uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Sharing is Caring: Integrating Health Information Systems to Support Patient-Centred Shared Homecare
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.ORCID iD: 0000-0002-6839-3651
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In the light of an ageing society with shrinking economic resources, deinstitutionalization of elderly care is a general trend. As a result, homecare is increasing, and increasingly shared between different health and social care organizations. To provide a holistic overview about the patient care process, i.e. to be patient-centred, shared homecare needs to be integrated. This requires improved support for information sharing and cooperation between different actors, such as care professionals, patients and their relatives.

The research objectives of this thesis are therefore to study information and communication needs for patient-centered shared homecare, to explore how integrated information and communication technology (ICT) can support information sharing, and to analyze how current standards for continuity of care and semantic interoperability meet requirements of patient-centered shared homecare.

An action research approach, characterized by an iterative cycle, an emphasis on change and close collaboration with practitioners, patients and their relatives, was used. Studying one specific homecare setting closely, intersection points between involved actors and specific needs for information sharing were identified and described as shared information objects. An integration architecture making shared information objects available through integration of existing systems was designed and implemented. Mobile virtual health record (VHR) applications thereby enable a seamless flow of information between involved actors. These applications were tested and validated in the OLD@HOME-project. Moreover, the underlying information model for a shared care plan was mapped against current standards. Some important discrepancies were identified between these results and current standards for continuity of care, stressing the importance of evaluating standardized models against requirements of evolving healthcare contexts.

In conclusion, this thesis gives important insights into the needs and requirements of shared homecare, enabling a shift towards patient-centered homecare through mobile access to aggregated information from current feeder systems and documentation at the point of need.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2009. , p. 98
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 414
Keywords [en]
health informatics, user-centred design, integrated health information systems, homecare services, cooperative work, health informatics standardization
National Category
Biomedical Laboratory Science/Technology
Identifiers
URN: urn:nbn:se:uu:diva-9527ISBN: 978-91-554-7390-7 (print)OAI: oai:DiVA.org:uu-9527DiVA, id: diva2:173112
Public defence
2009-02-13, Auditorium Minus, Gustavianum, Akademigatan 3, Uppsala, 09:15
Opponent
Supervisors
Available from: 2009-01-23 Created: 2009-01-23 Last updated: 2018-11-05Bibliographically approved
List of papers
1. Scenarios to capture work processes in shared homecare-From analysis to application
Open this publication in new window or tab >>Scenarios to capture work processes in shared homecare-From analysis to application
2010 (English)In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 79, no 6, p. E126-E134Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Shared homecare is increasingly common, and in order to develop ICT that support such complex cooperative and interdisciplinary work it is crucial to obtain an understanding of work processes at the clinical level before the development is initiated. It is also crucial, but difficult, to correctly transfer this insight to the development team. METHOD: User-centered scenario building in interdisciplinary working groups is applied for capturing cooperative work routines, information demands, and other central preconditions in shared homecare. RESULTS: Use of scenarios for analysis of cooperative work and as information carrier is described via a case from the multi-disciplinary OLD@HOME project. Both current and future work scenarios were elicited. To illustrate the process of transforming scenarios into more technical descriptions (use cases), and finally into an application, examples showing the transparency in resulting use cases and in the implemented system are provided. CONCLUSION: In this case study, scenarios proved to be useful not only in initial system development phases but throughout the entire development process, improving accessibility and assessment of end user needs. For the development team, scenarios assisted in solving usability issues, and served as a basis for describing use cases and for further system development. More importantly, the shared care scenarios ensured the provision of different perspectives on common work processes, which are often neglected in conventional requirements specifications. This also improved understanding between different clinical groups and between clinicians and developers.

Keywords
Interdisciplinary communication, Integrated health care systems, Software design, Nursing records, Medical records, Home care services
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-97968 (URN)10.1016/j.ijmedinf.2008.07.007 (DOI)000278192800014 ()18762445 (PubMedID)
Available from: 2009-01-23 Created: 2009-01-23 Last updated: 2018-11-03
2. Studying intersection points - an analysis of information needs in shared homecare of elderly
Open this publication in new window or tab >>Studying intersection points - an analysis of information needs in shared homecare of elderly
2009 (English)In: The Journal on Information Technology in Healthcare, Vol. 1, p. 1-20Article in journal (Refereed) Published
Abstract
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-97969 (URN)
Available from: 2009-01-23 Created: 2009-01-23 Last updated: 2018-11-03Bibliographically approved
3. Bridging the gap: a virtual health record for integrated home care
Open this publication in new window or tab >>Bridging the gap: a virtual health record for integrated home care
2007 (English)In: International Journal of Integrated Care, ISSN 1568-4156, E-ISSN 1568-4156, Vol. 7, no June, p. e26-Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: The coexistence of different information systems that are unable to communicate is a persistent problem in healthcare and in integrated home care in particular. THEORY AND METHODS: Physically federated integration is used for design of the underlying technical architecture to implement a mobile virtual health record for integrated home care. A user centered system development approach is followed during design and development of the system. RESULTS: A technical platform based on a service-oriented approach where database functionality and services are separated has been developed. This guarantees flexibility with regard to changed functional demands and allows third party systems to interact with the platform in a standardized way. A physically federated integration enables point-of-care documentation, integrated presentation of information from different feeder systems, and offline access to data on handheld devices. Feeder systems deliver information in XML-files that are mapped against an ideal XML schema, published as an interface for integration with the information broker, and inserted into the mediator database. CONCLUSIONS: A seamless flow of information between both different care professionals involved in integrated home care and patients and relatives is provided through mobile information access and interaction with different feeder systems using the virtual health record.

Keywords
medical records systems, computerized, integrated advanced information management systems, information storage and retrieval, internet, home care services, nursing record
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-97970 (URN)17637872 (PubMedID)
Available from: 2009-01-23 Created: 2009-01-23 Last updated: 2017-12-14Bibliographically approved
4. Modeling and sharing of personalized care plans using ContSYS, openEHR reference model and archetypes to support collaboration in shared homecare of elderly
Open this publication in new window or tab >>Modeling and sharing of personalized care plans using ContSYS, openEHR reference model and archetypes to support collaboration in shared homecare of elderly
(English)In: J Am Med Inform AssocArticle in journal (Refereed) Submitted
Abstract
Identifiers
urn:nbn:se:uu:diva-97971 (URN)
Available from: 2009-01-23 Created: 2009-01-23 Last updated: 2018-11-03Bibliographically approved

Open Access in DiVA

fulltext(2375 kB)2141 downloads
File information
File name FULLTEXT01.pdfFile size 2375 kBChecksum SHA-1
260cc641d851d470bc137cfdfa65be3ab0b9665321a64a08e901d93e0f8723ba8d60dc79
Type fulltextMimetype application/pdf
cover(96 kB)145 downloads
File information
File name COVER01.pdfFile size 96 kBChecksum SHA-1
8c736c85133f4e6f6fbc45a3326e21d462b167222eb6c7276b0613d431ada5fc393badf6
Type coverMimetype application/pdf
Buy this publication >>

Authority records BETA

Hägglund, Maria

Search in DiVA

By author/editor
Hägglund, Maria
By organisation
Department of Medical Sciences
Biomedical Laboratory Science/Technology

Search outside of DiVA

GoogleGoogle Scholar
Total: 2141 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

isbn
urn-nbn

Altmetric score

isbn
urn-nbn
Total: 9073 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf