<p>eHealth has been adopted by many countries across the globe in response to cut down cost and improve the quality of life. Sweden has been engaged in providing web-based health care services for its citizens for the past decade and county councils have the responsibility to develop them. The main aim of this thesis is to present answers to the following research questions:What strategies (formal and informal) guide the development of web-based health care services provided by the Swedish county councils?What barriers exist in relation to the development and usage of web-based health care services provided by the county councils from the viewpoint of their IT leaders?From the perspective of IT leaders in the county councils and in their capacity to develop, manage and monitor their organizations‘ website content, which web-based health care services are mostly accessed by users and what age group utilize the services most?The thesis is an exploratory research conducted through a survey based on a mail questionnaire that was posted to all 21 county councils in Sweden with 18 councils responding. The results show that all county councils have formally adopted the National eHealth Strategy to guide the development of web-based health care services and some have other informal strategies as well. Technological barriers, resistance to use the web-based services and changing business process to integrate ICTs have been identified by IT leaders as major challenges that impede the development of web-based health care services in Swedish county councils. Swedish citizens more frequently access prescription renewal and booking and cancellation of appointments than other available web-based health care services which depicts a trend towards the use of advanced interactive services than basic information seeking, and people in the ages of 46 to 55 have been identified as the frequent users of web-based health care services according to IT leaders from the county councils.</p>

Title: Hälsa i sociala medier - En kvalitativ studie om hur hälsoinformatörer upplever och påverkas  av hälsobudskap i sociala medier. Title: Health in social media - A qualitative study of how health communicators perceive and are affected by health messages in social media. Author: Anna Hedström Institute: Karlstad University. Faculty of health, nature and engineering sciences. Tutor: Owe Stråhlman Date: 150615 Number of pages: 34 Keywords: eHealth literacy, health communication, health informers, health literacy, health messages, media literacy, social media   Background: With an increased interest in diet and exercise, also health and fitness messages have increased in both traditional and social media. The general guidelines on physical activity and diet are forgotten as training tips increase in the media. Research shows that it is common for individuals to retrieve information from the media when it comes to their own health. In doing so media literacy, health literacy and eHealth literacy becomes increasingly important for health communicators and for those who receive health information.   Objectives: The aim of this study was to examine health communicators’ experiences of health messages in social media, and how they are affected by them.   Method: Qualitative interviews were chosen as a method to collect data. Six individuals participated in the study, four of them were females and two were men. The criterion for participation was to somehow work to inform about health. To analyze the data collected, qualitative contained analysis were used.   Results: The analysis revealed four categories; the health informer experiences of social media content, social media's impact on customers, social media's impact on the health informer work and the health informers use of social media in their work. The results show that health informers experience a certain lack of knowledge among health messages in social media and that many of them are too extreme. These health informers experience that their customers are more well-informed now than a few years ago, due to the use of Facebook, Instagram and blogs. Using social media to search information about diet and exercise is good because it is easily accessible and it is fast, but if one does not have the knowledge of what should be weeded out, these advantages can easily become disadvantages. Respondents feel that it has become a larger equality on diet and exercise that they believe may be due to health messages disseminated on social media. Health communicators can work with to get their customers to be more critical of what they read.   Conclusion: The conclusion of the result is that the health communicators indirectly affected by health messages on social media by their clients that often come with questions about things they read or want help to look like some bloggers they follow. Health communicators work is affected in the way that they need to take advantage of social media to help its customers as well as possible and they must also talk to their customers about the source criticism and that they should focus on what feels good for the customer .

Problemställning: eHälsa är nutiden och framförallt framtiden inom hälso- och sjukvård och anses kunna stärka delaktighet och medbestämmande för patienten. Den nya tidens patienter kräver ökad insyn, delaktighet och självbestämmande.                                   Syfte: Syftet med studien var att belysa eHälsa med fokus på patient empowerment.                                                                                                                                                                                                                               Metod: Litteraturstudie med 14 vetenskapliga artiklar som utifrån en induktiv ansats har granskats, analyserats och jämförts.                                                                                                                                                                    Resultat och konklusion: Resultatet visar att eHälsa ökar tillgängligheten för hälsoinformation samt hälso- och sjukvård i hemmet. eHälsa kan och bör användas som ett komplement i vården för att stärka patient empowerment, detta under förutsättning att patienten har förmåga att hantera och förstå informations- och kommunikationsverktygen, samt att ett samarbete finns med hälso- och sjukvården.                                                                                                                Implikation: Vidare forskning som berör hur sjuksköterskan kan implementera eHälsa i omvårdnadsarbetet behövs. eHälsa som begrepp bör även belysas tillsammans med övriga riktlinjer som berör informations- och kommunikationsteknologi i Kompetensbeskrivning för legitimerad sjuksköterska. Patientutbildning i eHälsa och dess tjänster bör ingå i den praktiska vårdverksamheten för att optimera egenvård och därmed bidra till att patienten erhåller empowerment. Det är även av stor vikt att sjuksköterskestuderande redan under utbildning får kunskap om eHälsa och eHälsotjänster. / Problem: eHealth is the present and, in particular, the futures of health care. It is considered to be able to strengthen the involvement and participation of the patient. The modern patient demand increased transparency, participation and autonomy.                                                                                                                                                                                                                                                                                                                                                       Aim: The aim of this study was to highlight eHealth, focusing on patient empowerment.                                                                                                                                                                                                                                                                                                                                               Method: A literature study with 14 scientific articles, that have been reviewed, analyzed and compared with an inductive approach.                                                                                                                                                              Results and conclusions: The results show that eHealth increases the availability of health information and health care at home. eHealth can and should be used as a supplement in health care to enhance patient empowerment, provided that the patient has the ability to manage and understand information and communication tools, and that collaboration exists with the health care provider.                                                                                                                                 Implication: Further research on how nurses can implement eHealth within the nursing practice is needed. eHealth as a concept should also be highlighted along with other guidelines related to information and communication technology in the Description of Competence for Registered Nurses. Patient education in eHealth and its services should be included in the health care practice to optimize self care for patients, so that they thereby could receive empowerment. It is also of great importance that the student nurse, already during education, gains knowledge of eHealth and eHealth services.

Many countries have formulated their eHealth visions and billions of dollars have been spent on supporting the eHealth development throughout the world. An important part of the development is the electronic patient record (EPR). To enable sharing and increase cooperation between care providers, most Swedish county councils have decided to use a region-wide EPR. The health professionals often experience numerous problems and consider the region-wide EPR to be too generic and require them to tailor their practices instead of the system evolving towards supporting their needs. The aim of the PhD research is to gain knowledge of adoption when deploying and using region-wide health IT systems. This is accomplished by studying, analysing and reflecting upon what region-wide health IT systems are and how professionals use them in their practice. In the research a grounded theory method has been used, which means that the empirical data, not theories and hypotheses, have driven the research process. The data-gathering methods have been interviews, observations, participating in meetings, questionnaires, seminars and conducting literature reviews. In order to be able to improve the adoption, a set of four key principles has been identified: (1) Evolving systems-Engaged users, (2) Treat IT deployment and usage as part of organisational development, (3) Identify, respect and support differences, and (4) Identify what must be customised and what can be centralised. These four principles challenge the traditional way of developing enterprise-wide IT and emphasise the importance that users must engage in the development, procurement and deployment process to identify their similar and unique needs and procedures. It is crucial that both the similarities and uniqueness are respected and supported. The similarities can be supported by a centralised, standardised solution, while uniqueness requires a customised solution. In order to accomplish that, the IT deployment and usage needs to be treated as an important part of the on-going organisational development, and the IT systems must evolve, i.e., be continuously developed in order to engage the users to participate.

Im Gesundheitswesen müssen ganz unterschiedlich strukturierte Einrichtungen bei der Behandlung von Patienten zusammenarbeiten. Die Arbeit stellt Lösungen vor, die eine solche Zusammenarbeit mit Hilfe verteilter Anwendungen auf Basis von Webservices und Peer-to-Peer Technologie unterstützen. Dabei werden vorhandene Strukturen und Beziehungen zwischen diesen Einrichtungen benutzt, um gute Ergebnisse bei der Suche nach Daten und der Steuerung von Abläufen zu erzielen.

abstract: Sexual assault at colleges and universities in the United States is a significant health and human rights issue that impacts somewhere between one-in-four and one-in-five students. Despite the alarmingly high burden, overall rates of disclosing to crisis, health, and victim services, and reporting to schools and law enforcement remain low. In order to buffer students from associated short- and long-term harm, and help them reestablish safety and pursue justice, empirically-supported, innovative, and trauma-informed secondary prevention strategies are needed. To address this pressing issue, the current study used a trauma-informed, feminist community research approach to develop and design a prototype of an internet-based decision aid specifically tailored to assist students at Arizona State University who experience sexual assault with making informed choices about reporting and seeking care, advocacy, and support on and off campus. Results from preliminary alpha testing of the tool showed that: 1. It is feasible to adapt decision aids for use with the target population, and 2. While aspects of the tool can be improved during the next phases of redrafting and redesign, members of the target population find it to be acceptable, comprehensible, and usable. / Dissertation/Thesis / Doctoral Dissertation Global Health 2018

Context: Now a days Information technology has become a part of health-care delivery this makes life much easier for patients and health-care professionals. The increase in demand for communication among the different health information systems and health professionals has made interoperability complex and whereas interoperability is mainly focused at semantic and technical levels of communication. Yet, the social interoperability, an important part of communication between computerized systems and health professionals, is overlooked. Obje ctive s: In this study we explore the differences between interoperability and social interoperability. Furthermore investigate the social interoperability in practice and the problems that affect the health-care. Methods: We start with the literature survey to learn the definitions of interoperability and social interoperability. Later, case study approach is carried out to investigate the social interoperability in Interoperability. Interviews were also conducted as part of the observations in cases. Re sults: The similarities and differences in definitions of interoperability and social interoperability are sorted out from the literature study. Five cases have been investigated to identify the social interoperability in practice. Analyses of these cases have identified some of the major problems for health information systems that do not meet social interoperability. Conclusions: Interoperability definitions agree that interoperability is undoubtedly important for health data communication, but their goals in achieving interoperability is concerned only about computerized systems and very less focused on social interoperability. The case studies are used to find out the social communication using in health information systems. We realize that the communication between the users and the information systems are quite complex. The developed systems are witnessing the usability difficulties to the health-care providers that affect the patient care. / Healthcare is delivered by diagnosing diseases, prescribing medicines, prevention of illness. Doctors, nurses and medical organizations deliver the service to the patients. Most of the communication between patients, caregivers and computers are observed in the care setting. eHealth is the healthcare and delivery process that are supported by electronic and communication technology. Some of the eHealth applications used today are patient information system, ePrescription, lab systems, electronic health records etc. One or more times every eHealth tool (here tool represents a software application) will communicate with other eHealth tools for information exchange. The communication of these tools gave birth to interoperability that should actually make the information exchange easier. eHealth interoperability is the ability of one or more computers and software applications communicate with each other for health information exchange and make use of the information. More communication among the tools makes the communication complex and interoperability challenging. Furthermore, interoperability among the heath information systems is observed majorly at three levels and they are semantic, social, and technical. Semantic is about how two or more tools share information and make use of that information. Technical interoperability is about the technologies and networks used to communicate among those applications. Social interoperability is concerned about the environment and the human processes involved in the information exchange. In our study we explore through various definitions of interoperability and social interoperability in a focus to find the differences and similarities among those definitions. Furthermore we have observation of some cases from various primary care centers in order to find out how social interoperability is in practice. We apply our findings to figure out the social problems involved in the care environment. Though, technical and semantic interoperability is mostly concerned by the researchers, but here we find, social interoperability (along with the technical and semantic), is also playing important role in healthcare. The audience of this study can be healthcare professionals, like doctors, nurses and information technology people, Research workers, Academia and all the people who are interested in eHealth. / Rambabu Garlapati +91-9032248045 Rajib Biswas +88-01717144431

In the light of challenges the lack of interoperability in systems and services has long been recognized as one of the major challenge to the wider implementation of the eHealth applications. The opportunities and positive benefits of achieving interoperability are eventually considerable, whereas various barriers and challenges act as impediments. The purpose of this study was to investigate the interoperability among different health care organizations. The knowledge of this study would be supportive to health care organizations to understand the interoperability problems in health care organizations. In the first phase of literature review interoperability challenges in Sweden and other EU countries were identified. On the basis of findings interviews were conducted to know the strategies and planning about interoperability in health care organizations. After analysis of interviews, questionnaires were conducted to know the opinions of different medical IT administrator and health professionals. The authors find after the analysis of interviews and questionnaire that adopting eHealth standard, same system, insuring the security of patient’s health record information and same medical language could be implemented in Sweden and other EU countries health organizations. / Muhammad Azam-0046 760806528,Izhar Hussain-0046 700183425

Background: The eHealth era has fully arrived and initiatives to increase and improve utilization of ICT in health care organizations are made in Sweden as in many other countries. However, much focus in research take place after implementation, evaluating the effects of these initiatives, and very little focus is regarding why development projects actually result in certain functionality. Also, few are problematizing the concept of what eHealth services are and what their contribution shall be on the health care environment. Aim and Objective: The main aim of this research was to explore and understand different perspectives and assumptions regarding aims in an eHealth service development. Further, the aim was to create an understanding for how these trough social interaction and activity in an actual development project will construct actual functionality. Method: A qualitative research method was chosen and conducted from a social constructivist point of view. A case, consisting of an eHealth service development project in Jonkoping County Council, where used for data collection through observations and interviews with the participants in the project team. To support formulation of research questions and thematization, a research metaphor was developed. Results: The result of this thesis contains several theoretical and empirical based perspectives and assumptions on eHealth services. eHealth services are expected to support efficiency, information security, extensive usage, pushing bigger changes in the health care environment, be a new and exciting way of working, changing the roles of patients and caregivers and creating empowered and motivated patients. Other result show that, even if all participants felt pleased with the project result, it was hard to relate all choices in functionality to their effect on use quality and expected outcome from using them. Implications are made for how soft system aspects should be included in the project process in development of eHealth services for defining and managing use quality and its relation to system quality.

eHealth has been adopted by many countries across the globe in response to cut down cost and improve the quality of life. Sweden has been engaged in providing web-based health care services for its citizens for the past decade and county councils have the responsibility to develop them. The main aim of this thesis is to present answers to the following research questions:What strategies (formal and informal) guide the development of web-based health care services provided by the Swedish county councils?What barriers exist in relation to the development and usage of web-based health care services provided by the county councils from the viewpoint of their IT leaders?From the perspective of IT leaders in the county councils and in their capacity to develop, manage and monitor their organizations‘ website content, which web-based health care services are mostly accessed by users and what age group utilize the services most?The thesis is an exploratory research conducted through a survey based on a mail questionnaire that was posted to all 21 county councils in Sweden with 18 councils responding. The results show that all county councils have formally adopted the National eHealth Strategy to guide the development of web-based health care services and some have other informal strategies as well. Technological barriers, resistance to use the web-based services and changing business process to integrate ICTs have been identified by IT leaders as major challenges that impede the development of web-based health care services in Swedish county councils. Swedish citizens more frequently access prescription renewal and booking and cancellation of appointments than other available web-based health care services which depicts a trend towards the use of advanced interactive services than basic information seeking, and people in the ages of 46 to 55 have been identified as the frequent users of web-based health care services according to IT leaders from the county councils.