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Professional decision making with digitalisation of patient contacts in a medical advice setting: a qualitative study of a pilot project with a chat programme in Sweden
Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computing Education Research.ORCID iD: 0000-0001-7472-2215
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology.
Reykjavik Univ, Sch Comp Sci, Reykjavik, Iceland..
2021 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 11, no 12, article id e054103Article in journal (Refereed) Published
Abstract [en]

Objectives: Patient e-services are increasingly launched globally to make healthcare more efficient and digitalised. One area that is digitalised is medical advice, where patients asynchronously chat with nurses and physicians, with patients having filled in a form with predefined questions before the chat. This study aimed to explore how occupational professionalism and the possibility of professional judgement are affected when clinical patient contact is digitalised. The study’s overall question concerns whether and how the scope of the healthcare staff’s professional judgement and occupational professionalism are affected by digitalisation.

Design and setting: A qualitative study of healthcare professionals working in a pilot project with a chat programme for patients in a medical advice setting in Sweden.

Participants and analysis: Contextual inquiries and 17 interviews with nurses (n=9) and physicians (n=8). The interviews were thematically analysed. The analysis was inductive and based on theories of decision making.

Results: Three themes emerged: (1) Predefined questions to patients not tailored for healthcare professionals’ work, (2) reduced trust in written communication and (3) reduced opportunity to obtain information through chat communication.

Conclusions: The results indicate that asynchronous chat with patients might reduce the opportunity for nurses and physicians to obtain and use professional knowledge and discretionary decision making. Furthermore, the system’s design increases uncertainty in assessments and decision making, which reduces the range of occupational professionalism.

Place, publisher, year, edition, pages
BMJ BMJ Publishing Group Ltd, 2021. Vol. 11, no 12, article id e054103
Keywords [en]
human-computer interaction
National Category
Human Computer Interaction Nursing
Research subject
Health Care Research; Human-Computer Interaction
Identifiers
URN: urn:nbn:se:uu:diva-460276DOI: 10.1136/bmjopen-2021-054103ISI: 000726845300028PubMedID: 34857576OAI: oai:DiVA.org:uu-460276DiVA, id: diva2:1616860
Funder
Afa Sjukförsäkringsaktiebolag, 180 250Available from: 2021-12-05 Created: 2021-12-05 Last updated: 2024-01-15Bibliographically approved

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Cajander, ÅsaHedström, Gustaf

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Computerized Image Analysis and Human-Computer InteractionDivision of Visual Information and InteractionComputing Education ResearchHealth Services ResearchDepartment of Information Technology
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