Increasing lifestyle-related ill health, escalating health care costs, expanding health inequalities within and between nations, and an aging population are challenges facing governments globally. Governments, especially in industrialized countries like Sweden, are investing in health promotion and health communication, especially in ICT-supported health communication as a way to increase health literacy and empowerment at individual and population levels. Studies show that many eHealth communication efforts are narrow in scope, medical oriented and therefore not enough to address the complexity of lifestyle-related ill health and equity issues. This thesis proposes integrating health promotion values and principles in the design process of eHealth systems for health promotion in order to develop usable, sustainable, engaging, eHealth resources that are adaptable to their context of use and user’s skills. The overall aim of this thesis was study the participatory development process of an interactive ICT-supported health communication channel for health promotion and enhancing health literacy in PHC context. Participatory Action Research (PAR) with a multi-phase and multi-method approach was used in this thesis. A model entitled Spiral Technology Action Research’ (STAR) was used to guide the development of the health channel. This design process was framed in three developmental and evaluation phases corresponding to formative, process and outcome evaluation. A total of 146 participants consisting of professionals from primary health care services, information technology and academia, and local citizens participated in the project’s different phases. A triangulation of methods was used to collect the data; survey, document analysis, participatory observations with field notes, individual interviews, focus groups, think aloud protocols and log statistics. Qualitative and quantitative content analyses were used to analyse data. The results revealed that integrating health promotion values and principles in the design process proved to be valuable not only to the content of the channel, but also in PHC practice. The different design phases yielded valuable results that built into each other and contributed to an eHealth channel that was perceived as relevant to the local people’s need for health communication; accessible and user friendly. The results also indicated that an Internet based interactive health channel, could be a valuable resource for enhancing health literacy if users are involved in the design.

There are high expectations regarding mobile technology and how it can be used to promote improvements in the quality and efficiency in healthcare. There appears to be a gap between the goals and strategy on the macro level and the micro level experiences of the usage of mobile devices among healthcare professionals.   The purpose of this study is to examine the perceptions, experiences and expectations of nursing care providers at two wards with regards to the recently implemented mobile platform COSMIC Nova Ward and other related IT artefacts. Special emphasis has been on COSMIC Nova Ward Tablet, a part of COSMIC Nova Ward, facilitated in iPad MINIs. It is designed to act as a tool to facilitate the provision of care and has been introduced at both the wards during a pilot project. Even though the two wards are similar in both practice and structure, the pilot project resulted in failure at one of the wards and a relative success at the other.   A comparative case study of the perceptions, experiences and expectations of the nursing personnel at the two wards was conducted in order to highlight the differences in the outcomes of the pilot project. By reflexively comparing these with theory, it was concluded that there are several factors other than adequacy of the IT system that determine the outcome of the implementation of a mobile platform in a clinical setting.   These findings were then compared with existing legislation and policies, in order to identify potential discrepancies between the nursing personnel’s usage of IT with the regional and national goals and strategy. It was then determined that there needs to be a clear connection between the usage of IT and the goals and strategy within healthcare.

The area of eHealth has been increased in the recent age but also facing a lot of challenges. In relation to these, there exists a lack of interoperability among different healthcare organizations in the way of providing care services to the healthcare professionals and the patients. Interoperability among the healthcare organizations is appreciated not only by the academia but also by the policy-makers and other related personnel. Today, implementation of interoperability has become an intricate job than expectations. Interoperability is resisted by different barriers but potentially can give several benefits to all stakeholders and ultimately should be focused. The study is conducted for investigation of challenges and benefits of interoperability among healthcare organizations in the Blekinge County. In the first phase, after having a comprehensive review of literature, the challenges and benefits for the implementation of interoperability among Swedish healthcare organizations are identified. Depending on the findings, interviews were conducted with the eHealth professionals of the Blekinge County to clearly understand about the strategies and plans regarding the interoperability among the healthcare organizations in the Blekinge County. After performing a thorough analysis, questionnaire were conducted with the Medical IT administrators and with other related personnel to know about their opinions about the problem. The authors find after analyzing the results of the study that focus on resolving issues like standards adaptation, accessibility, integration, privacy and proper ICT infrastructure could provide interoperable environment among municipality healthcare centers and hospitals in the Blekinge County and other areas in the Sweden.

In the presence of challenges arise from ageing populations, increasing incidence of chronic diseases, high health care cost, rapid changes in technological equipment and medical knowledge, eHealth offers tremendous abilities to develop and deliver health care services to the end user that is both seamless and integrated according to the needs and requirements of individuals. Even though the prospective of eHealth is accepted in academia as well as among policy-makers, health care planners and health care practitioners, the implementation of its applications has appeared to be difficult then expectations. In order for successful implementation of eHealth, it is necessary to offer eHealth services according to the citizens and patients expectations. The purpose of this study was to investigate citizens‘ accessing the eHealth services in the county of Blekinge by identifying the accessible, currently accessed, projected and imagined eHealth services. The knowledge from this study would be supportive to the regional health authorities to understand the citizens‘ needs and requirements for a successful delivery of eHealth services in county of Blekinge. In the first phase through extensive review of the literature the eHealth services which are more in health care practices within European countries were identified. On the basis of findings of first phase interviews were conducted to know strategies plans regarding eHealth services. After analysis of interviews, questionnaire was conducted to know the citizens opinions about eHealth services. The authors find that, after understanding the success criteria of effectively running eHealth services within European countries, many eHealth services could be implemented successfully in the county of Blekinge. The rules of interoperability among Hospitals, GP‘s, Primary Cares and Dental Services would provide substantial benefits to citizens and they can access the eHealth services whenever and wherever they want. Moreover in future citizens would have eHealth services according to their expectation. / Farrukh Sahar - 0046 707267187, Muhammad Asim - 0046 737355716

The project of the mobile application Nestresuju aims to create a digital tool in czech language, which effectiveness in the development of stress management skills will be tested and at the same time will be user-friendly and an appealing platform. Specifically, the mobile application Nestresuju target into the help with development of stress management skills through digital transformation of the psychological theory of coping strategies of R. Lazarus and S. Folkman. So far, the project has included several phases, including 1.5-year theoretical research, preparation, and programming phases, which was followed by a pilot survey involving 20 students from Prague universities. The results of quantitative, and especially qualitative data from the final interviews and user data showed that Nestresuju is perceived as useful and shows a trend of possible reduction of perceived stress. All sections of the application were mentioned as useful without significant differentiations. Overall, the tool was rated as professional and trustworthy, even though it is a student project. The results of the pilot survey serve as recommendations for updates in Nestresuju. Followed by main study conducted on a broader sample to verify the effectiveness of the digital tool. The importance of the eHealth application...

Das eHealth Service Engineering für seltene Erkrankungen erörtert die systematische Entwicklung von wissensbasierten medizinischen Dienstleistungen (eHealth-Services). Im Fokus der Forschungsarbeit steht das komplexe Problem der Informationsversorgung von Patienten mit degenerativen Nervenerkrankungen (hier: Amyotrophe Lateralsklerose, kurz: ALS). Der unvorhersehbare Krankheitsverlauf, der mit schwerwiegenden Symptomen einhergeht, stellt hohe Anforderungen an die behandelnden Ärzte und beteiligten Akteure, um den betroffenen Patienten eine umfassende Beratung anzubieten. Die Herausforderung ist es, das persönliche Beratungsgespräch IT-basiert zu unterstützen und Patienten eine bedarfsgerechte Informationsbasis für die partizipative Entscheidungsfindung zu bieten. Der exemplarische Anwendungsfall wird anhand umfangreicher Quellenanalysen multidimensional konzeptualisiert. Die extrahierten Konzepte und Relationen werden strukturiert und zu einem semiformalen Gesamtgraphen aggregiert. Dieser Wissensgraph verdeutlicht die fünf systemischen Entwicklungsbereiche Informationen über Patienten (1), Informationen für Patienten (2), Dokumentation bisher getroffener Entscheidungen (3) und dementsprechende Offerten von medizinischen Produkten und Dienstleistungen (4) sowie Management und Koordination der Versorgung (5). Für die Teilbereiche (1-4), welche die Informationsversorgung betreffen, wird eine formale Repräsentation in Form einer RDF-basierten Ontologie (Dispedia) entwickelt und als Linked Data veröffentlicht. Die Nutzung der Dispedia Ontologie wird durch die prototypische Implementierung einer eHealth Anwendung demonstriert. Das Ergebnis ist eine bedarfsgerechte Informationsversorgung für Patienten mit seltenen Erkrankungen.

Digitaliseringen har drivit utvecklingen av nya kraftfulla informationssystem med potential att effektivisera sjukvården. Internet har blivit en primär källa för människor att söka hälsorelaterad information och vårdsektorn står inför utmaningen att utveckla digitala system som fokuserar på patienten och dennes välmående. Den här undersökningen har genomförts för att besvara hur eHälsotjänster kan designas för att stödja en personcentrerad vård. Det gjordes med hjälp av en designorienterad ansats och resulterade i fyra designriktlinjer som beskriver hur patienters behov för översikt, kontroll och anpassning av behandlingen bör bemötas. De fyra designriktlinjerna har implementerats i en prototyp som har validerats och utvärderats. Undersökningen har bidragit med ökad kunskap kring hur eHälsotjänster kan designas för personcentrerad vård och har därmed besvarat undersökningens frågeställning. / Digitization has driven the development of new powerful information systems, with the potential to improve the efficiency in the healthcare system. The Internet has become a primary source for seeking healthcare related information and therefore the healthcare sector are facing a challenge with developing digital systems with person-centered focus. This study has aimed to answer the question “How can eHealth solutions be designed to maintain a person centeredness in the healthcare”. The study has used a design-oriented approach that resulted in four design guidelines that address patients needs for an overview, control and adaption of the content in their treatment. The design guidelines describe how eHealth can be designed for person-centered care and the guidelines represent the results that was identified in the study. The four guidelines have been applied in a prototype, and evaluated by different test persons. The study showed that the guidelines will contribute to increased knowledge about how eHealth can be designed for person-centered care and have given an answer for the research question.

Background: Smartphones and related applications are increa singly gaining relevance in the healthcare domain. We previously assessed the demands and preferences of medical students towards an application accompanying them during a course on general practice. The current study aims to elucidate the factors associated with adop tion of such a technology. Therefore we provided students with a prototype of an application specifically related to their studies in general practice.

The implementation of digital innovations in the healthcare sector is faced with different barriers and challenges. The complex system of regulations, the lack of interoperability, and highly dynamic interorganisational networks lead to missing widespread adoption of eHealth solutions. Digital platforms can help to overcome these barriers by providing a holistic infrastructure. They create a modularised foundation that innovators can use to create own innovations and provide them to demanders of digital solutions. As intermediaries, they can be accessed both by healthcare professionals and eHealth solution providers. Providers can offer their eHealth services via the platform. Healthcare professionals can use these services to create own interorganisational information systems. In the field of information systems research, effects and strategies for two-sided platforms are well researched and the potentials of eHealth platforms are also discussed. However, the organisational and technological design and methods for the construction of platforms are fewer questioned. Nonetheless, platform owners can benefit from implementation strategies and architectural guidance to create sustainable platforms and surrounding ecosystems. This doctoral thesis questions how domain-specific platforms can be designed systematically. Conducting a design-science research process, it develops both a modelling system and the Dresden Ecosystem Management Method (DREEM) to support the development of platforms in different domains. Furthermore, it describes the design characteristics of two-sided platforms in the healthcare sector and provides an evaluation approach to analyse the platforms’ ability to create a viable innovation ecosystem in the healthcare sector. The doctoral thesis contributes by providing methodical guidance for platform owners and researchers to design and evaluate digital platforms in different domains and improves the understanding of platform theory in the healthcare sector.:A. Synopsis of the Doctoral Thesis 1. Introduction 2. Foundational Considerations 3. Requirements for Design Artefacts and Knowledge 4. Structure of the Doctoral Thesis 5. Conclusion B. Paper 1 - Governance Guidelines for Digital Healthcare Ecosystems C. Paper 2 - Revise your eHealth Platform! D. Paper 3 - Business Model Open ”E-Health-Platform” E. Paper 4 - Modelling Ecosystems in Information Systems F. Paper 5 - Designing Industrial Symbiosis Platforms G. Paper 6 - Management of Digital Ecosystems with DREEM H. Paper 7 - Guiding the Development of Digital Ecosystems I. Paper 8 - Towards Maintenance Analytics Ecosystems J. Paper 9- Sustainability of E-Health-Projects K. Paper 10 - ISO 11354-2 for the Evaluation of eHealth-Platforms

Durante los últimos meses, el COVID-19 ha generado diversos cambios en el ámbito económico, social y personal de la sociedad. Tanto en el Perú como en todos los países del mundo se enfrentan a un entorno cambiante que los forza a adaptarse a los nuevos hábitos de vida y de consumo. De este modo, los rubros más importantes y básicos de la sociedad se vieron en la obligación de incurrir a nuevas formas de atención al consumidor, sin dejar la buena experiencia de consumo y de calidad de servicio para el usuario. El presente artículo destaca un enfoque en la intención de uso de plataformas eHealth, a partir del modelo UTAUT 2. Del mismo modo, nos basamos en la revisión de la literatura de los constructos incorporados en el modelo UTAUT 2 en un contexto pandémico que permitirá comprender los factores de la adaptación e intención de uso de las herramientas tecnológicas eHealth. / In recent months, COVID-19 has generated various changes in the economic, social and personal sphere of society. Both in Peru and in all the countries of the world they face a changing environment that forces them to adapt to new habits of life and consumption. In this way, the most important and basic areas of society were forced to incur new forms of customer service, without leaving a good consumer experience and quality of service for the user. This article highlights a focus on the intention to use eHealth platforms, based on the UTAUT 2 model. In the same way, we are based on the literature review of the constructs incorporated in the UTAUT 2 model in a pandemic context that will allow us to understand the factors of adaptation and intention to use eHealth technological tools. / Trabajo de investigación