Two studies published on the effects of patient accessible electronic health records

Members of the HTO group recently got two journal articles published, on the effects of patients accessible electronic health records (PAEHRs) in Sweden.  Both studies were picked up by Swedish media after press releases had been published by Uppsala University.

The first article, “On threats and violence for staff and patient accessible electronic health records” was published September 28 and written by Ulrika Åkerstedt, Åsa Cajander, me and Ture Ålander. The open access article, which you can find here, is based on Ulrika’s masters thesis and presents results from a survey study conducted with healthcare professionals at the emergency and psychiatric departments at Uppsala University Hospital. Among other things, the study showed that the fear of being exposed to threats and violence from patients increased as a consequence of PAEHRs being launched in Region Uppsala. Shortly after the article was published this press release was published by Uppsala University. The news spread from there and Forskning.se, Dagens medicin, SVT Nyheter and Vetenskapsradion all published their own articles based on the press release. Åsa and I were also invited to write a popular science summary on Ciennce.se. The article by Dagens Medicin and the article by SVT Nyheter also took things further by e.g. adding interviews Åsa Cajander and representatives from the psychiatry department in Region Uppsala!

Our second article with a PAEHR theme, “Patients’ Experiences of Accessing Their Electronic Health Records: National Patient Survey in Sweden” was published November 1 and written by me, Åsa Cajander and Christiane Grünloh from the HTO-group as well as several other researchers in the DOME consortium (I introduced all researchers that are involved in the study in this blog post). In this article we focus on patients’ attitudes toward and experiences with PAEHRs in Sweden. It is clear from the results that patients really appreciate the possibilities that the Swedish PAEHR system, Journalen, gives them and that patients want access to new results in their PAEHR within a day after a new examination or visit. You can find many more results, and of course more details about the study, in the open access article published here (please help us share the news!). Even this article was presented in a press release from Uppsala University and the news was once again picked up by Forskning.se and we once again got an invitation to write a popular science version on Ciennce.se. This time around Inera (managing Journalen and several other Swedish eHealth systems), published their own press release about the study. The journal IT-Hälsa also wrote an article based on Inera’s release.

Presentation by Åsa Cajander and Jonas Moll at Medical Informatics Europe

During the first day of the Medical Informatics Europe (MIE) Conference Åsa Cajander and I presented the paper that was introduced in this blog post. Actually, this was the first presentation held by representatives from the HTO group during this year’s combined MIE/Vitalis event, but certainly not the last – we were active on stage, or as workshop leaders, during each and every day!

This particular presentation was based on a study that was conducted within the scope of a master’s thesis project at Uppsala University by Sara Englund and Anastasia Hansman. The project focused on the Swedish patient accessible electronic health record system Journalen (and hence was tightly connected to the DOME consortium) and more specifically on how nurses see that Journalen has affected their work environment and their communication with patients.

The result of the semi-structured interviews conducted with the nurses at a primary care center in Region Uppsala, first of all showed similar as our earlier interviews with physicians – Journalen has changed the interaction with patients, created an increased workload and created uncertainty regarding when to inform patients of results now that the patients can read even unsigned notes. Even though most of the results were in line with results from our earlier research in DOME, one new theme arose from the interview analysis – the need for new knowledge. Several nurses indicated that education was needed, focusing on how Journalen should be used both by patients and in the clinician-patient relationship. This is an important result, which should be taken very seriously.

All conference papers are published open access, so you can find all research presented at MIE here. You can find the paper that Åsa and I presented here.

Stay tuned for more posts about the HTO activities at MIE/Vitalis 2018! 🙂

Åsa Cajander interviewed about our HTO hosted workshop at Uppsala Health Summit!

The HTO group is presently involved in many different activities and one of the latest additions to the list is a workshop at Uppsala Health Summit, which Åsa Cajander (main organizer), Christiane Grünloh and Jonas Moll are organizing. This workshop was introduced by Åsa in this blog post. The planning has continued since then and now we have a setup which will soon be available in the pre-conference report which will be posted on the summit web page. On this page you can also already find a short description of our workshop, “Using Data for Better Cancer Treatments”.

In February, Åsa was interviewed about our workshop! Among other things, she discusses some challenges regarding the use of data for diagnosis and treatment of cancer and how we will make use of critical incidents as points of departure in the workshop. You can read about the interview here!

The summit will be held at Uppsala Castle, June 14-15, and according to the recently published summit programme our three-hour workshop will be held during the second day. Organizing this workshop will surely be an interesting and rewarding experience for all of us and hopefully we will come up with results that will inspire further research in this important area!

HTO and DISA planning activities

Last Monday, two workshops aimed at framing and planning future work activities were conducted within the HTO group. The first one concerned different aspects of the work environment within the HTO group and the second activity aimed specifically at planning the DISA project.

During the HTO workshop, we used the affinity diagram technique to map out aspects of the work environment that we liked and aspects where we felt improvements were needed. We started out by writing down our thoughts about good and not so good aspects on post-its for a few minutes whereafter we gathered by a whiteboard on which we arranged our positive remarks in columns with related notes. After all notes had been added to the whiteboard each column was labeled to make it clear which areas worked well. Among the identified positive aspects were; good support and organization, good athmosphere and good ability to communicate to the public. When we were done with the positive side we did the same for the negative aspects that needed some degree of improvement. Among the negative aspects we found; somewhat unclear boundaries between pojects, hard to get an overview of what everyone is doing and sometimes too much information in the HTO slack channels.

Later on the same day we had the workshop for planning the DISA project. Diane, Ida and I planned the workshop and invited the other DISA members to the two hour activity. Everyone started out by writing down 2-3 studies they would like to perform within the scope of the project (some of these studies had already started). This was to make sure that every participant got the chance to express what they wanted from the project.  Those who could not attend sent their ideas to one of the participating colleagues before the workshop. After about 15 minutes everyone presented their ideas shortly and put their notes on the whiteboard. Again, the affinity diagram technique was used to cluster ideas from different participants into categories. On the picture above Diane has just started the process of assigning a label to each of the categories. On the poster to the left of the post-its the main parts of the DISA project are mapped out. The next step was to match the proposed studies to the different parts of DISA shown on the poster. This exercise resulted in a study being added – this was needed in order to make sure that the last year of the project was sufficiently covered.

The second hour of the workshop was devoted to placing the proposed and already ongoing studies on a timeline, drawn on another whiteboard, which contained relevant deadlines (like conference submission dates, special issue deadlines and dates when individual project members’ contracts with the University went out). After we had placed the studies we were conducting, or wanted to conduct, during the first year on the timeline we added information about who should lead the different studies. The end result of this workshop activity was the timeline which clearly showed all the important dates, studies and responsibilities.

Several guest researchers visiting us this week!

Several guests, that are involved in joint eHealth projects with Åsa Cajander and me, have been visiting us this week. The blog picture was taken yesterday and shows, from left to right, me, Christiane Grünloh (KTH, TH Köln), Gunilla Myreteg (Örebro University) and Maria Hägglund (Karolinska institutet).

Christiane Grünloh, who is a Ph.D. student from the Royal Institute of Technology (KTH) and living in Germany, will be with us this entire week to work with us on a large observation/interview/survey study which will be conducted with physicians and nurses at Uppsala University hospital. She is also a member of the HTO group, but is mostly connecting from Germany via Skype. We have been working mostly on refining the interview template, since we have not yet conducted any interviews. Yesterday, Gunilla Myreteg from Örebro University and Maria Hägglund from Karolinska Institutet also joined in to, among other things, help us finalize and pilot the interview template. It was a very productive day – it’s nice to sit down with colleagues you don’t meet that often to really focus on a common task. Those who want to know more about our study at the oncology department, which is a part of the DISA project as well as the larger DOME consortium, can read this blog post for an introduction of the entire research team behind the study and this blog post for an introduction of the different parts of the study.

While all of us were gathered, we also took the chance to work on the first paper based on a large national patient survey, which we and several other researchers within the DOME consortium are also a part of. And of course we couldn’t just split up after being done working – we had to end the day at a nice Italian restaurant here in Uppsala!  🙂

A new eHealth research adventure is about to start!

The ethics application I wrote about quite a while ago, regarding a new large observation/interview/survey study, has now finally been approved! This means that a new eHealth research adventure will now begin for the research team  [Read more…]

 

The team behind a new large study on electronic health records in Sweden

In my last blog post on my personal blog I wrote about the application for ethical review, concerning a new large interview/survey/observation study with doctors and nurses at Akademiska Sjukhuset in Uppsala. The study, which will… [Read entire post]