- Text DocumentA Methodology to Assess Changes in Healthcare Infrastructure in Stockholm(Infrahealth 2017 - Proceedings of the 6th International Workshop on Infrastructure in Healthcare 2017, 2017) Shreenath, Vinutha Magal; Moustaid, Elhabib; Meijer, SebastiaanDesigning major shifts in complex systems such as healthcare requires a combination of approaches and perspectives. A considerable change in healthcare infrastructure is due to occur in Stockholm with a major emergency department being closed. As this change impacts operations as well as governance, multiple methods are needed to assess it. In this paper, we present an approach combining simulations and data mining of healthcare data to assess the changes to healthcare system in Stockholm; and discuss the opportunities and challenges of doing so.
- Text DocumentChallenges and Opportunities of Health and Care Co-production with Social Media: a Qualitative Study(Infrahealth 2017 - Proceedings of the 6th International Workshop on Infrastructure in Healthcare 2017, 2017) Daneshvar, Hadi; Anderson, StuartFuture of health in EU faces the triple challenges of ageing, fiscal restriction and inclusion. Co-production offers ways to manage informal care resources to help them cater for the growing needs of elderly people. We investigate the opportunities and the challenges in use of Social Media (SM) as an enabler of co-production in health and care. In order to do this, we conducted a qualitative study using interviews and online observations of activities of professional carers, voluntary organisations and informal carer. We found that particular types of SM are currently used to enable co-production through coordination and communication across boundaries. Particularly Twitter and Facebook are used to connect carers, disseminate information and invite volunteers. However, there are still many other types of SM which are rarely used in this sector due to their limitations. Nevertheless, carers showed interest in using systems which help them to engage people in shaping of services, sharing of experiences and encouraging care activities.
- Text DocumentManeuvering a Pilot Implementation to Align Agendas Across Sectors(Infrahealth 2017 - Proceedings of the 6th International Workshop on Infrastructure in Healthcare 2017, 2017) Mønsted, Troels; Hertzum, Morten; Søndergaard, JensA prerequisite for pilot implementations in complex organizational settings is that the agendas of the stakeholders of the system are maneuvered into alignment. In this paper we present a study of the pilot implementation of the IT-supported, preventive intervention TOF (Tidlig Opsporing og Forebyggelse). A core element of TOF is an IT system that stratifies citizens into risk groups on the basis of self-reported lifestyle information and data retrieved from the medical records of the general practitioners (GPs). In addition, the system facilitates cross-sectoral coordination between preventive offers at the GP and at municipal health centers. We find that TOF succeeded in maneuvering the agendas of the involved stakeholders by gaining the foothold, legitimacy, and GP motivation required to carry out the pilot implementation.
- Text DocumentCare coordination with a patient centred plan(Infrahealth 2017 - Proceedings of the 6th International Workshop on Infrastructure in Healthcare 2017, 2017) Vuokko, Riikka; Mäkelä-Bengs, Päivi; Karsten, HelenaIn Finland, a standardized data structure for continuous health and care planning is implemented as a Health and Care Plan (HCP) module in all electronic health record systems (EHR). The structure was initially published in 2011 and gradually implemented in the various EHR systems. In this study, the focus is on comparing the specifications of the data structure and the responses to a spring 2016 survey. We analyse the HCP as a representation that is interpreted in different contexts and for different purposes by those involved. The interactionist theory by Strauss (1993) is used as the lens to discern dualistic dimensions of interpretations. We found these dimensions: consensus vs. dissent, old vs. new, single vs. multiple, clearly imagined vs. unclear, and unchanging vs. changing. The implications of these for HCP use and development are discussed.
- Text DocumentEmerging versions of patient involvement with Patient Reported Outcomes(Infrahealth 2017 - Proceedings of the 6th International Workshop on Infrastructure in Healthcare 2017, 2017) Langstrup, HenrietteIt is a central argument in the growing Danish PRO-arena, that a large-scale collection of PRO from patients in the Danish Healthcare system will pave the way for more genuine patient involvement in clinical decision-making, quality management and governance of the health services. In this paper I discuss how patient involvement is being (re)configured when increasingly connected to national visions of participatory healthcare. A central discussion centers on ‘meaningful use’ of patient-generated data promoting patients’ expectations and experiences as a criterion for how to proceed with the national use of PRO. But how do assumptions of what constitutes meaning for patients interact with the kinds of roles that patients are expected to take on with PROtools? What forms of participation are assumed to be meaningful and thus good and which are not? In sketching emerging versions of patient involvement with PRO, I want to point to the need for further empirical exploration of how patients and professionals engage with PRO in specific daily practices and to stimulate a general discussion of all too simple normativities of the so-called ‘participatory turn’ in healthcare. I draw on empirical insights from an ongoing study of establishment of a national initiative for systematic collection of PROs in Denmark.
- Text DocumentDeveloping Rural Healthcare Services: How to Create Efficient Services Using Service Design Methods(Infrahealth 2017 - Proceedings of the 6th International Workshop on Infrastructure in Healthcare 2017, 2017) Alhonsuo, Mira; Miettinen, Satu; Marttila, HennaThis paper presents a workshop model that can be used to develop digital healthcare services in rural communities. The workshop model is based on a case study done in South Africa in the context of health-related information and communication services. Participants in this case study were semi-trained home-based health caregivers working in rural communities. The research was structured around design methods drawn mainly from the service design field that enable user participation in the development process and that create a common understanding and mission through increased empathy among participants as well as co-creative flows while working together. The primary outcome from the case study was a workshop model, which focused on investigating and developing solutions to address the most important caregiver needs during a typical working day. This leads to interactions, which increases empathy among the participants. The goal of the case study was to design a mobile application that makes the caregivers’ services more efficient. This research is part of the Critical Communication, Safety and Human-centered Services of the Future (CRICS) project, which runs from 2016–2017, and which is funded by Tekes, the Finnish Funding Agency for Technology and Innovation. It was conducted in cooperation with Cape Peninsula University of Technology (CPUT), Cape Town, South Africa
- Text DocumentComplex integrations in health care(Infrahealth 2017 - Proceedings of the 6th International Workshop on Infrastructure in Healthcare 2017, 2017) Bjørnstad, Camilla; Christensen, Bente; Ellingsen, GunnarIntegrations in health care are hard to manage in practice due to their complex organizational realities. To categorise the integrations as syntactic, semantic or pragmatic may help to better plan the process in developing them, and deciding how to manage them in a good way and hence obtain well-functioning integrations.
- Text DocumentInfrastructures for Sense Making(Infrahealth 2017 - Proceedings of the 6th International Workshop on Infrastructure in Healthcare 2017, 2017) Tellioğlu, Hilda; Habiger, Michael; Cech, FlorianThis paper is about discussing infrastructures as enablers of users’ sense making. Infrastructures facilitate process-oriented, interactive and socially sense making in case of complex problem settings like care giving. On an example of a platform that is used to support informal care givers, it expresses the importance of different channels in interaction mechanisms of infrastructures that are meant to support non-professional care givers in their daily activities, especially to deal with situations of uncertainty and mental overload.
- Text DocumentGenerification in change: the complexity of modelling the healthcare domain(Infrahealth 2017 - Proceedings of the 6th International Workshop on Infrastructure in Healthcare 2017, 2017) Silsand, Line; Christensen, BenteIn this paper we explore the concept of ”generification” through a Model-Driven Development (MDD) approach. We claim that the concept of generification is in change as the MDD approach, exemplified by the openEHR framework, gives a network of voluntary clinical users a prominent role in the generification process. The customization is no longer ”in the hands” of the vendor, and needs to be formalized for the public healthcare service to take the ownership of the generification process and the standarization of clinical information. Empirically, we have followed the development of a new EPR system adhering to MDD methodology from 2012 to 2016.
- Text DocumentEvolving relations between the practices of nurses and patients and a new patient portal(Infrahealth 2017 - Proceedings of the 6th International Workshop on Infrastructure in Healthcare 2017, 2017) Kensing, Finn; Lomborg, Stine; Moring, CamillaThe paper offers preliminary reflections on a patient portal that is part of a glocal digital infrastructure – an EHR - currently being implemented at 18 hospitals in two of the five Danish regions covering more than half of the population. We focus on the evolving relations between the technology and the practices of nurses and patients in a rehabilitation program after a blood cloth, with a specific interest in how the rehabilitation infrastructure promotes clinical governance and patient empowerment. Our analytical lens is that of patient empowerment, understood broadly as the patient’s capacity for and experience of self-care within the infrastructure. This, we contend, may be seen as a specific and increasingly important aspect of clinical governance.