Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • 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
Patient Empowerment Meets Concerns for Patients: a Study of Patient Accessible Electronic Health Records in Sweden
KTH, School of Computer Science and Communication (CSC). TH Köln - University of Applied Sciences, Germany.ORCID iD: 0000-0003-2319-3186
University of Skövde, School of Informatics. The Informatics Research Centre.ORCID iD: 0000-0001-8957-9853
Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction..ORCID iD: 0000-0001-7472-2215
University of Skövde, School of Informatics. The Informatics Research Centre.ORCID iD: 0000-0002-8607-948X
Show others and affiliations
2016 (English)In: Exploring Complexity in Health: An Interdisciplinary Systems Approach / [ed] Alexander Hoerbst, Werner O. Hackl, Nicolette de Keizer, Hans-Ulrich Prokosch, Mira Hercigonja-Szekeres, Simon de Lusignan, IOS Press, 2016Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Background

As part of a EU project, the Swedish county Uppsala launched a patient portal, Journalen in 2012 [1]. Patients can now access their Electronic Health Records (EHR) online, which is aimed to increase patient empowerment. The medical professionals reacted strongly on patients accessing the medical records. Main concerns were related to quality of care, the effect on their work environment, providing bad news through the eHealth service, and also the wellbeing of patients. While the opportunities of implementing these e-health services seem promising, the concerns of the medical professionals have to be understood and addressed, as well as the actual use of the system by patients. This presentation integrates results from two interview studies with physicians and patients related to patients accessing their medical records online [2,3].

Method

The presented results are synthesis of the interviews studies with 12 physicians [2] and 30 patients [3], which took place about 6–12 months after the launch of the portal. The synthesis presented in this paper focus on Technological Frames [4] of physicians and patients including the attitudes and experiences in relation to possible (1) anxiety creation, (2) increased of workload, and (3) the general value of patients reading medical records.

Results Anxiety creation due to receiving bad news. Many physicians believe that breaking bad news to patients during a patient encounter is vital as this would give them the possibility to also explain treat- ments and answer questions. Somewhat unexpectedly, some patients preferred receiving bad news through Journalen instead of waiting for the physicians. The patients argue that waiting times causes more anxiety. The choice of not accessing is also important, as there are patients who do not want to receive bad news before a patient encounter. Workload increases. Many physicians are worried about the work- load of doctors, as reading the medical record online may result in increased number of phone calls because of anxious patients. However, many patients did not tend to take any additional contacts to ask questions. Some of the patients even believe that access to their medical records reduces the number of contacts with healthcare. Usefulness of accessing online. Many physicians are concerned that online access will have a negative impact on the patient such as increased anxiety and misconceptions as they lack understanding of medical terms. Unlike the doctors’ perspective, many patients argue that they do not have major difficulties in understanding the contents. They also argue that Journalen was central to their coping with their decease.

Conclusion

From this study it is clear that the Technological Frames of physicians differ from those of patients, and that they have different attitudes and experiences towards the system. The intention from the politicians was that the system would contribute to Patient Empowerment, but that framing of the technology differs from the physicians’ view, as they are concerned of the consequences. More research is needed on the framing of the technology and how that has been changed after the launch of the system.

[1] Erlingsdottir, G., Lindholm, C. When patient empowerment encounters professional autonomy: The conflict and negotiation process of inscribing an eHealth service. Scandinavian journal of public administration 2015;19(29):27- 48.

[2] Grünloh, C., Cajander, Å., Myreteg, G., “The Record is our Work Tool!” - Physicians’ Framing of a Patient Portal in Sweden. J Med Internet Res (submitted).

[3] Rexhepi, H., Åhlfeldt, R.-M., Cajander, Å, & Huvila, I. (2015). Cancer Patients’ Attitudes and Experiences of Online Medical Records, 1–8. Proceedings of the 17th International Symposium on Health Information Management Research ISHIMR 2015.

[4] Orlikowski, W.J., Gash, D.C. Technological Frames: Making sense of information technology in organizations. Transactions on Information Systems 1994;12(2):174–207. doi: 10.1145/196734.196745

Place, publisher, year, edition, pages
IOS Press, 2016.
Series
Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365 ; 228
Keywords [en]
eHealth and intersectoral documentation, health telematics, telemedicine, Digital healthcare strategies, Health information and process management, Hospital information systems, computerized medical record systems, Research IT infrastructures and EHR data reuse, Human factors
National Category
Human Computer Interaction Computer and Information Sciences
Identifiers
URN: urn:nbn:se:kth:diva-215971ISBN: 978-1-61499-677-4 (print)ISBN: 978-1-61499-678-1 (electronic)OAI: oai:DiVA.org:kth-215971DiVA, id: diva2:1150466
Conference
HEC2016: This was a joint conference that united the Medical Informatics Europe (MIE) conference, the conferences of the German Association for Medical Informatics, Biometry and Epidemiology (GMDS), the German Society for Epidemiology (DGEpi), the International Epidemiological Association – European Region and the European Federation for Medical Informatics (EFMI).
Note

QC 20171102

Available from: 2017-10-19 Created: 2017-10-19 Last updated: 2018-01-13Bibliographically approved

Open Access in DiVA

fulltext(112 kB)26 downloads
File information
File name FULLTEXT01.pdfFile size 112 kBChecksum SHA-512
cd4babd36b330800e760066eacef6f916a898b9ede3544848eb480b3861f75adef34daea5ec226d2ad045207fdbe46315efc19feef50c83044de7908312f67c1
Type fulltextMimetype application/pdf

Other links

Proceedings

Search in DiVA

By author/editor
Grünloh, ChristianeRexhepi, HanifeCajander, ÅsaÅhlfeldt, Rose-MharieMyreteg, GunillaHuvila, Isto
By organisation
School of Computer Science and Communication (CSC)
Human Computer InteractionComputer and Information Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 26 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: 134 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • 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