Rose-Mharie Åhlfeldt | University of Skövde (original) (raw)

Papers by Rose-Mharie Åhlfeldt

JMIR. Journal of medical internet research/Journal of medical internet research, May 17, 2023

The Nordic countries are forerunners in online record access (ORA) which has now become widesprea... more The Nordic countries are forerunners in online record access (ORA) which has now become widespread. The importance of accessible and structured health data has also been highlighted by policymakers internationally. To ensure the full realization of ORA'spotential in the short and long term, there is a pressing need to study ORA from a cross-disciplinary, technical, clinical, humanistic, and social sciences perspective that looks beyond strictly technical aspects. In this viewpoint paper, we explore the policy changes in the European Health Data Space (EHDS) proposal to advance ORA across the European Union, and introduce a Nordic-led research project that carries out the first of its kind, large-scale international investigation of patients' ORA; NORDeHEALTH. We argue that the EHDS proposal will pave the way for patients to access and control third-party access to their electronic health records (EHRs). This will have implications within Europe and globally as it will further extend the boundaries for accessing and using EHRs for primary and secondary data use. Research such as that led by the NORDeHEALTH project is essential in guiding the design and implementation of solutions to meet the requirements of the EHDS proposal. Further international collaboration and research are needed to ensure that socio-technical and contextual factors are considered to ensure successful and secure implementation.

Patients' online access to their EHR together with the rapid proliferation of medical information... more Patients' online access to their EHR together with the rapid proliferation of medical information on the Internet has changed the way patients use the information to learn about their health. It is well documented that patients often turn to the Internet to find information about their health and care. However, little is known about patients´ information seeking behaviour when using online EHRs. By using information horizons as an analytical tool this paper aims to investigate the information behaviour of cancer patients who have chosen to view their EHRs (readers) and to those who have not made that option (non-readers). Thirty interviews were conducted with patients. Based on information horizons, it seems that non-reading is associated with living in a narrower information world in comparison to readers. The findings do not suggest that the smallness would be a result of an active avoidance of information, or that it would be counterproductive for the patients.

Medical Informatics Europe, 2015

In this workshop, examples and experiences from ongoing work to develop and implement eHealth ser... more In this workshop, examples and experiences from ongoing work to develop and implement eHealth services for citizens will be provided. Challenges and potential solutions based on different international contexts will be discussed in interactive sessions. The results will form a report suggesting strategies and activities that could provide potential solutions to the identified challenges.

Studies in health technology and informatics, May 18, 2023

Patient-Accessible Electronic Health Records (PAEHR) are particularly disputed in mental healthca... more Patient-Accessible Electronic Health Records (PAEHR) are particularly disputed in mental healthcare. We aim to explore if there is any association between patients having a mental health condition and someone unwanted seeing their PAEHR. A chi-square test showed a statistically significant association between group belonging and experiences of someone unwanted seeing their PAEHR.

UNSTRUCTURED The Nordic countries are forerunners in online record access (ORA) which has now bec... more UNSTRUCTURED The Nordic countries are forerunners in online record access (ORA) which has now become widespread. The importance of accessible and structured health data has also been highlighted by policymakers internationally. To ensure the full realization of ORA’spotential in the short and long term, there is a pressing need to study ORA from a cross-disciplinary, technical, clinical, humanistic, and social sciences perspective that looks beyond strictly technical aspects. In this viewpoint paper, we explore the policy changes in the European Health Data Space (EHDS) proposal to advance ORA across the European Union, and introduce a Nordic-led research project that carries out the first of its kind, large-scale international investigation of patients’ ORA; NORDeHEALTH. We argue that the EHDS proposal will pave the way for patients to access and control third-party access to their electronic health records (EHRs). This will have implications within Europe and globally as it will further extend the boundaries for accessing and using EHRs for primary and secondary data use. Research such as that led by the NORDeHEALTH project is essential in guiding the design and implementation of solutions to meet the requirements of the EHDS proposal. Further international collaboration and research are needed to ensure that socio-technical and contextual factors are considered to ensure successful and secure implementation.

Even though the word" strategy" is used extensively in literature, very few works exist... more Even though the word" strategy" is used extensively in literature, very few works exist that explore what strategies as documents are and how they are used. Many organizations know they should have an IT strategy, and many have created one-but do not use it in the ...

Patient Empowerment (PE) allows patients to be more active in managing their own health and quali... more Patient Empowerment (PE) allows patients to be more active in managing their own health and quality of life. The aim of this paper is to analyze how trust affects PE, in the context of healthcare information systems. An interview study was conducted concerning patients' online access to electronic healthcare records. Results show that PE requires that patients trust the information that healthcare professionals and their electronic health record systems provide. Without trust, patients cannot control their own participation in relation to the healthcare professionals. This may result in a diminished ability to participate in the healthcare processes regarding their own care. Practical implications include acquired knowledge about and awareness of how trust influences PE, with particular emphasis on healthcare professionals. A trust model is presented that illustrates the trustor-trustee dimensions of PE. This model has both theoretical and practical implications in its illustration of how trust and PE connect.

Municipalities manage a significant part of society's services, and hence also handle a vast amou... more Municipalities manage a significant part of society's services, and hence also handle a vast amount of information. A municipality's activities include managing a significant part of society's services, and the municipality's supply and management of information are, therefore, critical for society in general, but also for achieving the municipality's own operational goals. However, investigations show weaknesses in the municipalities' work on information security, and there is a need to study and identify the current level of security. This paper presents the result from a GAP analysis mapping the Swedish municipalities' current situation for systematic information security work, based on the demands made on municipalities from both research and social perspectives. The result shows that the information security level regarding the systematic security work is generally low and that there is a need for adapted tools for Information Security Management Systems in order to support municipalities.

IT/IS are very essential from a strategic point of view, as is electronic business (e-business). ... more IT/IS are very essential from a strategic point of view, as is electronic business (e-business). Strategic e-business can mean competitive advantage, more efficient and well-structured links between partners, and a more coherent set of supporting information and ...

Inf. Res., 2016

Patients reading their medical records : Differences in experiences and attitudes between regular... more Patients reading their medical records : Differences in experiences and attitudes between regular and inexperienced readers

Health Informatics Journal, 2016

Patients’ access to their online medical records serves as one of the cornerstones in the efforts... more Patients’ access to their online medical records serves as one of the cornerstones in the efforts to increase patient engagement and improve healthcare outcomes. The aim of this article is to provide in-depth understanding of cancer patients’ attitudes and experiences of online medical records, as well as an increased understanding of the complexities of developing and launching e-Health services. The study result confirms that online access can help patients prepare for doctor visits and to understand their medical issues. In contrast to the fears of many physicians, the study shows that online access to medical records did not generate substantial anxiety, concerns or increased phone calls to the hospital.

Studies in health technology and informatics, 2014

As many evaluations show, healthcare organizations do not accomplish the intended effects of thei... more As many evaluations show, healthcare organizations do not accomplish the intended effects of their eHealth systems due to inadequate usability. On behalf of the Swedish Ministry of Health and Social Affairs, the usability of current eHealth systems in Swedish healthcare have been analysed from the perspective of healthcare and social service professionals. The objective of the study was to report on current problems, potential solutions as well as to relate these to research in relevant areas. Using a participatory approach, seven workshops were held where researchers within health informatics collaborated with staff from different care providers, representatives of the national associations of health and social care professionals and the national eHealth system vendor organization. This paper presents a foundation for further development of eHealth systems, condensed into 10 issues that the Swedish health and social care professionals find imperative to improve. The study emphasizes that the development of eHealth systems is always a matter of organizational and process development and must be integrated into the care practice improvement process. Further, based on the findings, some identified challenges are discussed.

Even though the word “strategy” is used extensively in literature, very few works exist that expl... more Even though the word “strategy” is used extensively in literature, very few works exist that explore what strategies as documents are and how they are used. Many organizations know they should have an IT strategy, and many have created one – but do not use it in the optimal sense. It can be a tool for driving an organization towards its goals, and that they are a way for organizations to ensure that the technology they invest in is relevant for their purposes. Merging the process and document perspectives constitutes a great research challenge for the future. This paper explores how the concept “strategy” is treated in scientific literature, and creates an overview model of how these concepts are used in scientific literature.

ABSTRACT Information and Communication Technology for health and wellbeing ('eHealth&... more ABSTRACT Information and Communication Technology for health and wellbeing ('eHealth') is becoming increasingly important to deliver top-quality care to European citizens. There are a number of currently ongoing national and international efforts related to public access to eHealth services. In Sweden, the action research project DOME (Deployment of Online Medical Records and eHealth Services) aims to study and contribute to ongoing national deployment projects. This paper presents the DOME project's objectives, goals and methods as well as expected results regarding the national deployment of online medical records.

Health Informatics Journal

Despite the fact that patient accessible electronic health records (PAEHRs) have been around for ... more Despite the fact that patient accessible electronic health records (PAEHRs) have been around for many years in several countries, there is a lack of research investigating patient’s preferences for receiving bad news, including through PAEHRs. Little is also known about the characteristics of the patients who prefer to receive bad news through the PAEHR in terms of, for example medical diagnosis, age and educational level. This study, based on a national patient survey in Sweden ( N = 2587), investigated this. Results show that, generally, receiving bad news by reading in the PAEHR is still among the least preferred options. Additionally, a higher proportion of men want to receive bad news in the PAEHR compared to women ( p = 0.001), and the same goes for those who are not working/have worked in healthcare ( p = 0.007). An effect of disease groups was also found, showing that diabetes patients in particular, want to receive bad news through the PAEHR.

Lakartidningen; 110(15), pp 774-774 (2013), 2013