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Worlds Apart - Doctors’ Technological Frames and Online Medical Records
Uppsala University, Sweden.ORCID iD: 0000-0001-7472-2215
KTH, School of Computer Science and Communication (CSC), Media Technology and Interaction Design, MID. CUAS Cologne University of Applied Sciences, Germany.ORCID iD: 0000-0003-2319-3186
Högskolan i Skövde, Sweden.ORCID iD: 0000-0001-8957-9853
2015 (English)In: Schriften aus der Fakultät Wirtschaftsinformatik und Angewandte Informatik der Otto-Friedrich-Universität Bamberg (22), University of Bamberg Press , 2015, 357-369 p.Conference paper, Published paper (Refereed)
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.

Place, publisher, year, edition, pages
University of Bamberg Press , 2015. 357-369 p.
Keyword [en]
Patient Empowerment, eHealth, healthcare information systems
National Category
Human Computer Interaction Information Systems
Research subject
Humanities and Social sciences
Identifiers
URN: urn:nbn:se:kth:diva-175467ISBN: 978-3-86309-352-5 (print)ISBN: 978-3-86309-353-2 (print)OAI: oai:DiVA.org:kth-175467DiVA: diva2:861630
Conference
The 15th IFIP TC.13 International Conference on Human-Computer Interaction - INTERACT, 14 to 18 September 2015, Bamberg, Germany
Note

QC 20151019

Available from: 2015-08-25 Created: 2015-10-15 Last updated: 2016-04-29Bibliographically approved
In thesis
1. To Share or Not to Share?: Expectations of and Experiences with eHealth Services that Allow Users Access to their Health Information
Open this publication in new window or tab >>To Share or Not to Share?: Expectations of and Experiences with eHealth Services that Allow Users Access to their Health Information
2016 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis investigates expectations of and experiences with eHealth services that allow users access to their health information. Although eHealth services are endorsed by many politicians and patients, they are met with strong resistance by health care professionals. Lacking this support hinders the uptake of the full potential of the service, especially with relation to patient participation and empowerment.

This research investigates the frames of reference that are constructed by stakeholders in relation to eHealth services, such as direct-to-consumer genetic testing and electronic health records. The results are based on empirical data gathered during an experiment with media informatics students in Germany, and from interviews with physicians in Uppsala, Sweden.

The eHealth services in question were framed by the participants of the conducted studies as potentially harmful for its users. The negative expectations were based mainly on a generalized view of patients as not sufficiently knowledgable and hence unable to understand the health information provided by the service. The participants in the reported studies (physicians and students in their role as designers) felt a responsibility to prevent any potential harm for the users of the eHealth service. Due to the framing based on assumed negative consequences for a supposedly vulnerable user group, the participants preferred to advocate against access rather than for patient empowerment and participation. Accessing health information was associated as holding little value for the users.

This research enhances the understanding of the elements underlying this skepticism and concern. It shows that a specific view of patients and/or prospective users of an eHealth system can result in incongruent technological frames and value attribution. In line with participatory and value-sensitive design approaches as well as the aim to increase technology acceptance, patients and health care professionals should not only be included in the design process but also engage in joint activities in order to enable reframing.

Abstract [sv]

Avhandlingen undersöker förväntningar på och erfarenheter av e-hälsotjänster som ger användare tillgång till sin egen hälsoinformation. Även om e-hälsotjänster har fått stöd av många politiker och patienter har de mötts av starkt motstånd från sjukvårdspersonal. Utan deras stöd blir det svårt att realisera tjänstens fulla potential, särskilt när det gäller patientens delaktighet och egenmakt.Forskningen undersöker de referensramar som konstrueras av intressenter för att förstå e-hälsotjänster, till exempel genetisk testning direkt till konsument och elektroniska patientjournaler. Resultaten baseras dels på empiriska data som samlats in i ett experiment med studenter i Tyskland, dels på intervjuer med läkare i Uppsala.De undersökta e-hälsotjänsterna upplevdes (were framed) av studiernas deltagare som potentiellt skadliga för användarna. De negativa förväntningarna baserades huvudsakligen på en allmän syn på patienter som inte tillräckligt kunniga och därmed oförmögna att förstå tjänstens hälsoinformation. Deltagarna i de rapporterade studierna (läkare och studenter i rollen som formgivare) kände ansvar för att förhindra eventuella skador för e-hälsotjänstens användare. Beroende på de förväntat negativa följderna för de förmodat utsatta patientgrupperna föredrog undersökningens deltagare att ta ställning emot patienternas åtkomst snarare än att ta ställning för deras deltagande och ökade egenmakt. Att ha tillgång till hälsoinformation bedömdes vara av lågt värde för användarna.Forskningen ökar förståelsen av de element som ligger till grund för deltagarnas upplevda skepsis och oro. Den visar att en specifik bild av patienter och/eller framtida användare av ett e-hälsosystemet kan leda till inkongruenta tekniska referensramar och värdebedömningar. I linje med inriktningarna deltagande design och värdebaserade design samt målet att öka teknisk acceptans, bör patienter och hälso- och sjukvårdspersonal inte bara ingå i designprocessen, utan också delta i gemensamma aktiviteter för att möjliggöra omtolkningar av sina tekniska referens- ramar.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2016. 53 p.
Series
TRITA-CSC-A, ISSN 1653-5723 ; 2016:09
Keyword
eHealth, electronic health records, technological frames, expectations, patients, health care professionals
National Category
Human Computer Interaction
Research subject
Human-computer Interaction; Technology and Health
Identifiers
urn:nbn:se:kth:diva-185803 (URN)978-91-7595-965-8 (ISBN)
Presentation
2016-06-02, 1440, Lindstedtsvägen 3, Stockholm, 10:00 (English)
Opponent
Supervisors
Available from: 2016-04-28 Created: 2016-04-27 Last updated: 2016-04-28Bibliographically approved

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Cajander, ÅsaGrünloh, ChristianeRexhepi, Hanife

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