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Many see the role of health informatics research as informing the development and implementation of information technology in clinical practice. The aim of this study is to see if this role is realized in the ongoing implementation of a large-scale health information system in central Norway. By doing a document analysis of the planning documents for the implementation, we assess to what extend evidence from the scientific community is explicitly referenced and used in the implementation planning. We found that evidence available is not explicitly used, and that evidence required is not widely available. [ABSTRACT FROM AUTHOR]

Interdisciplinary team communication in eHealth development is challenging because all disciplines have unique, intrinsic discursive practices, theories and artefacts. Due to these factors, members of interdisciplinary teams can experience problems in communication and collaboration. Through a centered focus, members can benefit individually, inspire one another, and ultimately reach a timely delivery of their common pedagogical goal(s). Using the lens of dialogism, this paper aims to identify the conceptual considerations that arose during the development of a Massive Open Online Course (MOOC) for higher education in eHealth. Methods included auto-ethnography and interdisciplinary dialogue supported by literacy artefacts, including visual material. Results yielded a visual tool for meta-assessment of team communication, and an organizing principle for topics in the MOOC. A major implication is that especially for eHealth, scientific communicative competence of experts—while establishing a common understanding—can lead to a unique and meaningful delivery of high pedagogical quality. [ABSTRACT FROM AUTHOR]

Background:Addictive disorders and substance use are significant health challenges worldwide, and relapse is a core component of addictive disorders. The dynamics surrounding relapse and especially the immediate period before it occurs is only partly understood, much due to difficulties collecting reliable and sufficient data from this narrow period. Mobile sensing has been an important way to improve data quality and enhance predictive capabilities for symptom worsening within physical and mental health care, but is less developed within substance use research. Methodology:This scoping review aimed to reviewing the currently available research on mobile sensing of substance use and relapse in substance use disorders. The search was conducted in January 2019 using PubMed and Web of Science. Results:Six articles were identified, all concerning subjects using alcohol. In the studies a range of mobile sensors and derived aggregated features were employed. Data collected through mobile sensing were predominantly used to make dichotomous inference on ongoing substance use or not and in some cases on the quantity of substance intake. Only one of the identified studies predicted later substance use. A range of statistical machine learning techniques was employed. Conclusions:The research on mobile sensing in this field remains scarce. The issues requiring further attention include more research on clinical populations in naturalistic settings, use of a priori knowledge in statistical modeling, focus on prediction of substance use rather than purely identification, and finally research on other substances than alcohol. [ABSTRACT FROM AUTHOR]

In order to improve health care processes (both in terms of quality and efficiency), we do need insight into how these processes are actually executed in reality. Interviewing health personnel and observing them in their work, are proven field-work techniques for gaining this insight. In this paper, we will introduce a complementary technique. This technique, called process mining, is based on the automatic analysis of digital events, registered in different information systems that support clinical work. Based on an event log, process mining can help in constructing a model of the process (discovery) or with checking to which extend an actual process confirms to a prescriptive model of it (conformance). This paper will briefly discuss two examples, which illustrate the use of process mining. [ABSTRACT FROM AUTHOR]

In this paper we present a longitudinal perspective of exchange of information providers in hospital and home health care. More specifically we address how this practice has changed over the last six years. In three different studies we have investigated how the information exchange between hospital and home health care throughout a patient transition from admission to discharge has changed over the last six years. The information processes have gone from being mainly paper-based to being digitalized. However, there are still professional challenges to overcome which may contribute to improvements for patients in transition. [ABSTRACT FROM AUTHOR]

The recent development of mobile technologies allows nurses to receive different types of requests anywhere. However, the interruptions generated by these devices often presents a challenge for nurses in their daily work in a hospital department. In previous inquires we have investigated nurses' strategies to managing technology-mediated interruptions in the form of nurse calls. This study reports on an effort to co-design a system that supports an important strategy employed by nurses. Through the involvement of domain experts, the study elicits requirements for an awareness system to support nurses' collaborative effort in handling nurse calls. [ABSTRACT FROM AUTHOR]

This paper explores information sharing in multidisciplinary clinical collaboration between three hospitals. Our study draws on qualitative interviews with surgeons and radiologists in two county hospitals and one university hospital. The analysis shows that the actors shared a restricted amount of information about the patients they have in common and that different actors used the shared information in different ways. However, much communication was still needed to clarify and negotiate the meaning of shared data and its implications for collaborative care. To conclude, while the arguments for a shared information space may appear convincing, the communication practice observed should illustrate that IS also needs to support the communicative process in clinical collaborative work. [ABSTRACT FROM AUTHOR]

Large wall-mounted screens placed at locations where health personnel pass by will assist in self-coordination and improve utilisation of both resources and staff at hospitals. The sensitivity level of the information visible on these screens must be adapted to a close-to-public setting, as passers-by may not have the right or need to know anything about patients being treated. We have conducted six informal interviews with health personnel in order to map what kind of information they use when identifying their patients and their next tasks. We have compared their practice and needs to legislative requirements and conclude that it is difficult, if not impossible, to fulfil all requirements from all parties. [ABSTRACT FROM AUTHOR]

This paper reports on the experiences with establishing a multidisciplinary healthcare informatics research community at the Norwegian University of Science and Technology (NTNU) in Trondheim, Norway. A multidisciplinary research group in healthcare informatics must maintain strong connections to computer science, social science, biomedicine and healthcare researchers. Those organizing the research must create a milieu that fosters true collaboration across disciplines. The researchers must have good access to healthcare institutions, to healthcare professionals as well as to patients. A healthcare informatics laboratory creates an arena for experiments as well as for validation of health-it technologies. [ABSTRACT FROM AUTHOR]

Inter-hospital communication amounts for a great deal of clinicians' work time. While communication is essential to coordinate care, it can also be time consuming and interruptive, and breakdown in communication is an important source of medical errors. One contributor to the interruptive nature of communication is the use of synchronous media, and there is clearly a potential for novel technologies. To assess communication patterns and media usage we performed an ethnographic field study in the peri-operative environment at a Norwegian hospital, as well as interviews with nurses. We analyze the results with regards to choice of media, characteristics of the conversations taking place and meta-messages, and account for addressing, obtrusiveness and information richness in the message exchanges. We find a relative high degree of interruptiveness in communication, and ascribe it to 1) a lack of situational awareness between locations in the peri-operative domain, as well as 2) use of synchronous media. This suggests that design of novel technology for intra-hospital communication should aim at supporting sender-receiver awareness and signaling of availability. [ABSTRACT FROM AUTHOR]

Since operating room departments are among the costliest resources at a hospital, much attention is devoted to maximize their utilization. Operating room activities are however notoriously hard to plan in advance. This has to do with the unpredictable, problem-solving nature of the work and that the work is carried out by a multidisciplinary team of health personnel, members of which also have commitments outside the operating room department. We assume that operating room teams have the capacity to coordinate themselves and that coordination might be facilitated by visualizing relevant information on wall-mounted boards. To characterize clinical situations that require coordination and re-planning of the teams' work, we have developed a realistic scenario. We analyse and discuss the information security challenges that follow from displaying information on the whereabouts of other teams, actors and patients on wall-mounted boards in the operating rooms. Information security threats could be mitigated by de-identification techniques. Information demands could thereby be met without sacrificing the privacy of those whose information is displayed. [ABSTRACT FROM AUTHOR]

Collaboration in hospitals is coordinated mainly by communication, which currently happens by face-to-face meetings, phone calls, pagers, notes and the electronic patient record. These habits raise problems e.g., delayed notifications and unnecessary interruptions. Dealing with these problems could save time and improve the care. Therefore we designed and prototyped a mobile messaging solution based on two specific scenarios coming from observations at a cardiology department of a Norwegian hospital. The main focus was on supporting the work of nurses. One prototype supported patient management while another one dealt with messages related to medication planning. The evaluation of the prototypes suggested that messaging-based collaboration support is worth to explore and also gave ideas for improvement. [ABSTRACT FROM AUTHOR]

In the context of patients communicating about their disease, there are several channels along which this can be done. Most of these channels do not take the patient as primary input, but provide authoritative information. The Narrator system supplies patients with information extracted from personal stories in plain text format called "narratives". These will be processed and stored using techniques from both Information Retrieval and Natural Language Processing. As such, the system will be set up as a toolbox implementing different approaches while a Service Oriented Architecture provides the framework for integration. In this paper such approaches are described together with efforts to combine them within a suitable architecture. Furthermore, some of the important implementation details are discussed. As a starting point for the system, experiments have been carried out with initial narratives, the results of which are discussed. [ABSTRACT FROM AUTHOR]

The Internet is nowadays a powerful medium and can help patients to become better-informed citizens. Increasingly, citizens are searching for health information on the Internet. The Internet-based resource often acts as a virtual healthcare professional. The effectiveness of the communication between the patient and the virtual healthcare professional depends partly upon the presence of contextual information. The issue here is to what extent the contextualization of information is needed for effective information seeking and for the person's understanding of the retrieved/received information. The impact of contextualization on information search also closely relates to the person's cognitive resources. Using a theoretical communication framework (Te'eni 2001), we explore contextualization in a health website, and discuss the above issues and the possible relevance of contextualized information on the informed patient. [ABSTRACT FROM AUTHOR]

Background: Information about health prevention can contribute to the awareness and the knowledge of consumers and patients about their own health. Messages originating from other users (cases) can be perceived as more credible and hence more persuasive. With this in mind, we have developed an informative website called SeniorGezond, which includes a case-based tailoring component, in the domain area of fall incidences. Objectives: To investigate whether the use of cases is suitable for presenting and tailoring educative health information; and to gain insights in the user's opinion about the use of cases to provide tailored preventive information. Methods: We conducted a qualitative study using questionnaires, focus group discussions, interviews, and observations. Participants were elderly, family caregivers and healthcare professionals. Results: Users were able to find relevant cases for their problems, but had a mixed reaction on the usefulness and appreciation of the cases. Conclusions: There is a need for a delicate balance between a recognizable story with all the important health information and good readable and concise information. A good text structure is required to support this. While cases do have potential in health education, further research is needed in order to identify the necessary requirements which will make the cases successful. [ABSTRACT FROM AUTHOR]

Elderly users are increasingly becoming active consumers of Internet technologies. Developing websites dedicated to this user group presents several design issues (such as that of ‘design for all’, participatory design, patient empowerment and cognitive usability assessment methods). SeniorGezond is a health information resource currently under development. It aims to support elderly users in their search and access of appropriate information in the area of fall incidences. The current development of SeniorGezond provides a useful illustration on how design issues can be addressed and applied in a practical setting. [ABSTRACT FROM PUBLISHER]

Presents the Synapses approach to sharing based on a standardized shared record, the Federated Healthcare Record, which is implemented in an open and flexible manner using the Common Object Request Broker Architecture (CORBA). Architecture proposed by the Technical Committee 251 of the European Committee for Standardization; Electronic healthcare records; health informatics.

Introduction: An increasing group of patients with multiple chronic conditions are living at home. However, rapid changes in health status are common within this group, causing a need for health care services across a broad range of professions and settings. Such "transitional care" typically requires access to relevant, accurate and timely information for all providers involved in the care of the affected individual in order to ensure high quality and safe care. Several studies have shown, however, that the information exchange needed to support such transitions is challenging. Introduction and use of electronic patient records (EPRs) has proven to facilitate the provision of care. In Norway, where the current study was conducted, hospitals and home care settings have different EPR systems that are not compatible. To overcome this shortcoming, face-toface communication, use of telephone and ordinary mail has been the traditional ways to support exchange of patient information across health care settings. In 2011, national initiatives were taken to facilitate electronic communication between hospitals and home health care and general practitioners in the municipalities. An electronic messaging system (emessages) was introduced and implemented in the EPRs. The e-message system is designed to support communication and exchange of information between providers in different care settings and during the phases of a hospital stay. Moreover, the e-messages provide a set of specific messages for targeted purposes; some messages are standardized and aimed for exchanging specific information while so-called dialogue messages are aimed for interactive collaboration. Our research question was: how has information exchange between hospitals and home health care throughout a patient's transition from admission to discharge changed over the last ten years?. Methods: This paper departs from three explorative studies addressing exchange of information between hospital and home health care during patients' transition between the two. All three studies were conducted in Norway. Data were collected by semi-structured interviews in 2005, 2011/12 and 2014. Of the total 136 providers in both hospital and home health care services who were interviewed, 21 were interviewed in 2005, 74 in 2011/12, and 41 in 2014. Data were analysed by applying a deductive-inductive approach. Results: The analysis showed two overall findings. The first overall finding was that the mode of information exchange changed across the three data sets. The most remarkable change was the transition from using mainly paper-based and oral information exchange in 2005, via using hybrid systems combining e-messages with paper and oral communication in 2011/12, to routinely using e-messages in 2014. However, use of oral communication was considered to be significant for discussions and clarifications of some of the patients' problems. The second overall finding was that the "distance" between hospital and home health care diminished from 2005 to 2014. At the point of the first data collection there was little attention to the need for exchanging information between the providers. With the introduction of e-messages, the exchange of information and an awareness of the other part went from being almost absent to being the normal practice in 2014. However, information exchange can still fail if health care providers do not follow the guidelines that describe when to inform each other and what kinds of information should be exchanged. Discussion and conclusion: For the 10 last years the authorities in Norway have launched recommendations and strategies for building systems aimed to improve the information gap when patients are transferred across health care settings. Our study shows that changes have occurred from the first initiative in 2005 to the present practice. The change that has had the most evident impact on ensuring information exchange between healthcare professionals at different care settings has been the introduction of e-messages. They have contributed to enhanced quality of care as well as representing a more secure way of transferring information. Not only does e-messages work as a tool for exchanging information but it also serves as a catalyst for the health care providers' awareness and reflection on what information collaborators need to receive to care for the patients. However, we identified that the latter is still a professional challenge to overcome. The providers struggle with deciding and agreeing on what is accurate and relevant information for the receiver. In addition, information exchange can still fail if the guidelines are not followed. The findings indicate a need for increased awareness on professional, organisational and technological improvements in future development of collaboration across the health care settings. [ABSTRACT FROM AUTHOR]