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Grünloh, C., Cajander, Å. & Myreteg, G. (2016). "The Record is Our Work Tool!"-Physicians' Framing of a Patient Portal in Sweden. Journal of Medical Internet Research, 18(6), 470-483
Åpne denne publikasjonen i ny fane eller vindu >>"The Record is Our Work Tool!"-Physicians' Framing of a Patient Portal in Sweden
2016 (engelsk)Inngår i: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 18, nr 6, s. 470-483Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: Uppsala County in Sweden launched an e-health patient portal named Journalen in 2012, which allows patients to access their medical records over the Internet. However, the launch of Journalen was critically debated in the media. The professionals were strongly skeptical and one reason was possible negative effects on their work environment. This study hence investigates the assumptions and perspectives of physicians in order to understand their framing of the patient portal in relation to their work environment.

Objective: The study uses the concept of Technological Frames to examine how physicians in different specialties make sense of the patient portal in relation to their work environment.

Methods: 12 semi-structured interviews were conducted with physicians from different specialties. Interviews were transcribed and translated. A theoretically informed thematic analysis was performed.

Results: The thematic analysis revealed four main themes: work tool, process, workload, and control. Physicians perceive medical records as their work tool, written for communication within healthcare only. Considering effects on work environment the physicians held a negative attitude and expected changes, which would affect their work processes in a negative way. Especially that patients might read their test results prior to the physician was seen as possibly harmful for patients and as an interference with their established work practices. They expected the occurrence of misunderstandings and needs for additional explanations, which would consequently increase their workload. Other perceptions were that the portal would increase controlling and monitoring of physicians, and increase or create a feeling of mistrust from patients. Regarding benefits for the patients most of the physicians believe there is only little value in the patient portal and that patients would mostly be worried and misunderstand the information provided.

Conclusions: Supported by the study we conclude: 1) The transfer of a paper-based healthcare process where patients read on paper, into a digital process challenges current work practices and has consequences for the work environment. Mostly this is explained by the changing positions between the physicians and the patient: the latter can drive the process, which reduces the physicians’ ability to guide the patient. 2) The physicians’ experiences were expressed as worries: patients would not understand the content of the record and become unnecessary anxious from misunderstandings. The concerns are to some extent based on a generalized view of patients, which might disregard those, who already actively participate in healthcare. This study hence reveals a need to provide physicians with information about the values for patients from using patient portals. 3) A change of work practices may be beneficial to increase patient participation, but such changes should preferably be designed and discussed with physicians. However, the strong resistance from the physicians made this challenging when launching Journalen.

sted, utgiver, år, opplag, sider
Toronto: JMIR Publications Inc., 2016
Emneord
Patient accessible electronic health records, medical records, e-health services for patients, patient portal, technological frame, physicians
HSV kategori
Forskningsprogram
Teknik och hälsa
Identifikatorer
urn:nbn:se:kth:diva-185804 (URN)10.2196/jmir.5705 (DOI)000382312400037 ()27349531 (PubMedID)2-s2.0-84977587367 (Scopus ID)
Merknad

QC 20160428

Tilgjengelig fra: 2016-04-28 Laget: 2016-04-27 Sist oppdatert: 2018-10-08bibliografisk kontrollert
Cajander, Å., Grünloh, C. & Rexhepi, H. (2015). Worlds Apart - Doctors’ Technological Frames and Online Medical Records. In: Schriften aus der Fakultät Wirtschaftsinformatik und Angewandte Informatik der Otto-Friedrich-Universität Bamberg (22): . Paper presented at The 15th IFIP TC.13 International Conference on Human-Computer Interaction - INTERACT, 14 to 18 September 2015, Bamberg, Germany (pp. 357-369). University of Bamberg Press
Åpne denne publikasjonen i ny fane eller vindu >>Worlds Apart - Doctors’ Technological Frames and Online Medical Records
2015 (engelsk)Inngår i: Schriften aus der Fakultät Wirtschaftsinformatik und Angewandte Informatik der Otto-Friedrich-Universität Bamberg (22), University of Bamberg Press , 2015, s. 357-369Konferansepaper, Publicerat paper (Fagfellevurdert)
Abstract [en]

The ability of individuals to access and use their online medical records serves as one of the cornerstones of national efforts to increase patient empowerment and improve health outcomes. However, the launch of online medical records in Uppsala County, Sweden, has been criticized by the medical profession and the local doctors’ union. The aim of this paper is therefore to present the results from an exploratory study where interviews with two oncologists are analysed and discussed based on the theory of Technological Frames and Patient Empowerment. The results indicate that medical doctors have different assumptions and perspectives that affect their use of technology and how they view patient empowerment in everyday clinical work.

sted, utgiver, år, opplag, sider
University of Bamberg Press, 2015
Emneord
Patient Empowerment, eHealth, healthcare information systems
HSV kategori
Forskningsprogram
Humaniora-samhällsvetenskap
Identifikatorer
urn:nbn:se:kth:diva-175467 (URN)978-3-86309-352-5 (ISBN)978-3-86309-353-2 (ISBN)
Konferanse
The 15th IFIP TC.13 International Conference on Human-Computer Interaction - INTERACT, 14 to 18 September 2015, Bamberg, Germany
Merknad

QC 20151019

Tilgjengelig fra: 2015-08-25 Laget: 2015-10-15 Sist oppdatert: 2018-01-11bibliografisk kontrollert
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0001-7472-2215