Hege Andreassen | University hospital of North Norway (original) (raw)
Papers by Hege Andreassen
Studies in Health Technology and Informatics, 2013
Increased patient involvement is a goal in contemporary health care, and of importance to the dev... more Increased patient involvement is a goal in contemporary health care, and of importance to the development of patient oriented ICT. In this paper we discuss how the design of patient-user interfaces can affect patient involvement. Our discussion is based on 12 semi-structured interviews with patient users of a web-based solution for patient--doctor communication piloted in Norway. We argue ICT solutions offering a choice of user interfaces on the patient side are preferable to ensure individual accommodation and a high degree of patient involvement. When introducing web-based tools for patient--health professional communication a free-text option should be provided to the patient users.
Tidsskrift For Den Norske Laegeforening Tidsskrift For Praktisk Medicin Ny Raekke, Nov 16, 2006
The use of the Internet for health purposes increases in the Norwegian population, more in some d... more The use of the Internet for health purposes increases in the Norwegian population, more in some demographic groups than in others. In this questionnaire-based study, we explore the use of the Internet for such purposes. 1007 Norwegians aged 15 years and older were interviewed by telephone in October 2005. 58% of the respondents in 2005 had used the Internet for health purposes, compared to 31% in 2001. Having visited the GP last year, being female, being young, living in a urban area, and having a white-collar occupation were positively related to the use of the Internet for health purposes. 37% of the respondents considered the Internet to be an important or very important source of health information. 72% considered face-to-face communication with health care personnel to be important or very important. Nearly a quarter of the users (23%) reported that they had felt reassured by health information found on the net, whereas 10 % experienced increased anxiety from the same type of information. Norwegians' use of the Internet for health purposes continues to grow, but doctors and other health care personnel remain the most important sources of health information in the Norwegian population.
Medicine 2.0, 2015
Internet is used for a variety of health related purposes. Use differs and has differential effec... more Internet is used for a variety of health related purposes. Use differs and has differential effects on health according to socioeconomic status. We investigated to what extent the Norwegian population use the Internet to support exercise and diet, what kind of services they use, and whether there are social disparities in use. We expected to find differences according to educational attainment. In November 2013 we surveyed a stratified sample of 2196 persons drawn from a Web panel of about 50,000 Norwegians over 15 years of age. The questionnaire included questions about using the Internet, including social network sites (SNS), or mobile apps in relation to exercise or diet, as well as background information about education, body image, and health. The survey email was opened by 1187 respondents (54%). Of these, 89 did not click on the survey hyperlink (declined to participate), while another 70 did not complete the survey. The final sample size is thus 1028 (87% response rate). Com...
Medicine 2.0, 2015
Internet is used for a variety of health related purposes. Use differs and has differential effec... more Internet is used for a variety of health related purposes. Use differs and has differential effects on health according to socioeconomic status. We investigated to what extent the Norwegian population use the Internet to support exercise and diet, what kind of services they use, and whether there are social disparities in use. We expected to find differences according to educational attainment. In November 2013 we surveyed a stratified sample of 2196 persons drawn from a Web panel of about 50,000 Norwegians over 15 years of age. The questionnaire included questions about using the Internet, including social network sites (SNS), or mobile apps in relation to exercise or diet, as well as background information about education, body image, and health. The survey email was opened by 1187 respondents (54%). Of these, 89 did not click on the survey hyperlink (declined to participate), while another 70 did not complete the survey. The final sample size is thus 1028 (87% response rate). Compared to the Norwegian census the sample had a slight under-representation of respondents under the age of 30 and with low education. The data was weighted accordingly before analyses. Sixty-nine percent of women and 53% of men had read about exercise or diet on the Internet (χ(2)= 25.6, P<.001). More people with higher education (71%, χ(2)=19.1, P<.001), reported this. The same gender difference was found for using Internet-based interventions with 20% of women compared to14% of men reporting having used these interventions (χ(2)=7.9, P= .005), for having posted a status about exercise or diet on Facebook or other SNS (23% vs 12%, χ(2)=18.8, P<.001), and for having kept an online exercise or diet journal (21% vs 15%, χ(2)=7.0, P=.008). Evaluations of own physical appearance accounted for some of the gender differences in using online exercise or diet journals. Seven percent of the total sample reported having used electronic communication to ask professionals about exercise or diet, while a few more had discussed online with peers (10%). Asking professionals online was more common amongst those with only primary education (13%, χ(2)<10.5, P=.005). Gender and education are related to how the Internet is used to support health behaviors. We should be aware of the potential role of the Internet in accelerating social disparities in health, and continue to monitor population use. For Internet- and mobile-based interventions to support health behaviors, this study provides information relevant to tailoring of delivery media and components to user.
Health Policy and Technology, 2012
ABSTRACT Patient oriented information and communication technologies (ICT), often labelled e-heal... more ABSTRACT Patient oriented information and communication technologies (ICT), often labelled e-health, are on the rise in European health care. How does this affect patient roles? On the one hand e-health is argued to stimulate an active empowered patient, but on the other recent empirical studies link e-health to the survival of a passive compliant patient role. In this study of secondary sources 20 e-health policy and related documents from the European Union were investigated to identify dominant conceptualizations of the patient role in e-health policy. The findings highlight how the policy rhetoric on patient involvement through e-health relies on the aspects of information and consumerism, and that this rhetoric, paradoxically, has the unintended effect of strengthening the opposing ideal of the compliant patient. The study aims to open for a broader discussion on the potential and limitations of e-health in future patient care and treatment.
For a long time, and in most corners of the world, great promises have been maintained from ICT i... more For a long time, and in most corners of the world, great promises have been maintained from ICT innovations in health care, both in regards to quality and efficiency. A related challenge for social science has been to explain the details of ICT diffusion; what makes some ICT innovations succeed and other disappear. In studying a wide range of such innovations (e-health, telemedicine) and diffusion processes in Norway, we have identified a conflicting logic - between innovation enthusiasm and routine responsibility - as a major explanation of how promising projects only rarely are transformed into normal routine. Understanding the detailed aspects of project organisation and enthusiasm-based driving forces, and how these act as system correction/critique, is necessary to comprehend what comes forward as lack of success, or missing diffusion. In this study we have investigated what innovation projects, in the making, bring with them on a managerial level in health care institutions. W...
Qualitative interviews are much used in e-health research. It is a challenge that qualitative stu... more Qualitative interviews are much used in e-health research. It is a challenge that qualitative studies in e-health are of varying quality, and not always based in an explicit methodological framework. In this paper, we present easy-to-use guidelines for using qualitative interviews in e-health research that are firmly based in social science methodology. The paper outlines some topics and practical advice that are of special interest for e-health. We draw on the qualitative methods literature and our own experiences from e-health research, where we have used qualitative interviews for more than 10 years and in studies among several different user groups. Qualitative interviews stand out as a well-suited method to grasp the socio-technical complexity and rapid changes that characterise the e-health sector.
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 16, 2006
The use of the Internet for health purposes increases in the Norwegian population, more in some d... more The use of the Internet for health purposes increases in the Norwegian population, more in some demographic groups than in others. In this questionnaire-based study, we explore the use of the Internet for such purposes. 1007 Norwegians aged 15 years and older were interviewed by telephone in October 2005. 58% of the respondents in 2005 had used the Internet for health purposes, compared to 31% in 2001. Having visited the GP last year, being female, being young, living in a urban area, and having a white-collar occupation were positively related to the use of the Internet for health purposes. 37% of the respondents considered the Internet to be an important or very important source of health information. 72% considered face-to-face communication with health care personnel to be important or very important. Nearly a quarter of the users (23%) reported that they had felt reassured by health information found on the net, whereas 10 % experienced increased anxiety from the same type of i...
Studies in health technology and informatics, 2013
In this paper, we explore the use of videoconferences (VCs) in medical practice, and discuss how ... more In this paper, we explore the use of videoconferences (VCs) in medical practice, and discuss how characteristics of the context affect the use of VCs. Forty-seven VCs were observed and videotaped, and 41 semi-structured interviews were conducted. Our findings suggest the use of VCs for acute collaborative work differs from the non-acute use of VCs. Non-acute use facilitates collaboration throughout the entire patient trajectory, while acute use facilitates medical problem solving in the moment. Strict specialization and division of labor reduce the cases to discuss and the discussion of complex treatment trajectories. Acute collaborative work is past and present work, while non-acute collaboration reflects past, present, and future treatment, that is, an overall trajectory.
Studies in health technology and informatics, 2013
Increased patient involvement is a goal in contemporary health care, and of importance to the dev... more Increased patient involvement is a goal in contemporary health care, and of importance to the development of patient oriented ICT. In this paper we discuss how the design of patient-user interfaces can affect patient involvement. Our discussion is based on 12 semi-structured interviews with patient users of a web-based solution for patient--doctor communication piloted in Norway. We argue ICT solutions offering a choice of user interfaces on the patient side are preferable to ensure individual accommodation and a high degree of patient involvement. When introducing web-based tools for patient--health professional communication a free-text option should be provided to the patient users.
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 30, 2002
This study investigates the assumption that the Norwegian population's use of Internet health... more This study investigates the assumption that the Norwegian population's use of Internet health services has an impact on health related attitudes and behaviour. In 2000 and 2001, 1,006 and 1,018 subjects were randomly selected from the general population in Norway and interviewed over the telephone. In 2001, a web-based questionnaire was presented to 600 of a 2,800 member Internet panel who reported having used the Internet for health purposes; 79% responded. The proportion of Norwegians who use the Internet for health purposes increased from 19% in 2000 to 31% in 2001. The proportion of those wishing to use e-mail in interaction with their doctor increased from 30% to 45%. Based on information from the Internet, 33% of users in 2001 have asked their doctor specific questions; 11% have suggested a diagnosis, 21% have altered their diet and/or lifestyle; 10% have started with health products or programmes without consulting their doctor. 13% have experienced anxiety, while 48% hav...
BackgroundEuropean citizens are increasingly being offered Internet health services. This study i... more BackgroundEuropean citizens are increasingly being offered Internet health services. This study investigated patterns of health-related Internet use, its consequences, and citizens' expectations about their doctors' provision of e-health services.MethodsRepresentative samples were obtained from the general populations in Norway, Denmark, Germany, Greece, Poland, Portugal and Latvia. The total sample consisted of 7934 respondents. Interviews were conducted by telephone.Results44 % of the total sample, 71 % of the Internet users, had used the Internet for health purposes. Factors that positively affected the use of Internet for health purposes were youth, higher education, white-collar or no paid job, visits to the GP during the past year, long-term illness or disabilities, and a subjective assessment of one's own health as good. Women were the most active health users among those who were online. One in four of the respondents used the Internet to prepare for or follow up doctors' appointments. Feeling reassured after using the Internet for health purposes was twice as common as experiencing anxieties. When choosing a new doctor, more than a third of the sample rated the provision of e-health services as important.ConclusionThe users of Internet health services differ from the general population when it comes to health and demographic variables. The most common way to use the Internet in health matters is to read information, second comes using the net to decide whether to see a doctor and to prepare for and follow up on doctors' appointments. Hence, health-related use of the Internet does affect patients' use of other health services, but it would appear to supplement rather than to replace other health services.
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, 2004
Nearly half of the Norwegian population claim that they would like to use the internet to communi... more Nearly half of the Norwegian population claim that they would like to use the internet to communicate with their general practitioner. A web-based system complying with Norway's strict statutory requirements for the processing of personal data was developed and tested in an effort to assess the implications of this mode of communication. The system was tested for one year in a group practice with six doctors. 200 patients were recruited and randomized into intervention and control groups. Data was collected through questionnaires, interviews and system logs. The 48 patients who used the system sent on average 3.3 messages, the six doctors sent between nine and 65 messages each. Traditional inquiries (visits, telephones) to the doctor averaged 3.2 and 4.5 for the intervention and control group respectively. 41% of the messages were inquiries about health issues, 22% were about renewals of prescriptions and sick leave notes, while 13% were requests for an appointment. Patients and doctors were both positive to this mode of communication. Patients who did not use the service said that they expected to use it in the future. Electronic communication appears to replace some consultations and telephone inquiries. The study gives reason to expect that communication between patients and general practitioners over the internet will be more important in the future.
Qualitative Health Research, 2006
Social Science & Medicine, 2011
There is increasing interest in using electronic mail and other electronic health technologies (e... more There is increasing interest in using electronic mail and other electronic health technologies (e-health technologies) in patient follow-ups. This study sheds light on patients’ reception of provider-initiated e-health in their everyday environments. In a research project carried out in Norway (2005–2007), an electronic address for a hospital dermatology ward was offered to 50 patient families for improved access to expert advice from the patients’ homes. Drawing on semi-structured interviews with 12 families, this paper explores how the electronic address was integrated into everyday health practice. The research illuminates how the electronic address did not only represent changes related to treatment procedures and frequency or nature of expert contact; it was also important to other practices in the everyday lives of the families of patients with chronic illness. Once in place on the patients’ computers, the electronic address was ascribed at least four different roles: it was used as the intended riverbed for a flow of information, but also as a safety alarm, as a shield to the medical gaze and as a token of competence in care and parenting. The multiplicity in use and reception of an electronic address in patient settings illustrates the need to include patients’ everyday practices in current professional and political discussions of e-mail and other e-health technologies. Thus this paper argues that there is a need for research on electronic patient–provider communication that moves beyond frequency of use and questions on how technology will affect medical encounters. Social science equally needs to investigate how provider-initiated e-health technologies gets involved in patients’ moral and social performance of health and illness in everyday life.► A patient perspective in e-health needs to include everyday practices that goes beyond the moments of treatment and professional contact ► A focus on micro-negotiations of technology is necessary when trying to understand e-health technologies and health and illness in the making ► E-health tools have multiple roles in private settings ► Frequency of use is not the best starting point when evaluating how patients’ relate to e-health technologies ► There is more to patients’ interest in their doctors’ e-mail addresses than a longing for information and expert advice to be used in home treatment
Information, Communication & Society, 2010
The potential for information technologies (ITs) to contribute to a struggle against social inequ... more The potential for information technologies (ITs) to contribute to a struggle against social inequalities in health is discussed in contemporary policy and research. Expectations are on IT to facilitate access to health expertise and knowledge, and hence result in improved health practices and outcomes for individuals. In this article, the authors argue that this currently dominant understanding of the relation between IT and social inequalities in health is constraining as well as insufficient to explain the persistence of health inequalities in digitalized western societies. Human action is reduced to be about rational choice, and technology is expected to be a passive tool to be employed by implementers and policy-makers. Drawing on case studies from two telemedicine projects in Norway, this analysis combines perspectives from sociology concerned with structural inequalities on the one hand, with science technology studies on the other. It reveals how the practice and performance of IT is tied to the practice and performance of local differences, and this might be important to a discussion of the social distribution of health. Combining these two perspectives allows for an alternative understanding of how IT and social inequalities in health interact.
Social Trends, 2010
ABSTRACT The empowered patient is a near ubiquitous ideal in contemporary health care. In health ... more ABSTRACT The empowered patient is a near ubiquitous ideal in contemporary health care. In health professional literature as well as in public policy and debates involving patient organizations, the need to empower the patient and extend his or her control over health matters is agreed upon. The authors argue this phenomenon deserve more attention from medical sociology. The increasing use of the term ‘empowerment’ – both as a political ideal and as a descriptive concept – strikes as an interesting entrance to explore the multifaceted expressions of health and illness in contemporary society. The paper suggests some critical comments and opening questions for such a project.
Studies in Health Technology and Informatics, 2013
Increased patient involvement is a goal in contemporary health care, and of importance to the dev... more Increased patient involvement is a goal in contemporary health care, and of importance to the development of patient oriented ICT. In this paper we discuss how the design of patient-user interfaces can affect patient involvement. Our discussion is based on 12 semi-structured interviews with patient users of a web-based solution for patient--doctor communication piloted in Norway. We argue ICT solutions offering a choice of user interfaces on the patient side are preferable to ensure individual accommodation and a high degree of patient involvement. When introducing web-based tools for patient--health professional communication a free-text option should be provided to the patient users.
Tidsskrift For Den Norske Laegeforening Tidsskrift For Praktisk Medicin Ny Raekke, Nov 16, 2006
The use of the Internet for health purposes increases in the Norwegian population, more in some d... more The use of the Internet for health purposes increases in the Norwegian population, more in some demographic groups than in others. In this questionnaire-based study, we explore the use of the Internet for such purposes. 1007 Norwegians aged 15 years and older were interviewed by telephone in October 2005. 58% of the respondents in 2005 had used the Internet for health purposes, compared to 31% in 2001. Having visited the GP last year, being female, being young, living in a urban area, and having a white-collar occupation were positively related to the use of the Internet for health purposes. 37% of the respondents considered the Internet to be an important or very important source of health information. 72% considered face-to-face communication with health care personnel to be important or very important. Nearly a quarter of the users (23%) reported that they had felt reassured by health information found on the net, whereas 10 % experienced increased anxiety from the same type of information. Norwegians' use of the Internet for health purposes continues to grow, but doctors and other health care personnel remain the most important sources of health information in the Norwegian population.
Medicine 2.0, 2015
Internet is used for a variety of health related purposes. Use differs and has differential effec... more Internet is used for a variety of health related purposes. Use differs and has differential effects on health according to socioeconomic status. We investigated to what extent the Norwegian population use the Internet to support exercise and diet, what kind of services they use, and whether there are social disparities in use. We expected to find differences according to educational attainment. In November 2013 we surveyed a stratified sample of 2196 persons drawn from a Web panel of about 50,000 Norwegians over 15 years of age. The questionnaire included questions about using the Internet, including social network sites (SNS), or mobile apps in relation to exercise or diet, as well as background information about education, body image, and health. The survey email was opened by 1187 respondents (54%). Of these, 89 did not click on the survey hyperlink (declined to participate), while another 70 did not complete the survey. The final sample size is thus 1028 (87% response rate). Com...
Medicine 2.0, 2015
Internet is used for a variety of health related purposes. Use differs and has differential effec... more Internet is used for a variety of health related purposes. Use differs and has differential effects on health according to socioeconomic status. We investigated to what extent the Norwegian population use the Internet to support exercise and diet, what kind of services they use, and whether there are social disparities in use. We expected to find differences according to educational attainment. In November 2013 we surveyed a stratified sample of 2196 persons drawn from a Web panel of about 50,000 Norwegians over 15 years of age. The questionnaire included questions about using the Internet, including social network sites (SNS), or mobile apps in relation to exercise or diet, as well as background information about education, body image, and health. The survey email was opened by 1187 respondents (54%). Of these, 89 did not click on the survey hyperlink (declined to participate), while another 70 did not complete the survey. The final sample size is thus 1028 (87% response rate). Compared to the Norwegian census the sample had a slight under-representation of respondents under the age of 30 and with low education. The data was weighted accordingly before analyses. Sixty-nine percent of women and 53% of men had read about exercise or diet on the Internet (χ(2)= 25.6, P<.001). More people with higher education (71%, χ(2)=19.1, P<.001), reported this. The same gender difference was found for using Internet-based interventions with 20% of women compared to14% of men reporting having used these interventions (χ(2)=7.9, P= .005), for having posted a status about exercise or diet on Facebook or other SNS (23% vs 12%, χ(2)=18.8, P<.001), and for having kept an online exercise or diet journal (21% vs 15%, χ(2)=7.0, P=.008). Evaluations of own physical appearance accounted for some of the gender differences in using online exercise or diet journals. Seven percent of the total sample reported having used electronic communication to ask professionals about exercise or diet, while a few more had discussed online with peers (10%). Asking professionals online was more common amongst those with only primary education (13%, χ(2)<10.5, P=.005). Gender and education are related to how the Internet is used to support health behaviors. We should be aware of the potential role of the Internet in accelerating social disparities in health, and continue to monitor population use. For Internet- and mobile-based interventions to support health behaviors, this study provides information relevant to tailoring of delivery media and components to user.
Health Policy and Technology, 2012
ABSTRACT Patient oriented information and communication technologies (ICT), often labelled e-heal... more ABSTRACT Patient oriented information and communication technologies (ICT), often labelled e-health, are on the rise in European health care. How does this affect patient roles? On the one hand e-health is argued to stimulate an active empowered patient, but on the other recent empirical studies link e-health to the survival of a passive compliant patient role. In this study of secondary sources 20 e-health policy and related documents from the European Union were investigated to identify dominant conceptualizations of the patient role in e-health policy. The findings highlight how the policy rhetoric on patient involvement through e-health relies on the aspects of information and consumerism, and that this rhetoric, paradoxically, has the unintended effect of strengthening the opposing ideal of the compliant patient. The study aims to open for a broader discussion on the potential and limitations of e-health in future patient care and treatment.
For a long time, and in most corners of the world, great promises have been maintained from ICT i... more For a long time, and in most corners of the world, great promises have been maintained from ICT innovations in health care, both in regards to quality and efficiency. A related challenge for social science has been to explain the details of ICT diffusion; what makes some ICT innovations succeed and other disappear. In studying a wide range of such innovations (e-health, telemedicine) and diffusion processes in Norway, we have identified a conflicting logic - between innovation enthusiasm and routine responsibility - as a major explanation of how promising projects only rarely are transformed into normal routine. Understanding the detailed aspects of project organisation and enthusiasm-based driving forces, and how these act as system correction/critique, is necessary to comprehend what comes forward as lack of success, or missing diffusion. In this study we have investigated what innovation projects, in the making, bring with them on a managerial level in health care institutions. W...
Qualitative interviews are much used in e-health research. It is a challenge that qualitative stu... more Qualitative interviews are much used in e-health research. It is a challenge that qualitative studies in e-health are of varying quality, and not always based in an explicit methodological framework. In this paper, we present easy-to-use guidelines for using qualitative interviews in e-health research that are firmly based in social science methodology. The paper outlines some topics and practical advice that are of special interest for e-health. We draw on the qualitative methods literature and our own experiences from e-health research, where we have used qualitative interviews for more than 10 years and in studies among several different user groups. Qualitative interviews stand out as a well-suited method to grasp the socio-technical complexity and rapid changes that characterise the e-health sector.
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 16, 2006
The use of the Internet for health purposes increases in the Norwegian population, more in some d... more The use of the Internet for health purposes increases in the Norwegian population, more in some demographic groups than in others. In this questionnaire-based study, we explore the use of the Internet for such purposes. 1007 Norwegians aged 15 years and older were interviewed by telephone in October 2005. 58% of the respondents in 2005 had used the Internet for health purposes, compared to 31% in 2001. Having visited the GP last year, being female, being young, living in a urban area, and having a white-collar occupation were positively related to the use of the Internet for health purposes. 37% of the respondents considered the Internet to be an important or very important source of health information. 72% considered face-to-face communication with health care personnel to be important or very important. Nearly a quarter of the users (23%) reported that they had felt reassured by health information found on the net, whereas 10 % experienced increased anxiety from the same type of i...
Studies in health technology and informatics, 2013
In this paper, we explore the use of videoconferences (VCs) in medical practice, and discuss how ... more In this paper, we explore the use of videoconferences (VCs) in medical practice, and discuss how characteristics of the context affect the use of VCs. Forty-seven VCs were observed and videotaped, and 41 semi-structured interviews were conducted. Our findings suggest the use of VCs for acute collaborative work differs from the non-acute use of VCs. Non-acute use facilitates collaboration throughout the entire patient trajectory, while acute use facilitates medical problem solving in the moment. Strict specialization and division of labor reduce the cases to discuss and the discussion of complex treatment trajectories. Acute collaborative work is past and present work, while non-acute collaboration reflects past, present, and future treatment, that is, an overall trajectory.
Studies in health technology and informatics, 2013
Increased patient involvement is a goal in contemporary health care, and of importance to the dev... more Increased patient involvement is a goal in contemporary health care, and of importance to the development of patient oriented ICT. In this paper we discuss how the design of patient-user interfaces can affect patient involvement. Our discussion is based on 12 semi-structured interviews with patient users of a web-based solution for patient--doctor communication piloted in Norway. We argue ICT solutions offering a choice of user interfaces on the patient side are preferable to ensure individual accommodation and a high degree of patient involvement. When introducing web-based tools for patient--health professional communication a free-text option should be provided to the patient users.
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 30, 2002
This study investigates the assumption that the Norwegian population's use of Internet health... more This study investigates the assumption that the Norwegian population's use of Internet health services has an impact on health related attitudes and behaviour. In 2000 and 2001, 1,006 and 1,018 subjects were randomly selected from the general population in Norway and interviewed over the telephone. In 2001, a web-based questionnaire was presented to 600 of a 2,800 member Internet panel who reported having used the Internet for health purposes; 79% responded. The proportion of Norwegians who use the Internet for health purposes increased from 19% in 2000 to 31% in 2001. The proportion of those wishing to use e-mail in interaction with their doctor increased from 30% to 45%. Based on information from the Internet, 33% of users in 2001 have asked their doctor specific questions; 11% have suggested a diagnosis, 21% have altered their diet and/or lifestyle; 10% have started with health products or programmes without consulting their doctor. 13% have experienced anxiety, while 48% hav...
BackgroundEuropean citizens are increasingly being offered Internet health services. This study i... more BackgroundEuropean citizens are increasingly being offered Internet health services. This study investigated patterns of health-related Internet use, its consequences, and citizens' expectations about their doctors' provision of e-health services.MethodsRepresentative samples were obtained from the general populations in Norway, Denmark, Germany, Greece, Poland, Portugal and Latvia. The total sample consisted of 7934 respondents. Interviews were conducted by telephone.Results44 % of the total sample, 71 % of the Internet users, had used the Internet for health purposes. Factors that positively affected the use of Internet for health purposes were youth, higher education, white-collar or no paid job, visits to the GP during the past year, long-term illness or disabilities, and a subjective assessment of one's own health as good. Women were the most active health users among those who were online. One in four of the respondents used the Internet to prepare for or follow up doctors' appointments. Feeling reassured after using the Internet for health purposes was twice as common as experiencing anxieties. When choosing a new doctor, more than a third of the sample rated the provision of e-health services as important.ConclusionThe users of Internet health services differ from the general population when it comes to health and demographic variables. The most common way to use the Internet in health matters is to read information, second comes using the net to decide whether to see a doctor and to prepare for and follow up on doctors' appointments. Hence, health-related use of the Internet does affect patients' use of other health services, but it would appear to supplement rather than to replace other health services.
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, 2004
Nearly half of the Norwegian population claim that they would like to use the internet to communi... more Nearly half of the Norwegian population claim that they would like to use the internet to communicate with their general practitioner. A web-based system complying with Norway's strict statutory requirements for the processing of personal data was developed and tested in an effort to assess the implications of this mode of communication. The system was tested for one year in a group practice with six doctors. 200 patients were recruited and randomized into intervention and control groups. Data was collected through questionnaires, interviews and system logs. The 48 patients who used the system sent on average 3.3 messages, the six doctors sent between nine and 65 messages each. Traditional inquiries (visits, telephones) to the doctor averaged 3.2 and 4.5 for the intervention and control group respectively. 41% of the messages were inquiries about health issues, 22% were about renewals of prescriptions and sick leave notes, while 13% were requests for an appointment. Patients and doctors were both positive to this mode of communication. Patients who did not use the service said that they expected to use it in the future. Electronic communication appears to replace some consultations and telephone inquiries. The study gives reason to expect that communication between patients and general practitioners over the internet will be more important in the future.
Qualitative Health Research, 2006
Social Science & Medicine, 2011
There is increasing interest in using electronic mail and other electronic health technologies (e... more There is increasing interest in using electronic mail and other electronic health technologies (e-health technologies) in patient follow-ups. This study sheds light on patients’ reception of provider-initiated e-health in their everyday environments. In a research project carried out in Norway (2005–2007), an electronic address for a hospital dermatology ward was offered to 50 patient families for improved access to expert advice from the patients’ homes. Drawing on semi-structured interviews with 12 families, this paper explores how the electronic address was integrated into everyday health practice. The research illuminates how the electronic address did not only represent changes related to treatment procedures and frequency or nature of expert contact; it was also important to other practices in the everyday lives of the families of patients with chronic illness. Once in place on the patients’ computers, the electronic address was ascribed at least four different roles: it was used as the intended riverbed for a flow of information, but also as a safety alarm, as a shield to the medical gaze and as a token of competence in care and parenting. The multiplicity in use and reception of an electronic address in patient settings illustrates the need to include patients’ everyday practices in current professional and political discussions of e-mail and other e-health technologies. Thus this paper argues that there is a need for research on electronic patient–provider communication that moves beyond frequency of use and questions on how technology will affect medical encounters. Social science equally needs to investigate how provider-initiated e-health technologies gets involved in patients’ moral and social performance of health and illness in everyday life.► A patient perspective in e-health needs to include everyday practices that goes beyond the moments of treatment and professional contact ► A focus on micro-negotiations of technology is necessary when trying to understand e-health technologies and health and illness in the making ► E-health tools have multiple roles in private settings ► Frequency of use is not the best starting point when evaluating how patients’ relate to e-health technologies ► There is more to patients’ interest in their doctors’ e-mail addresses than a longing for information and expert advice to be used in home treatment
Information, Communication & Society, 2010
The potential for information technologies (ITs) to contribute to a struggle against social inequ... more The potential for information technologies (ITs) to contribute to a struggle against social inequalities in health is discussed in contemporary policy and research. Expectations are on IT to facilitate access to health expertise and knowledge, and hence result in improved health practices and outcomes for individuals. In this article, the authors argue that this currently dominant understanding of the relation between IT and social inequalities in health is constraining as well as insufficient to explain the persistence of health inequalities in digitalized western societies. Human action is reduced to be about rational choice, and technology is expected to be a passive tool to be employed by implementers and policy-makers. Drawing on case studies from two telemedicine projects in Norway, this analysis combines perspectives from sociology concerned with structural inequalities on the one hand, with science technology studies on the other. It reveals how the practice and performance of IT is tied to the practice and performance of local differences, and this might be important to a discussion of the social distribution of health. Combining these two perspectives allows for an alternative understanding of how IT and social inequalities in health interact.
Social Trends, 2010
ABSTRACT The empowered patient is a near ubiquitous ideal in contemporary health care. In health ... more ABSTRACT The empowered patient is a near ubiquitous ideal in contemporary health care. In health professional literature as well as in public policy and debates involving patient organizations, the need to empower the patient and extend his or her control over health matters is agreed upon. The authors argue this phenomenon deserve more attention from medical sociology. The increasing use of the term ‘empowerment’ – both as a political ideal and as a descriptive concept – strikes as an interesting entrance to explore the multifaceted expressions of health and illness in contemporary society. The paper suggests some critical comments and opening questions for such a project.
From twenty years of information and communication technology (ICT) projects in the health sector... more From twenty years of information and communication technology (ICT) projects in the health sector, we have learned one thing: most projects remain projects. The problem of pilotism in e-health and telemedicine is a growing concern, both in medical literature and among policy makers, who now ask for large-scale implementation of ICT in routine health service delivery. In this article, we turn the question of failing projects upside down. Instead of investigating the obstacles to implementing ICT and realising permanent changes in health care routines, we ask what makes the temporary ICT project survive, despite an apparent lack of success. Our empirical material is based on Norwegian telemedicine. Through a case study, we take an in-depth look into the history of one particular telemedical initiative and highlight how ICT projects matter on a managerial level. Our analysis reveals how management tasks were delegated to the ICT project, which thus contributed to four processes of organisational control: allocating resources, generating and managing enthusiasm, system correction and aligning local practice and national policies. We argue that the innovation project in itself can be considered an innovation that has become normalised in health care, not in clinical, but in management work. In everyday management, the ICT project appears to be a convenient tool suited to ease the tensions between state regulatory practices and claims of professional autonomy that arise in the wake of new public management reforms. Separating project management and funding from routine practice handles the conceptualised heterogeneity between innovation and routine within contemporary health care delivery. Whilst this separation eases the execution of both normal routines and innovative projects, it also delays expected diffusion of technology.