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The importance of eHealth innovations: Lessons about patient accessible information
Jönköping University, Jönköping International Business School, JIBS, Informatics.
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Access to digital information and communication has an increasing importance in both the work of healthcare professionals and in patients’ everyday life and has transformed what we do and how we carry out activities. It changes the way in which healthcare is delivered, how information is exchanged within and between organizations and how patients and other actors access and manage information. Currently, innovation is imperative in the healthcare sector and today there is a focus on how different eHealth services can improve healthcare. With increased access to various eHealth services, there is a need to know more about the impact of eHealth innovations on healthcare.

The aim of this thesis is to acquire more knowledge about eHealth innovations in healthcare. The focus is on prerequisites to realize innovative eHealth services and eHealth services that provide patients with access to health information. The theoretical background addresses innovation, services and business models. This thesis is a compilatory work and includes five qualitative research papers. The first study is an interview study, the second is a literature review and the remaining three are case studies. The data collection consisted of interviews, surveys, workshops and secondary data collected from documents. The interview study and the case studies were performed in the Swedish eHealth setting.

The research contributes to our understanding of eHealth innovations with insights on prerequisites to realize eHealth innovations and knowledge on patient accessible information. The first study provides a classification of prerequisites that need to be considered to realize innovative eHealth services. When dealing with eHealth services, organizational and sematic interoperability are still a challenge, and they transcend organizational boundaries. This thesis provides knowledge on the recent trend of opening up electronic health records to patients. The knowledge derived from the studies on patient accessible electronic health records show that there is a discrepancy between the perceptions of patients and healthcare professionals. The thesis concludes that patients feel more involved and that the patient-professional relationship improves with patient access to electronic health records, whereas healthcare professionals have concerns about how patients will manage access to health information. This thesis also provides empirical insights on how business models can be represented in a public eHealth setting. By viewing public eHealth services as social innovations, the thesis contributes to the research on business models in a public healthcare setting by incorporating societal value into the representation of the business model.

The research in this thesis contributes to research in health informatics by discussing issues related to eHealth innovations and patient accessible information. Its practical importance lies in identifying issues that are important when discussing eHealth initiatives and the implications of giving patients online access to their electronic health record.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, Jönköping International Business School , 2017. , p. 60
Series
JIBS Dissertation Series, ISSN 1403-0470 ; 117
National Category
Information Systems, Social aspects Business Administration Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:hj:diva-38045ISBN: 978-91-86345-77-8 (print)OAI: oai:DiVA.org:hj-38045DiVA, id: diva2:1163009
Public defence
2017-12-08, B1014, Jönköping International Business School, Jönköping, 13:15
Opponent
Supervisors
Available from: 2017-12-05 Created: 2017-12-05 Last updated: 2017-12-05Bibliographically approved
List of papers
1. I got 99 problems, and eHealth is one
Open this publication in new window or tab >>I got 99 problems, and eHealth is one
2017 (English)In: Proceedings of the 16th World Congress on Medical andHealth Informatics (MedInfo), Hangzhou, China, 2017, HISA , 2017, Vol. 245, p. 258-262Conference paper, Published paper (Refereed)
Abstract [en]

Many eHealth initiatives are never implemented or merely endas pilot projects. Previous studies report that organizational,technical and human issues need to be properly taken into considerationif such initiatives are to be successful. The aim of thispaper is to explore whether previously identified challengeswithin the area have remained in the Swedish eHealth settingor whether they have changed. After interviewing experts ineHealth, we present a classification of areas of concern. Recurrenceof previously identified challenges was found, but alsonew issues were identified. The results of the study indicate thatthere is a need to consider organisational and semantic issueson both national and international levels. Legal and technicalchallenges still exist but it seems even more important tosupport eHealth initiatives financially, increase practitioners’knowledge in health informatics and manage new expectationsfrom patients.

Place, publisher, year, edition, pages
HISA, 2017
Keywords
Health Services, Telemedicine
National Category
Information Systems, Social aspects Business Administration
Identifiers
urn:nbn:se:hj:diva-38039 (URN)10.3233/978-1-61499-830-3-258 (DOI)29295094 (PubMedID)2-s2.0-85040531033 (Scopus ID)
Conference
16th World Congress on Medical and Health Informatics (Medinfo 2017), August 21st to 25th, 2017 in Xiamen, China
Available from: 2017-12-05 Created: 2017-12-05 Last updated: 2018-09-11Bibliographically approved
2. Healthcare in the age of open innovation – A literature review
Open this publication in new window or tab >>Healthcare in the age of open innovation – A literature review
2016 (English)In: Health Information Management Journal, ISSN 1833-3583, E-ISSN 1833-3575, Vol. 45, no 3, p. 121-133Article in journal (Refereed) Published
Abstract [en]

Background: In spite of an increased interest in open innovation and strategies that call for an increased collaboration between different healthcare actors, there is a lack of open innovation research in public contexts.

Objective: This article presents the results of a review regarding the healthcare sector’s engagement in open innovation as well as constraining factors and positive outcomes of open innovation in healthcare.

Method: The literature search focused on papers published in English between 2003 and 2014. Based on specified inclusion criteria, 18 articles were included.

Results: Results reveal that most studies focus on inbound open innovation where external knowledge is integrated with the internal knowledge base at an initial phase of the innovation process. Innovation primarily results in products and services through innovation networks. We also identified constraining factors for open innovation in healthcare, including the complex organizations of healthcare, the need to establish routines for capturing knowledge from patients and clinicians, regulations and healthcare data laws as well as the positive outcome patient empowerment.

Conclusion: The healthcare sector’s engagement in open innovation is limited, and it is necessary to perform further research with a focus on how open innovation can be managed in healthcare. 

Place, publisher, year, edition, pages
Sage Publications, 2016
Keywords
Diffusion of innovation, Health information exchange, Informatics, Review literature as topic, doctor patient relation, empowerment, human, information science, knowledge base, literature, mass communication, medical information system, organization, systematic review
National Category
Information Systems, Social aspects Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-35237 (URN)10.1177/1833358316639458 (DOI)000388852100004 ()27105481 (PubMedID)2-s2.0-85014463056 (Scopus ID)
Available from: 2017-03-21 Created: 2017-03-21 Last updated: 2017-12-05Bibliographically approved
3. The Role of PAEHRs in Patient Involvement
Open this publication in new window or tab >>The Role of PAEHRs in Patient Involvement
2018 (English)In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 42, no 11, article id 210Article in journal (Other academic) Published
Abstract [en]

With increased patient access to data, healthcare services are experiencing change where patients are moving away from being mere passive actors towards becoming more active and involved participants. In this paper, we explore the role of patient accessible electronic health records (PAEHRs) with respect to this increase in patient involvement. The study was performed as a case study and included nine interviews with patients and a survey that was responded to by 56 patients. Our results show that PAEHRs have a role in the enhancement of patient involvement because PAEHRs (i) foster a more balanced relationship between patients and healthcare professionals and (ii) increase access to information.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
EHR; PAEHR; Patient access; Patient involvement
National Category
Information Systems, Social aspects Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-38042 (URN)10.1007/s10916-018-1070-y (DOI)000445649500002 ()30255404 (PubMedID)2-s2.0-85054327474 (Scopus ID)
Available from: 2017-12-05 Created: 2017-12-05 Last updated: 2018-10-23Bibliographically approved
4. Same, same but different: Perceptions of patients’ online access to electronic health records among healthcare professionals
Open this publication in new window or tab >>Same, same but different: Perceptions of patients’ online access to electronic health records among healthcare professionals
2018 (English)In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811Article in journal (Refereed) Epub ahead of print
Abstract [en]

In this study, we explore how healthcare professionals in primary care and outpatient clinics perceive the outcomes of giving patients online access to their electronic health records. The study was carried out as a case study and included a workshop, six interviews and a survey that was answered by 146 healthcare professionals. The results indicate that professionals working in primary care perceive that an increase in information-sharing with patients can increase adherence, clarify important information to the patient and allow the patient to quality-control documented information. Professionals at outpatient clinics seem less convinced about the benefits of patient accessible electronic health records and have concerns about how patients manage the information that they are given access to. However, the patient accessible electronic health record has not led to a change in documentation procedures among the majority of the professionals. While the findings can be connected to the context of outpatient clinics and primary care units, other contextual factors might influence the results and more in-depth studies are therefore needed to clarify the concerns.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
electronic health records, healthcare service innovation and IT, organizational change and IT, patient-centeredness, work impact
National Category
Information Systems, Social aspects Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-38043 (URN)10.1177/1460458218779101 (DOI)XYZ ()29874962 (PubMedID)2-s2.0-85048166545 (Scopus ID)
Note

Included in thesis as submitted manuscript with the title: Same, Same but Different: Perceptions of Patients’ Online Access to EHRs among Healthcare Professionals

Available from: 2017-12-05 Created: 2017-12-05 Last updated: 2018-07-04
5. Business models in public eHealth
Open this publication in new window or tab >>Business models in public eHealth
2016 (English)In: 24th European Conference on Information Systems, ECIS 2016, 2016Conference paper, Published paper (Refereed)
Abstract [en]

Several countries develop strategies and policies to foster the use of eHealth services and stress the importance of business models to develop and implement digital services. Previous research on business models has however mostly focused on the private setting or a healthcare setting with multi-payer or market-based financial systems. In this paper, we explore the use of business models in eHealth as well as the consistency of such a model in a public healthcare setting. The study is performed through a case study of an eHealth service and to which we apply a business model framework. Data have been collected through interviews, documents and project meetings. The results show that all parts of the business model could be identified and provide an overview of the service but no clear guidance on how to reach a sustainable value in the future. It seems that, in the case of public healthcare, there is a need to add the notion of a societal value as well as issues related to future governance for the diffusion of the service to make the business model and the service sustainable.

Keywords
Business model, Digital service, Ehealth, Public healthcare, Health care, Information systems, Business model frameworks, Business modeling, Digital services, E-health services, Financial system, Public healthcares, Sustainable values, Information services
National Category
Information Systems, Social aspects Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-34232 (URN)2-s2.0-84995785818 (Scopus ID)
Conference
24th European Conference on Information Systems, ECIS 2016, 12 June 2016 through 15 June 2016, Istanbul, Turkey
Available from: 2016-12-08 Created: 2016-12-08 Last updated: 2017-12-05

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