Paper: Medical Records Online for Patients and Effects on the Work Environment of Nurses


We have one paper from the DISA project accepted for Medical Informatics Europe 2018. The paper is written by Åsa Cajander, Jonas Moll, Sara Englund and Anastasia Hansman and will be presented at the conference in Gothenburg 24-26 of April 2018. The paper is based on Sara Englund and Anastasia Hansmans study with interviews of nurses in primary care.

Below is the abstract of the paper: 

In 2012 Patients Accessible Electronic Health Records (PAEHR) was introduced in Region Uppsala, Sweden. When PAEHR was introduced heath care professionals were very concerned especially in relation to potential negative effects on their work environment. However, few studies exist that investigate in what way work environments have been affected, and no studies have focused on the nurses’ working in primary care. Hence, the purpose of this study was to fill this gap through seven interviews with primary care nurses that were transcribed and thematically analysed.

The study shows that the nurses’ experiences an altered contact as patients accessing PAEHR came prepared to meetings with more informed questions. They also experienced that the service had increased their work load and that it creates uncertainty for nurses who do not know when to inform the patient about test results etc. Finally, some implications are discussed in relation to the patients’ role in shared decision making.

What is a Filter Bubble?

Since the late 40’s, every president of the United States obtains multiple documents of informations several times a day. The documents are adjusted according to each new president’s desires. Donald Trump desires to receive a document that is unofficially called “The Propaganda Document”. On orders from Mr. Trump, it contains only positive news, flattering tweets about himself and in some cases, when there are no happy news, just pictures of him looking powerful. It is also said that the news and national security issues in other documents are ranked with the only purpose of not upsetting him.

Filter bubbles can happen to everyone, not just president Trump. It happens when we use Facebook, Google or almost any other social media that adapt their content to their users. By adapting the content, users will only see information in subjects they have earlier shown interest in. One example could be if a coder and a zookeeper Googles “python”, they will probably receive different results. We believe that the effect of filter bubbles might be much more than just getting different Google results. If people only find information that matches their interests and opinion they will not see things from several points of view. In our project, we are investigating if there are such thing as a harmful filter bubble and what it might look like.

Our names are Anna Normark and Rebecca Oskarsson. We are two master students in the IT engineering programme, currently working on our master thesis. Our thesis consists of investigating filter bubbles and their effects. We are invited to write some blog posts here by our reviewer Åsa Cajander and this is our first blog post on this topic and there will be two more coming up this spring. 

Announcing new course ”Complex IT Systems in Large Organizations”

This term, Åsa and I are giving, for the very first time, a course titled “Complex IT Systems in Large Organizations”. The aim of this course is to familiarize Computer Science students with the real-life complexity of buying, designing, implementing and maintaining IT systems in large organizations. Our wish is above all to increase students’ awareness for the main issues specific to each one of these processes and to make them acquainted with some of the problem-solving strategies used by practitioners today in order to overcome them. We have chosen to expose them to three different professional domains: healthcare, administrative bodies and private companies.

Our course concept revolves around students’ interviewing practitioners from each domain working with one or several of the processes mentioned above. In addition to the interview itself, the students’ task will be to summarize their findings into a brief written report accompanied with a short film. This material will then be shared between course participants in order to enable each student to learn about all the different domains and processes covered by the course.

We are currently looking for practitioners within healthcare, administration and private companies willing to be interviewed by our students, and hope that our project will stir interest among those different communities. Better preparing students to the intricacies of IT management in large organizations through making them benefit from lessons learned by more experienced practitioners is crucial if we want to improve the way IT systems are being handled – at all levels – in those big and complex organizations.

Work Domain Analysis of an Intensive Care Unit: a study on how digitalization affects nurses’ work

During the spring Sara Carlson, from the master program in Human-Computer Interaction at Uppsala University, will work on her master thesis about how changes in a work system due to digitalization can be modelled. She will conduct observations and interviews with nurses at an intensive care unit to investigate the effect of the new system that have been implemented. She will explore how these changes can be modelled in an Abstraction Hierarchy from the Cognitive Work Analysis framework, and compare her results to an analysis of the same intensive care unit made prior the system implementation.

We are looking forward to work with Sara and her interesting study, more updates will come!

Can Digital Forms with Contextual Instructions Improve Medical Certificates for Sick Leave? – A Master Thesis Study

To get paid sick leave in Sweden, one must obtain a medical certificate from a physician and get it approved by the Social Insurance Office (Försäkringskassan). A recent report showcase that 9,7 % of all medical certificate forms are sent back to the issuing physician by Försäkringskassan (2017), needing completion or re-phrasing of the filled in data. The biggest culprit in the form is the field where one should describe how the patient’s condition hinders them from working.

In collaboration with EPJ, Region Uppsala and the company Inera, I will in my master thesis evaluate if a digital version of the form can help mitigate the frequent rejection of forms (due to phrasing). With a number of different prototypes, we will try to uncover if contextual instruction to each form field can help physicians fill in the form in a way that better corresponds with Försäkringskassans expectations.

The project has a great potential not only to ease the burden of an already strained health care system (and their patients), but also in regards of understanding physicians’ needs when it comes to IT. In the best of worlds, the results can help us design better health care systems and ensure a sound health care. It is truly exciting to work on projects that has the potential to impact many patients’ life quality, where an early approved medical certificate can mean the world to many.

Author background

Anton Björsell, Uppsala University. The study is my master thesis project within HCI and is planned to be executed throughout February to May this year. Except my focus on HCI, I also hold a bachelor’s degree in Media and Communication Studies. My favourite kind of research is the one which makes an honest attempt to understand humans and their needs. I am very excited about the project and grateful for having the opportunity to work with a topic that concerns so many people.

Start the Semester with Some Splendid Seminars

On Friday the 19th of January we have the pleasure of starting the day with two open seminars, so if you wish you can join us. From Reykjavik University we have Associate Professor Marta Lárusdóttir and from openhagen Business School professor Torkil Clemmensen. Torkil Clemenssen will talk about the socio-Technical Future of HCI and Marta Lárusdóttir will discuss research on the integration of UCD in industry.

The seminars will start at 10.00 in the Faculty Room at Ångström laboratory.

Marta Lárusdóttir
Integrating UCD in Agile Projects in Industry: Research Results and Future Work

Marta will give a talk on the interplay between usability activities and agile software development processes used in the IT industry. Marta has conducted research on this topic for many years collaborating with international researchers and students. Marta will give a summary of the results of these studies and describe future work on this important topic.

Marta Larusdottir is an Associate Professor at Reykjavik University with a PhD in Human-computer interaction. Marta has extensive leading knowledge in the area of evaluation and user feedback in software development. Particularly, she is a well known researcher in agile software development and how the user perspective is integrated in agile processes and has written several papers and arranged workshops on that subject.

This presentation will be followed directly by the presentation by professor Torkil Clemmensen.

Prof. Torkil Clemmensen, Copenhagen Business School
The Socio-Technical Future of HCI

Human-Computer Interaction (HCI) builds on the ideology of empowering the end-users of computers, so that they understand what is happening and can control the outcome (Nielsen, 2005). How does that work for HCI in organizations and societies? While HCI historically has been based on applying cognitive psychology to understand the individual user (Card, Moran, & Newell, 1983), one strong trend in modern and contemporary HCI is to study applications in business, managerial, organizational, and cultural contexts. To design HCI for organizations, the big thing may be to do some kind of HCI design action research that constructs or modifies one or more HCI artefacts within their existing organizational contexts: sketches, prototypes, templates, running systems – anything that changes the interactions that managers and employees do and experience. Hence, the future topics and theory of HCI may indeed be socio-technical.

Torkil Clemmensen is a professor at the Department of Digitalization, Copenhagen Business School, Denmark. His research interest is in psychology as a science of design with a focus on cultural psychological perspectives on usability, user experience, and digitalization of work. He contributes to Human-Computer Interaction, Design, and Information Systems.

Torkil Clemmensen will also lead the discussion in the afternoon when we have the half time seminar for yours truly.

A Seminar (in Swedish) on the Implementation of IT in Healthcare

Back in December I was invited to give a seminar in Swedish at the EPJ department of Region Uppsala, the department in charge of many of the health-related IT systems used at the hospitals and primary care facilities in the region. My seminar was on the the current state of research in relation to how to implement IT in healthcare. Out of all the perspectives one can use to approach this area of challenges for healthcare, I devoted most of the seminar to presenting barriers and enablers to change management projects as well as IT development projects, and discussing these with the participants. The seminar was recorded and is now available on YouTube, if you find the topic interesting (and are comfortable with the Swedish language).

The HTO group, and more generally the HCI group at the Department of Information Technology, Uppsala University, have an ongoing collaboration with the EPJ department at the region, and there will be more seminars on a variety of topics given by us during the spring.