The Nordic countries share common interests to digitize services in the health care sector from which their eHealth strategies are a proof of. Sweden has specifically put effort on the global scheme by setting a goal of being the best in eHealth by 2025. As one of the main goals of the strategies is increasing patient empowerment, perspective of the health care professionals in this digital shift has yet remained less noticed and the concrete effects on them is still scarcely studied. This study focuses on providing the aspect of the health care professionals and how they have perceived and experienced the digital tools and eHealth services affecting their work and what attitudes they themselves have as users.                                This study utilized the mixed method approach and was done in collaboration with the Digga Halland project which aims towards enhancing health care workers’ digital competences and conditions to utilize eHealth. Previously collected baseline survey data from health care professionals in different municipalities in the Halland region was analysed and five health care professionals were recruited for in-depth, phenomenological interviews.             The results of this research indicate that the use of digital tools and services is common among health care professionals at work and outside work and the workers consider their digital competence rather good. However, the interview respondents presented varying attitudes towards digital services and eHealth depending on whether the services were evaluated from a professional role or outside work role when the professionals used the services themselves. Also, the current professional position guided whether the digital shift and eHealth were experienced more positively or negatively.

This research studies the interaction between eHealth and implementation success. eHealth has become an important subject of discussion and evaluation for healthcare organisations over the last decade or so, and has also been the focus of national healthcare programs and plans. Billions of pounds are being spent on implementations of eHealth. Those implementations endeavour to cut costs, while at the same time, achieving enhanced efficiency and accuracy. Hence, understanding success in eHealth has become an attractive topic for research and a requirement in healthcare practice. This research aims to understand the definitions and factors of success in implementations of eHealth. In doing so, it examined the suitability of the Delone and McLean Information Systems (D&M IS) success model to explain eHealth success. A multistage research design was adopted. The first stage was composed of a thorough Systematic Literature Review that covered the origins and development of eHealth, the different themes in the research around eHealth, the concept of Critical Success Factors in IS, and the available frameworks for IS implementations, in general, and eHealth, in specific. As for the second stage, which constituted the core of this study, it was based on an exploratory, mixed-methods approach to research where a triangulation of research methods, data collection tools, and data sources was employed. As part of this approach, two case studies were conducted. Within the case studies, 20 semi-structured interviews were carried out; the outcomes of the interviews were analysed using framework analysis. In addition, a survey took place, and feedback from the survey respondents was analysed using different quantitative statistical methods. Finally, content analysis was relied on to examine all the relevant existing documentations. This research found that information systems success models, already in existence, can facilitate the understanding of implementation success in eHealth. The D&M IS success model, in particular, was chosen and applied. The results of the qualitative and quantitative research showed that the D&M model is suitable to explain and define success in eHealth. In addition to the constructs that define success in eHealth, such achievement is attributed to a number of factors. This research found that eHealth shares a number of success factors with other IS implementation frameworks. At the same time, eHealth success factors that emerged from the case study, like; clinical engagement, the role of eHealth leadership, and clinical champions are discussed. This research led to the exploration of new factors that require a better understanding, such as; the effects of a national eHealth policy, the role of critical champions, and innovative methods of eHealth training. Links between eHealth success definitions, and success factors were investigated, as part of this study. The results of this research revealed statistically significant links between the achievement of organisational goals and user satisfaction, and ultimately, with implementation success. This work has allowed for the development of a potential eHealth specific version of the D&M model as a provisional model to be confirmed with further research. It identified success factors that affect the implementations of eHealth. Some of the factors are eHealth specific, which can also be developed into a provisional model. In addition, this work has resulted in a number of recommendations for implementers and evaluators of eHealth in practice.

Syfte Syftet med studien var att undersöka effekten på astmakontroll och lungfunktion av ett web-baserat stödprogram för astmapatienter inom primärvården. Metod Studien var en 2-armad randomiserad, kontrollerad studie med kvantitativ ansats som pågick under 6 månader. Båda grupperna fick astmavård utifrån hur den bedrivs på vårdcentralerna och interventionsgruppen fick även tillgång till ett nyskapat web-baserat stödprogram (Astmakollen) för astmapatienter. Totalt slutförde 83 deltagare studien, varav 39 ingick i interventionsgruppen och 44 i kontrollgruppen. Resultat Denna studie visade signifikant förbättring av astmakontroll hos de patienter som haft tillgång till det web-baserade stödprogrammet Astmakollen under 6 månader. Medelvärdet på astma kontroll test i interventionsgruppen steg med 2,23 poäng medan värdet i kontrollgruppen var tämligen oförändrat. Effektstorleken för denna förändring mätt i Cohens d var 0,57. Medelvärdet av lungfunktionen i interventionsgruppen steg med 0,3% under studietiden medan den försämrades i kontrollgruppen och effektstorleken uppgick till 0,45. Skillnaden mellan grupperna var signifikant. Konklusion I denna studie framkommer det att e-hälsa kan ge en förbättrad astmakontroll och bibehållen lungfunktion samt vara ett komplement till dagens astmavård genom att öka tillgängligheten av individanpassad och evidensbaserad vård. / Objective The aim of this study was to examine the impact on asthma control and lung function of a web-based support program for asthma patients in primary care. Method The study was a quantitative, parallel, 2-arm, randomized controlled trial over a 6-month period. Both groups received asthma care based on how it was conducted at the health centers and the intervention group also gained access to a newly created web-based support program (Astmakollen) for asthma patients. In total, 83 participants completed the study, of whom 39 were in the intervention group and 44 in the control group. Results This study has showed significant improvement in asthma management in the sample group who had access to the web-based support program for 6 months. The mean score for asthma control test in the intervention group increased by 2,23 points while the score in the control group remained almost the same. The effect size for this change measured in Cohens d was 0,57. The mean score of lungfunction in the intervention group increased by 0,3% during the study period, while it deteriorated in the control group and the effect size amounted to 0,45. The difference between the groups were significant. Conclusions In this study, it appears that eHealth can provide improved asthma control and maintained lung function and be a complement in today's asthma care by increasing accessibility of personalized and evidence-based care.

The diploma thesis focuses on optimization of the current project management in the organization. It assesses compliance with the seven principles of project management according to the PRINCE2 methodology in particular. Moreover, the thesis elaborates a project proposal. The overall objective of the thesis is to implement project management tools in the company.

The purpose of this dissertation was to evaluate the biological, behavioral, and psychosocial attributes of individuals diagnosed with chronic obstructive pulmonary disease (COPD). Specific aims were to: 1) explore the predictive power of spirometry measures for event-free survival in patients with heart failure and suspected COPD, focusing on the differences in survival between those with and without airflow limitation; 2) examine the psychometric properties of the Multidimensional Scale of Perceived Social Support (MSPSS) in patients with concomitant COPD and heart failure; and 3) test the efficacy of a theory-based, multidimensional, self-care educational intervention using an eHealth platform on measures of symptom severity and variability, anxiety and depressive symptoms, perceived self-care ability, perceived self-care adherence, and selfcare information needs (knowledge) in a sample of adult patients with stable COPD. Specific aim one was addressed by evaluation of the predictive power of spirometry measures (forced expiratory volume/second [FEV1], forced vital capacity [FVC], and the ratio of FEV1/FVC) for event-free time to combined hospitalization/mortality after controlling for clinical and sociodemographic variables. This analysis revealed that those patients with airflow limitation were 2.2 times more likely to experience hospitalization/mortality compared to those without airflow limitation. The second specific aim was addressed with a psychometric evaluation of the Multidimensional Scale of Perceived Social support (MSPSS) which included determination of internal consistency reliability, the factor structure and construct validity by hypothesis testing in participants with comorbid COPD and heart failure. The MSPSS was a valid and reliable instrument to measure perceived social support in patients with comorbid COPD and heart failure. The third specific aim was addressed by a trial of an eHealth educational intervention in participants with COPD (N = 20). This intervention resulted in significant change in symptom severity evaluation in patients categorized as having medium symptom severity for the following symptoms: distress due to cough, chest tightness, dyspnea with activity and fatigue; these symptoms were perceived as more severe in the intervention period. Anxiety, depressive symptoms and perceived self-care ability were unchanged; however, perceived self-care adherence scores improved, and knowledge needs were significantly reduced after the intervention.

A North American man has approximately a one in six chance of being diagnosed with prostate cancer in his lifetime. In most cases, there is no clearly optimal treatment, so he may be invited to participate in a treatment decision between several medically reasonable options, each with potential short- and long-term side effects. Information needs are high at diagnosis and can continue to be elevated for years or decades. Many men and their families seek information online, where, due partly to the array of websites available and high variation in information preferences, it can be difficult to find personally relevant and useful websites. This research sought to address this issue by developing methods to categorize prostate cancer websites and exploring quantitative and qualitative relationships between websites, information-seekers, and individuals’ assessments of websites. The research involved a series of three studies. In the first study, 29 men with prostate cancer participated in a needs assessment involving questionnaires, an interview, and interaction with a prototype website. In the second study, a detailed classification system was developed and applied to a set of forty websites selected to be representative of the variety of prostate cancer websites available. The third (online) study collected clinical, cognitive, and psychosocial details from 65 participants along with their ratings of websites from study two. A number of hypotheses were tested. One finding was that, compared to men with greater trust, men with lower trust in their physician tended to judge commercial websites as less relevant and useful, and found websites with descriptions of personal experiences more relevant and useful. Analyses also addressed a number of exploratory questions, including whether website and individual attributes might predict preferences for websites. Using discriminant analysis on 80% of the data, two functions were identified that predicted ratings significantly better than chance. These relationships were then validated with 20% of the data held back for testing. The results are discussed in terms of their implications for information tailoring and recommender systems for prostate cancer patients searching for information online. Limitations of the current research and recommendations for future research are also presented.

Electronic health records (EHRs) facilitate storing, organizing, and sharing personal health information. The academic literature suggests that multimedia information (MM; image, audio, and video files) should be incorporated into EHRs. We examined the acceptability of MM-enabled EHRs for Ontario-based software vendors and physicians, using a qualitative analysis of primary and acute care EHR vendor websites, and a survey of physician perceptions regarding MM features in EHRs. Primary care EHR vendors provided more product-specific information than acute care vendors; however, neither group emphasized MM features in their EHRs. Physicians had slightly positive perceptions of image and video features, but not of audio features. None of the external factors studied predicted physicians‘ intention to use MM. Our findings suggest that neither vendors nor physicians are enthusiastic about implementing or using MM in EHRs, despite acknowledging potential benefits. Further research is needed to explore how to incorporate MM into EHR systems.

Electronic health records (EHRs) facilitate storing, organizing, and sharing personal health information. The academic literature suggests that multimedia information (MM; image, audio, and video files) should be incorporated into EHRs. We examined the acceptability of MM-enabled EHRs for Ontario-based software vendors and physicians, using a qualitative analysis of primary and acute care EHR vendor websites, and a survey of physician perceptions regarding MM features in EHRs. Primary care EHR vendors provided more product-specific information than acute care vendors; however, neither group emphasized MM features in their EHRs. Physicians had slightly positive perceptions of image and video features, but not of audio features. None of the external factors studied predicted physicians‘ intention to use MM. Our findings suggest that neither vendors nor physicians are enthusiastic about implementing or using MM in EHRs, despite acknowledging potential benefits. Further research is needed to explore how to incorporate MM into EHR systems.

A North American man has approximately a one in six chance of being diagnosed with prostate cancer in his lifetime. In most cases, there is no clearly optimal treatment, so he may be invited to participate in a treatment decision between several medically reasonable options, each with potential short- and long-term side effects. Information needs are high at diagnosis and can continue to be elevated for years or decades. Many men and their families seek information online, where, due partly to the array of websites available and high variation in information preferences, it can be difficult to find personally relevant and useful websites. This research sought to address this issue by developing methods to categorize prostate cancer websites and exploring quantitative and qualitative relationships between websites, information-seekers, and individuals’ assessments of websites. The research involved a series of three studies. In the first study, 29 men with prostate cancer participated in a needs assessment involving questionnaires, an interview, and interaction with a prototype website. In the second study, a detailed classification system was developed and applied to a set of forty websites selected to be representative of the variety of prostate cancer websites available. The third (online) study collected clinical, cognitive, and psychosocial details from 65 participants along with their ratings of websites from study two. A number of hypotheses were tested. One finding was that, compared to men with greater trust, men with lower trust in their physician tended to judge commercial websites as less relevant and useful, and found websites with descriptions of personal experiences more relevant and useful. Analyses also addressed a number of exploratory questions, including whether website and individual attributes might predict preferences for websites. Using discriminant analysis on 80% of the data, two functions were identified that predicted ratings significantly better than chance. These relationships were then validated with 20% of the data held back for testing. The results are discussed in terms of their implications for information tailoring and recommender systems for prostate cancer patients searching for information online. Limitations of the current research and recommendations for future research are also presented.

Today, the application of information and communication technologies to healthcare is on the agenda of many countries. The main aim is to make Electronic Healthcare Records (EHR) of a patient accessible anywhere at any time to all authorized users. This is even valid in the cross-border case / the European Commission has published eHealth interoperability recommendations to the EU Member States, in which the RIDE Project contributed, for the purpose of an interoperable European Health Network. Interoperable cross-border clinical data exchange is an ambitious goal with some challenges, the most obvious one being the variety of standards. This issue gets more complicated with the locally developed standards and coding systems. Each country has its own set of standards and it is not reasonable to make all possible combinations of mappings among them during multi-party EHR exchange. Instead, what needs to be done is keeping the legacy infrastructures of the participants and agreeing on a set of common EHR standards and coding systems. Then, each country shall develop &quot / Adapters&quot / transforming local EHR instances to the commonly agreed formats which will most probably be based on widely accepted standards such as HL7 CDA. This approach enables the structure level interoperability. As the second step, in order to achieve semantic interoperability, coded terms from locally defined coding systems shall be translated to international counterparts. In this thesis, our methodology is confirmed on Turkey&#039 / s National Health Information System. &quot / Transmission Schemas&quot / are automatically transformed to HL7 v3 CDA R2 and CEN EN 13606 standard formats. The local coded terms are translated by developing a mapping platform based on Unified Medical Language System (UMLS).