Ann Bygholm

eHealth Education of Professionals in the Baltic Sea Area

In this paper we present a study on the extent, level and content of e-Health in existing formal educational systems in Lithuania, Germany, Finland, Norway and Denmark with the objectives of identifying future educational needs within this area. The study was carried out as a desk-top study and took place within the context of the ICT for Health project. The results of the study on the one hand revealed a wide range of programs and courses that included e-Health, but on the other hand also showed that in the educations of health care professionals (physicians, nurses etc.) the integration of e-Health elements are often marginal or non-existing. Thus the study indicates that there is a need for a higher integration of e-Health in the education of health care professionals. We discuss what kind of knowledge of e-Health is needed and how it could or should be integrated in these educations. We argue that providing possibilities for applying and experimenting with e-Health system in a concrete and tangible manner is central in order to raise the acceptance and capabilities of health care professionals to use e-Health systems.

Implementation of an Infrastructure for Networked Learning

What are the conditions under which institutional actors decide upon Information and Communication Technology strategies for networked learning purposes? The question is discussed within the frame of a case study of the decision process during a shift from one learning platform to another in an education at Aalborg University. The aim is to explicate and understand the multiplicity of issues involved and to point the possible ways of handling such decision processes. On the one hand, the analysis shows that the predominant reasons for deciding to change are dissatisfaction with the existing system which is slow due to (too) many levels, lack of esthetic design, lack of coherence in practices and, generally, lack of relevant content. On the other hand, the predominant arguments for choosing the new system are more related to issues of operation, support, and management. We argue that the issues of dissatisfaction with the existing system will not automatically be solved by implementing a new one; that many of the problems with the existing system are related to the way it is used; and that the role of the system is vaguely defined in the organization.

Strategic planning of the master programme in health informatics at Aalborg University: targeting and updating the programme, to meet explicit customer needs

Education is essentially giving people new skills and qualifications to fulfil certain tasks. In planning and managing educational programmes it is crucial to know what skills and what qualifications are needed to carry out the tasks in question, not to mention the importance of knowing what tasks are relevant to carry out. The programme in health informatics at Aalborg University produces health informatics professionals. The students are developing skills in solving informatics problems in health care organisations. The programme has been running for 3 years now and to maintain the perception of the aim for the programme a number of activities have been launched. In the following, the programme will be presented, the activities to obtain information on how to keep the programme targeted and updated will be described and the changes that are going to be introduced will be outlined.

Developments in Participatory Design of Health Information Technology – A Review of PDC Publications from 1990–2016

The landscape of Participatory Design (PD) of Health Information Technology (HIT) is diverse and constantly evolving. This paper reviews the publications in the proceedings from the Participatory Design Conferences (PDCs) that have been held every two years since 1990. We used the Matrix Method to identify, describe and synthesise HIT publications from the proceedings. A total of 47 papers were included in the review and analysed in relation to six themes. The analysis reveals a significant volume of HIT research at PDCs, with a large amount of attention to digitalisation of health information, work procedures, records, secondary healthcare and health professionals. However, the analysis also shows a development from a primary focus on health workers and hospitals to a recent attention on HIT in everyday life and PD with patients, relatives, neighbourhoods and citizens in general. Additionally, the review shows a growing number of PD methods being applied. This paper concludes that research on PD and HIT appears to be maturing and developing with ongoing technological and societal development.

Compliance or patient empowerment in online communities: reformation of health care services?

New technologies enable a different organization of the publics admission to health care services. The article discusses whether online support groups in patient treatment are to be understood in the light of patient empowerment or within the tradition of compliance. The back-ground material of the discussion is complementary data from quantitative research on characteristics of patient support groups, and from two qualitative, in depth studies of the impact of patient networks for lung patients and for women with fertility problems. We conclude that in spite of the potential of online communities of opening up health care to the critical voice of the public, the quantitative and qualitative studies surprisingly point to a synthesis of the otherwise opposite positions of empowerment and compliance in patient care. Thereby the critical potential of online communities in health care services seems reverted into configuring ideal patients from diverse users.

Nursing Minimum Data Sets for documenting nutritional care for adults in primary healthcare: a scoping review

Objective: To identify all published nutritional screening instruments that have been validated in the adult population in primary healthcare settings and to report on their psychometric validity. Introduction: Within health care, there is an urgent need for the systematic collection of nursing care data in order to make visible what nurses do and to facilitate comparison, quality assurance, management, research and funding of nursing care. To be effective, nursing records should accurately and comprehensively document all required information to support safe and high quality care of patients. However, this process of documentation has been criticized from many perspectives as being highly inadequate. A Nursing Minimum Data Set within the nutritional area in primary health care could therefore be beneficial in order to support nurses in their daily documentation and observation of patients. Inclusion criteria: The review considered studies that included adults aged over 18 years of any gender, culture, diagnosis and ethnicity, as well as nutritional experts, patients and their relatives. The concepts of interest were: the nature and content of any nutritional screening tools validated (regardless of the type of validation) in the adult population in primary healthcare; and the views and opinions of eligible participants regarding the appropriateness of nutritional assessment were the concept of interest. Studies included must have been conducted in primary healthcare settings, both within home care and nursing home facilities. Methods: This scoping review used a two-step approach as a preliminary step to the subsequent development of a Nursing Minimum Data Set within the nutritional area in primary healthcare: i) a systematic literature search of existing nutritional screening tools validated in primary health care; and ii) a systematic literature search on nutritional experts opinions on the assessment of nutritional nursing care of adults in primary healthcare as well as the views of patients and their relatives. Multiple databases (PubMed, CINAHL, Embase, Scopus, Swemed+, MedNar, CDC, MEDION, Health Technology Assessment Database, TRIP database, NTIS, ProQuest Dissertations and Theses, Google Scholar, Current Contents) were searched from their inception to September 2016. Results: The results from the studies were extracted using pre-developed extraction tools to all three questions, and have been presented narratively and by using figures to support the text. Twenty-nine nutritional screening tools that were validated within a primary care setting, and two documents on consensus statements regarding expert opinion were identified. No studies on the patients or relatives views were identified. Conclusions: The nutritional screening instruments have solely been validated in an over-55 population. Construct validity was the type of validation most frequently used in the validation process covering a total of 25 of the 29 tools. Two studies were identified in relation to the third review question. These two documents are both consensus statement documents developed by experts within the geriatric and nutritional care field. Overall, experts find it appropriate to: i) conduct a comprehensive geriatric assessment, ii) use a validated nutritional screening instrument, and iii) conduct a history and clinical diagnosis, physical examination and dietary assessment when assessing primarily the elderlys nutritional status in primary health care.

Using Information and Communication Technologies to Promote Healthy Aging in Costa Rica: Challenges and Opportunities

Several authors have suggested that ICTs have the potential to promote healthy ageing by supporting social inclusion, access to products and services and learning. However, older people often do not use ICT and information about patterns of usage is scarce. Data from the Costa Rica Census 2011 and two questionnaires showed that older people between 65 and 74 years old, living in urban areas, with more education and higher socioeconomic status are the most active ICT users. They presented a tendency to mobility and connectivity when using ICTs, reported positive perceptions of technology and were favorably disposed to learning about and using ICT. Based on the analysis of data we conclude that opportunities to promote healthy aging through use of ICT include use of public infrastructure and community-based learning services to increase the number of ICT users and facilitate progression from social networking activities to activities supporting the maximization of functional status such as instrumental activities and learning for personal development.

Monitoring Technology Meets Care Work: Challenges of monitoring wet-beds in a nursing home

Monitoring technology, especially sensor-based technology, is increasingly taken into use in care work. Despite the simplicity of these technologies - aimed to automate what appear as mundane monitoring tasks - recent research has identified major challenges primarily related to the technologys ability to meet the complexity of care work. Understanding intersectional challenges between these care technologies and care work is fundamental to improve design and use of health informatics. In this paper we present an analysis of interaction challenges between a wet-sensor at the task of monitoring wet beds at a nursing home. The analysis identifies the multifaceted nature of monitoring work and the intricacy of integrating sensor technology into the complex knowledge system of monitoring work.

Learning from an Ambient Assisted Living Lab: the case of the intelligent bed.

This paper presents methodological lessons learned from an Ambient Assisted Living (AAL) lab exploring the use of intelligent beds in a nursing home. The living lab study was conducted over a period of three month. 20 intelligent beds were installed. Data was collected via self-registration, diaries, observations, interviews and workshops with residents, nurses, nursing assistants, management, building officers, and purchasers from the Municipality. The paper presents an analysis within the overall themes of technology, use, and care, which is discussed by use of the SWOT framework presenting strengths, weaknesses, opportunities, and threats identified in the living lab of the intelligent bed. The paper concludes by emphasizing the need for mature technology, long-term studies, clarification of role and tasks of different stakeholders, and attention on methods used for living lab evaluations.

E-learning to train staff in Danish Hospitals: three genres of e-learning

This paper presents a study of the use of e-learning in education and training of hospital staff in Denmark, in particular in relation with the implementation of electronic patient records (EPR). The study consists of a survey mapping the dissemination and main experience from using e-learning in Danish hospitals. The study shows a widespread use and a considerably agreement on the potentials of e-learning in education and training of hospital staff, but also problems and doubtfulness concerning the actual role of e-learning in the overall educational and organizational strategy for the hospital. The majority of hospitals use some sorts of computer-based training program to support the staff in acquiring necessary knowledge to operate the EPR. I argue that a more differentiated understanding is needed in order to realize the potentials and direct the use of e-learning in hospitals. Three genres of e-learning which differ in regards to qualification addressed are identified and I claim that a more explicit understanding of the differences between them is needed in order to guide the choice of e-learning of hospital staff.