Yes / Background: A Personal Health Record (PHR) is an electronic record that individuals use to manage and share their health information, e.g. data from their medical records and data collected by apps. However, engagement with their record can be low if people do not find it beneficial to their health, wellbeing or interactions with health and other services. We have explored the beliefs potential users have about a PHR, how it could be made personally relevant, and barriers to its use. Methods: A qualitative design comprising eight focus groups, each with 6–8 participants. Groups included adults with long-term health conditions, young people, physically active adults, data experts, and members of the voluntary sector. Each group lasted 60–90 min, was audio recorded and transcribed verbatim. We analysed the data using thematic analysis to address the question “What are people’s beliefs about making a Personal Health Record have relevance and impact?” Results: We found four themes. Making it work for me is about how to encourage individuals to actively engage with their PHR. I control my information is about individuals deciding what to share and who to share it with. My concerns is about individuals’ concerns about information security and if and how their information will be acted upon. Potential impact shows the potential benefits of a PHR such as increasing self-efficacy, uptake of health-protective behaviours, and professionals taking a more holistic approach to providing care and facilitating behaviour change. Conclusions: Our research shows the functionality that a PHR requires in order for people to engage with it. Interactive functions and integration with lifestyle and health apps are particularly important. A PHR could increase the effectiveness of behaviour change apps by specifying evidence-based behaviour change techniques that apps should incorporate. A PHR has the potential to increase health-protective behaviours and facilitate a more person-driven health and social care system. It could support patients to take responsibility for self-managing their health and treatment regimens, as well as helping patients to play a more active role when care transfers across boundaries of responsibility. / Leeds Informatics Board

Le système de santé d'aujourd'hui fait appel à de nombreuses technologies de l'information nommées TIS (Technologies de l’Information en Santé). Celles-ci ont donné naissance à de nouvelles formes d’interaction médecin-patient et ont complexifié l'approche thérapeutique dite
« centrée sur le patient ». Les TIS promettent une plus grande efficacité et l’augmentation de la satisfaction des patients par le biais d’une meilleure compréhension de la maladie pour le patient. Or, elles peuvent également devenir des sources de conflit pour le professionnel de la santé, étant donné leur utilisation en dehors des rencontres cliniques ainsi que leur tendance à agir comme des barrières communicationnelles lors des consultations. Cette recherche vise a étudier les critères de design nécessaires à la conception d’un TIS pouvant améliorer la relation médecin-patient et donc, faciliter la communication et améliorer l’alliance thérapeutique. L’étude utilise une approche centrée sur l’utilisateur et vise donc à comprendre les besoins et les attentes des médecins et des patients. En étudiant les nouvelles approches en santé et les TIS, il a été possible de comprendre le contexte et les besoins des utilisateurs en terme de communication. Ces derniers sont primordiaux au processus dit centré sur l’utilisateur. Le faible taux de rétention du discours du médecin devient une barrière communicationnelle importante, tout comme le temps pressurisé. La recherche nous montre que l’ajout d’un outil virtuel de vulgarisation peut, à l’aide de média visuels (tel que des modélisations, des animations 3D et des dessins), grandement aider la relation médecin-patient. / Today’s medical system is using an increasing number of information technologies to help healthcare professionals in their daily practice. Commonly known as HIT (Health Information Technologies), they create new forms of doctor-patient interaction and complexify the therapeutic approach called “patient centered approach”. Their use promises to improve the efficiency of the healthcare system and the overall satisfaction of the patient by improving his understanding of his illness, yet they can also become communication barriers during a consultation and even a source of conflict when used outside a clinical context. This research project aims at studying the design criteria for a Health Information tool that can help improve the doctor-patient relationship. The study uses a user-centered approach and therefore, focuses on understanding the needs and expectations of both doctors and patients. The study of the theoretical and "on the field" therapeutic approach shows that the pressurized time of the consultation, the many communication barriers and the low level of information remembered by patients are problems that can be solved by a HIT. A virtual vulgarization tool that uses multimedia such as 3D animations, 3D models and drawings can considerably help the doctor-patient relationship.

No description available.

Digitization of data offers more opportunities for future health and medicine care due to the availability of information technology in our everyday lives. Several studies have provided us with insights in designing persuasive eHealth services, but only a few studies have investigated the design of a persuasive eHealth application by using presently available smartphones and while including the target group. By pursuing an iterative design process, three smartphone application prototypes were created and tested with senior citizens by using cognitive walkthroughs, use case scenarios and semi-structured interviews. The results indicated that the target group involvement had positive influences on the design of the prototypes, with user insights uncovering setbacks and opportunities in the design. Thus, the study presents a set of primary characteristics for designing a persuasive eHealth application to be usable with smartphones and how the iterative design process with the involvement of senior citizens shaped the design.

In November 2012 Uppsala County Council (UCC) introduced an eHealth service, ‘My Health Record’, that gives all inhabitants over age 18 in Uppsala County access to their health records online. However, this service has not been evaluated before this study. We conducted an interview study, based on User Experience (UX) and Patient empowerment, with users of ‘My Health Record’ to get their opinions, and to see if and how the service can be improved. Our findings shows that the users are positive to the service and the aspects that can be improved mostly concern information and communication. Based on these results, we propose design principles as well as concrete design proposals which can be useful for re-designing the service as well as inspiration for similar projects. Additionally, an interesting finding is that the interviewees had very few opinions and complains on the actual interface, which could mean that the content (the health record) is so interesting that the interface becomes almost “invisible”. A conclusion we make is that UX and Patient empowerment is a good fit for each other, and that UX has advantages over traditional usability in services like this.

For opportunistic spectrum access and spectrum sharing in cognitive radio networks, one key problem is how to develop wireless access schemes for secondary users so that harmful interference to primary users can be avoided and quality-of-service (QoS) of secondary users can be guaranteed. In this research, dynamic wireless access protocols for secondary users are designed and optimized for both infrastructure-based and ad-hoc wireless networks. Under the infrastructure-based model, the secondary users are connected through a controller (i.e., an access point). In particular, the problem of wireless access for eHealth applications is considered. In a single service cell, an innovative wireless access scheme, called electromagnetic interference (EMI)-aware prioritized wireless access, is proposed to address the issues of EMI to the medical devices and QoS differentiation for different eHealth applications. Afterwards, the resource management problem for multiple service cells, specifically, in multiple spatial reuse time-division multiple access (STDMA) networks is addressed. The problem is formulated as a dual objective optimization problem that maximizes the spectrum utilization of secondary users and minimizes their power consumption subject to the EMI constraints for active and passive medical devices and minimum throughput guarantee for secondary users. Joint scheduling and power control algorithms based on greedy approaches are proposed to solve the problem with much less computational complexity. In an ad-hoc wireless network, the robust transmission scheduling and power control problem for collision-free spectrum sharing between secondary and primary users in STDMA wireless networks is investigated. Traditionally, the problem only considers the average link gains; therefore, QoS violation can occur due to improper power allocation with respect to instantaneous channel gain realization. To overcome this problem, a robust power control problem is formulated. A column generation based algorithm is proposed to solve the problem by considering only the potential subset of variables when solving the problem. To increase the scalability, a novel distributed two-stage algorithm based on the distributed column generation method is then proposed to obtain the near-optimal solution of the robust transmission schedules for vertical spectrum sharing in an ad-hoc wireless network.

For opportunistic spectrum access and spectrum sharing in cognitive radio networks, one key problem is how to develop wireless access schemes for secondary users so that harmful interference to primary users can be avoided and quality-of-service (QoS) of secondary users can be guaranteed. In this research, dynamic wireless access protocols for secondary users are designed and optimized for both infrastructure-based and ad-hoc wireless networks. Under the infrastructure-based model, the secondary users are connected through a controller (i.e., an access point). In particular, the problem of wireless access for eHealth applications is considered. In a single service cell, an innovative wireless access scheme, called electromagnetic interference (EMI)-aware prioritized wireless access, is proposed to address the issues of EMI to the medical devices and QoS differentiation for different eHealth applications. Afterwards, the resource management problem for multiple service cells, specifically, in multiple spatial reuse time-division multiple access (STDMA) networks is addressed. The problem is formulated as a dual objective optimization problem that maximizes the spectrum utilization of secondary users and minimizes their power consumption subject to the EMI constraints for active and passive medical devices and minimum throughput guarantee for secondary users. Joint scheduling and power control algorithms based on greedy approaches are proposed to solve the problem with much less computational complexity. In an ad-hoc wireless network, the robust transmission scheduling and power control problem for collision-free spectrum sharing between secondary and primary users in STDMA wireless networks is investigated. Traditionally, the problem only considers the average link gains; therefore, QoS violation can occur due to improper power allocation with respect to instantaneous channel gain realization. To overcome this problem, a robust power control problem is formulated. A column generation based algorithm is proposed to solve the problem by considering only the potential subset of variables when solving the problem. To increase the scalability, a novel distributed two-stage algorithm based on the distributed column generation method is then proposed to obtain the near-optimal solution of the robust transmission schedules for vertical spectrum sharing in an ad-hoc wireless network.

Personer som lider av migrän har i de flesta fall någon gång funderat över vad som är den utlösande faktorn. Ibland vet de svaret, ibland är svaret inte lika tydligt. Att ha kunskap och förståelse över sin migrän kan öka chanserna till självhjälp och ökad empowerment. Patienterna har tillräcklig kunskap för att kunna ta beslut som bidra till en bättre hälsa för individen. Patienten hjälper således sig själv till ett bättre välmående utifrån den kunskap som patienten har om sig själv och sin sjukdom. För att skapa en förståelse och större kunskap för sin sjukdom kan det underlätta att dokumentera sina migränanfall. Dokumentationen kan sedan användas för att hitta en gemensam nämnare till anfallen. Att dokumentera migränanfall kan också kallas för att föra en migrändagbok. Migrändagböcker kan ordineras ut av hälso- och sjukvård i form av enklare dokumentation på pappersark. Det finns också digitala lösningar där personer som lider av migrän kan dokumentera in mer utförliga uppgifter om sin migränattack via olika migränappar som finns att ladda ner. En digital lösning ger större möjlighet till en rikare information om personens sjukdom, men saknar ofta anpassning för migränpatienters särskilda behov och upplevda problematik. Personer som lider av migrän kan uppleva problematik med att interagera med digitala skärmar. Att interagera med skärmar kan vara en bidragande orsak till ett sämre mående, vilket framkom i denna undersökning. Syftet med denna studie var att undersöka hur ett gränssnitt för en mobil hälsoapplikation för migränpatienter kunde utformas med fokus på empowerment och god användarupplevelse. För att ta reda på detta, genomfördes 7 stycken semistrukturerade intervjuer. Informanterna fick berätta om sina upplevelse av migrän, deras egen kunskap om sin sjukdom, samt tekniska aspekter om hur de vill interagera med mobilappar under tiden som de har migrän. Den data som uppkom utifrån intervjuerna analyserades sedan med hjälp av kvalitativ kodning som resulterade i fyra olika teman. Behovet visar att dokumentation av migränanfall genom mobilapplikationer ska ske med så lite interaktionstid med skärmen som möjligt. Dokumentation av migränanfall kan med fördel ske med hjälp av tal och ljud. Själva gränssnittet ska vara enkelt och simpelt med avskalade ikoner som tydligt ska gå att identifiera. Det ska finnas möjlighet att manuellt eller med automatiska inställningar dämpa ljuset på skärmen. Resultatet av undersökningen mynnade sedan ut i lämpliga gränssnittsförslag i form av mockuper. För framtida forskning rekommenderas att utföra användartester med utökade prototyper, för att undersöka huruvida de designförslag som tagits fram i denna studie upplevs som en god användarupplevelse och bidrar till empowerment. / People who suffer from migraines have probably at some point thought about what the triggering factor is. Sometimes the answer is clear, and sometimes it’s not that obvious. To have understanding and knowledge of their migraine can increase the chances of self-help and also higher levels of empowerment. With self-help, the patient can make better decisions based on the knowledge of the disease, which can lead to a better well-being. In order to establish an understanding and more knowledge about their illness, it can be helpful to document the migraine attacks. The documentation can then be used to find a possible cause of the attacks. This is also called a migraine journal. Migraine journals can be prescribed by the health services, where you get a template with less words and with simple instructions of the tasks on them. There are also digital solutions, like mobile applications, that supports more detailed documentation. A digital solution provides more opportunities for more detailed information about the person's illness, but mobile apps often lacks adaption for the patient's specific needs and problems. Persons who suffers from a migraine attack, can experience difficulties when documenting a large amount of information on applications. The interaction with digital screens may worsen the symptom. This is one of the findings of this study. The purpose of this study was to examine how a user interface for a mobile health application, could be designed with focus of empowerment and a good user experience. To find out, 7 semi structured interviews were conducted. The informants were asked to tell about their experiences, their knowledge about their illness and some technical aspects of how they want to interact with mobile applications while they are suffering from an attack. The data that was obtained from the interviews were then analyzed using qualitative coding that resulted in four different themes. The study showed that the potential users wish to interact as little as possible with the screen. Documentation of migraine attacks can be done with the help of speech and sound. The interface itself should be easy with simple icons which are easy to identify. It should be possible to manually or automatically adjust the light on the screen. The result of the study contributed to suggestions for how to design a suitable interface for migraine patients. The interface is visualised in this report in the form of mockups. For future research , it is recommended to perform user tests with extended prototypes to investigate whether the design principles and design suggestions developed in this study are perceived as a good user experience and contribute to empowerment.

This thesis has its starting point in the digitalization of society focusing on the rapid development of mobile technologies and the increasing interplay between humans and machines. The use of information and communication technologies (ICT) is extending at a fast pace, affecting all parts of society, and the everyday life of most individuals. The fast progressing development of mobile technologies (smartphones and their accessories/ wearable’s) is creating new trends such as health tracking and quantified self. These mobile technologies can register an increasing number of physiological features, implying that the interconnection between the physiological and digital systems is increasing. This creates a range of new possibilities within health and medical research but it also creates new challenges and the need for new knowledge in how we relate these devices to our bodies. In the psychological perspective, smartphone use is increasing and previous studies imply that these devices are affecting our behaviour, our mental health as well as our cognitive functions. This implies for a need to understand the relation we have to these devices also in a psychological perspective, focusing on emotions and cognition. This study set out to explore the relation between humans and technologies from a systems perspective. The research question involved: How are users and smartphones related in physical and psychological perspectives? The methods used were questionnaires and interviews. The respondents were students in two European universities, who described their experiences of smartphone use, and three doctors (in medicine and biomedicine) that provided interesting aspects in how mobile technologies can be related to the human body from a system perspective   In a physical perspective the users as well as their physical environments could be described as converging with the digital systems. The need of being connected and have access to all life-spheres at once seemed to be an important driving force, implying that users are dependent on information and a converged life-style. In a psychological perspective, the emotional bond seemed stronger then the actual physical need. The perceptions of smartphones differed, but a common denominator described by both Swedish and Albanian users, was the perception of the smartphone as something with human-like features, comparable to a friend. The last part of the study concerned if smartphones can be seen as a new entity of our own system, comparable to an organ. The result suggests that this depends on the individual use, if the technologies is used to sustain health, the value it provides, and it is also a matter of the users ontological believes. The concept of physio-digital convergence is proposed as a new concept to analyse the development of increasing use of mobile technologies further.

This thesis investigates how actors within the health care sector work with innovation and development of information technology products, also called eHealth. eHealth services is an expanding area which will play a vital role in tomorrow's health care system. Staffs within health care organizations do have a lot of ideas of how to develop and improve the work process and how to provide better health care. The study was performed at Stockholms läns sjukvårdsområde (SLSO) and the purpose of this project is to evaluate the support given by SLSO innovation gateway. Innovation gateway is an approach that has been spread to some of Sweden's county councils, where the aim is to take advantage of the staffs ideas and to develop products and services based on activities that contribute to improving health care. Interviews and observations have been made to understand the innovation environment in Stockholms läns lansting. This gave an understanding for which user-centred aspects that are important to consider when developing eHealth innovations. Aspects like security, usability and availability are essential to consider when creating innovations that create value for patients and employees. The results also showed that staffs need better support from the organization and an understanding and knowledge in information technology, law and project management to be able to manage and develop eHealth innovations. The study has also shown that the client, the project and developers must all be involved in the innovation process and work with the organization to succeed. It requires a reallocation of resources to enable SLSO to provide the demanded support.