic health records in homecare: a qualitative study

Hagstedt

Hvitfeldt

Hägglund

2021

Preprint

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A Living Lab Method for Innovations to Increase Quality of Life for Elderly - A Pilot Case

Scandurra

Blusi²,

Dalin³

2015

Human Aspects of IT for the Aged Population. Design for Aging

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Informatics and Socio-Technical Challenges when Designing Solutions for Integrated eCare

Koch

Hägglund

Scandurra

Advances in Healthcare Information Systems and Administration

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The central role of eHealth to enable the successful implementation of integrated care is commonly acknowledged today. This is easier said than done. To provide correct, understandable, and timely information at the point of need and to facilitate communication and decision support for a network of actors with different prerequisites and needs are some of the big challenges of integrated care. This book chapter focuses on the specific challenges related to informatics and socio-technical issues when designing solutions for integrated eCare. Methods for requirements elicitation, evaluation, and system development using user-centred design in collaborative environments involving a variety of stakeholders are presented. Case studies in homecare of older patients, in the care of stroke patients, and regarding citizen eHealth services in general illustrate the application of these methods. Possible solutions and pitfalls are discussed based on the experiences drawn from the case studies. To address the main informatics and socio-technical challenges in integrated eCare, namely informatics-supported collaborative work and to provide coordinated continuity for the patient, top-down activities such as health informatics standardisation, and bottom-up activities resulting in the definition of concrete patient journey descriptions, interaction points, information needs (that can be transformed into standardised data sets), as well as visualisation and interaction patterns need to go hand in hand.

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Supporting citizen-centered care for seniors - experiences from two Swedish research projects

Cited by 3 publications

References 18 publications

Failed implementation of mobile access to electronic health records in homecare: a qualitative study

Failed implementation of mobile access to electronic health records in homecare: a qualitative study

A Living Lab Method for Innovations to Increase Quality of Life for Elderly - A Pilot Case

Informatics and Socio-Technical Challenges when Designing Solutions for Integrated eCare

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