Abstract The possibilities of teleradiology to modify the radiological service process in a regional, international and mobile setting were investigated by building new types of technical connections and then by evaluating their feasibility. First a teleradiology link based on low-end technology was built for primary care and hospital settings. On evaluation, the total diagnostic agreement between the transmitted images and the original films was 98%. Then, a work practice-oriented approach was used to gain an understanding of the relationship between the emerging teleradiology work practice and the newly implemented technology. Ethnographically informed fieldwork and cooperative workshops were utilized. According to findings, articulation work that supports the key tasks is mostly conducted at the receiving site, and radiologists have to rely on much less information in image interpretation. The decisions made at the sending site influence the outcome. To study the idea of consultations between different countries, a connection utilizing the Internet was built between university hospitals in Oulu, Reykjavik and Tromsø. After 131 images, a suitable image compression ratio was selected. Image quality and transfer time of the 80 clinical case readings were found to be adequate for teleradiology. A wireless image consultation system for radiological sub-specialist consultations based on a portable computer and a mobile phone with secure access to the hospital network was set up and tested. The transmitted images of 68 patients were acceptable for final diagnosis in 72% of the cases. The wireless link saved the senior radiologist a hospital visit in 24% of the cases. A smartphone was then used to communicate computed tomography scans in a feasibility study of 21 patient cases of brain attacks. All transmitted image series were suitable for giving a preliminary consultation to the clinic, and in one case even a final report could be made. In a real life clinical setting of the study with neuroradiological and neurosurgical emergencies, two different smartphone platforms with electronic patient record integration were built in European research projects and evaluated with sets of 115 and 150 patient cases. They were good for final diagnosis in 38% and 40% of the cases, respectively. The concept was found to be ready for clinical use. Finally a survey was made showing the status and trends of the usage of eHealth applications in Finland. The results from all the public health care providers and a representative sample of private providers showed that in 2005, teleradiology services were used by 18/21 hospital districts and the usage of all eHealth applications has progressed throughout the entire health care delivery system. Teleradiology services have become an integrated part of eHealth.

This diploma work analytically examines data resources and conditions for the implementation of an electronic identifier for an insured person in the Czech Republic with relation to the Europian Union. It describes the concept of a single electronic identification method and the possibilities for the utilization of different technologies and extreme situations that may arise in connection with the deficiencies of the judicial code, that would clearly work manipulation with the personal data, its security and access to it. Here compared in this work are the merits and disadvantages of the implementation or adversely the non-implementation of the electronic identifier via a cost-benetfit analysis that gives an answer to the economic question about the implementation of the project, and also describes the benefits for each group of beneficiaries.

The purpose of this dissertation is to explore the contemporary area of information technologies employed in health care (eHealth). Focusing on the systems already employed in the Czech Republic, it aims to analyse them, to quantify expenditures of their introduction and maximum benefits derived from these, as well as to evaluate their real current profit. Out of the three existing national systems, this dissertation concentrates on the two only (eRecept, ePACS), as it became impossible to evaluate the third -- IZIP system due to scarcity of the relevant information available. In the field of expenditures not only generally published numbers are taken into consideration, but this dissertation also evaluates the expenditures of other subjects involved (IT systems producers, health care providers, etc.). As the first dissertation in the Czech Republic it quantifies benefits derived from the existing eHealth systems and unlike foreign theses it greatly emphasizes just the expenditures of other subjects involved. Included in this dissertation is also the evaluation of achievements of the eHealth systems in the Czech Republic complete with supposed grounds for this situation. This dissertation also recommends courses of action for contractors of these systems to ensure future basis for more economical and successful eHealth systems. These recommendations are mainly based on analysis of development of the existing national eHealth systems. For the complex evaluation of the costs, maximum of possible and real benefit of the individual eHealth systems the research approach adopted in this dissertation includes descriptive method and SWOT analysis, extrapolation and abstraction, comparative and factor analysis.

The dissertation on Project of Electronic Nursing Documentation in the eHealth (worldwide concept of electronic healthcare) Context analyses use of information technology in healthcare focusing on electronic healthcare documentation and also analyses means of information technology implementation using project management. The dissertation goal is to create a plan of the Project of Electronic Nursing Documentation at University Hospital Plzeň using standardized methods of the IPMA Project Management focusing on risk analysis and management and use of acquired knowledge in the eHealth context. Software development and implementation of the new clinical information system module utilizes agile methods of software development. The dissertation states the definition of project and project management within its standardized methods, presents means of healthcare documentation in compliance with current legislation and terms of healthcare documentation use in its electronic form, describes the hospital information systems, data security policy and mentions the National Healthcare Information System.

This thesis describes the work of creating an automatic system for identifying synonyms and semantically related words in medical texts. Before this work, as a part of the project E-care@home, medical texts have been classified as either lay or specialized by both a lay annotator and an expert annotator. The lay annotator, in this case, is a person without any medical knowledge, whereas the expert annotator has professional knowledge in medicine. Using these texts made it possible to create co-occurrences matrices from which the related words could be identified. Fifteen medical terms were chosen as system input. The Dice similarity of these words in a context window of ten words around them was calculated. As output, five candidate related terms for each medical term was returned. Only unigrams were considered. The candidate related terms were evaluated using a questionnaire, where 223 healthcare professionals rated the similarity using a scale from one to five. A Fleiss kappa test showed that the agreement among these raters was 0.28, which is a fair agreement. The evaluation further showed that there was a significant correlation between the human ratings and the relatedness score (Dice similarity). That is, words with higher Dice similarity tended to get a higher human rating. However, the Dice similarity interval in which the words got the highest average human rating was 0.35-0.39. This result means that there is much room for improving the system. Further developments of the system should remove the unigram limitation and expand the corpus the provide a more accurate and reliable result.

The Live Well Springfield (LWS) movement is a collaborative effort of partner organizations in Springfield, Massachusetts. The project promotes healthy living by increasing knowledge and awareness of food and physical activity. A key LWS strategy was the creation of a website to function as an information hub. In addition to local event and health information, the website features 16 narratives depicting residents practicing healthy lifestyle choices, designed to encourage community engagement. To date, there has been no evaluation of the website’s reach and effect. A mixed methods approach, surveys and focus group discussions, was designed to collect data from people who live, work, or attend school in Springfield. Focus group participants were recruited in person at Springfield Community College, via recruitment posters (distributed at STCC), and through email requests from a previously compiled list of residents willing to be contacted. A website evaluation survey was developed using eHealth research constructs and the Expectation-Confirmation Model (ECM). This survey measured users’ perceived quality and satisfaction with the website. The survey was accessible via the livewellspringfield.org homepage, the LWS Facebook page, and emailed directly to potential respondents. The validated eHealth Literacy Scale (eHEALS) was incorporated into the survey and focus group sessions to assess self-reported skills for using eHealth resources. Each hour-long focus group (n=5 and n=6, respectively) was video/audio recorded and fully transcribed. Focus group transcripts were analyzed to thematically organize responses to narratives and fact-based health messages and assess the appeal, relevance, effectiveness, perceived purpose, and appropriateness. Survey data was analyzed to produce frequencies, descriptive statistics, and correlations. A mean eHEALS score of 4.22 of 5.00 (SD=0.83) was calculated from 36 responses, suggesting this sample felt very knowledgeable and confident using eHealth resources. Health Literacy Advisor (HLA) software was used to analyze an aggregate of all narratives, resulting in a Fry-based reading grade level of 8.4. On a five-point Likert scale, mean satisfaction with the website was 4.71 (SD=0.53), and mean likelihood to return was 4.76 (SD=0.51). Content analysis of focus group transcripts resulted in 184 responses coded for one or more themes. The largest proportion of responses (40.2%) related to effectiveness. One third of these effectiveness-related responses were negative toward the fact-based examples. Although the narratives were greatly preferred in both groups, all respondents made comments or agreed with suggestions to have both affective narratives and strictly fact-based health messages accessible, regardless of initial preferences. Results and interpretations will be reported to LWS partners to inform potential revisions of the website revisions and contribute to ongoing activities of the LWS initiative.

Noncommunicable disease are the leading cause of death and disability in the majority of theworld, and particularly for Sweden. Modifiable lifestyle behaviors such as smoking, alcohol consumption, unhealthy diets and lack of physical activity are main contributors and risk factors to acquiring these diseases. Despite the evidence linking these risk factors to the diseases, thehealthcare sector has often fallen short in implementing preventive strategies due to severalbarriers and factors within this setting. ICT in the health sector, known as eHealth, cancontribute greatly to relieve the burden in the health systems in implementing new prevention strategies, however eHealth has its own set of barriers hindering implementation that delayadoption of such interventions. In the context of Sweden, emphasis has been made to incorporate increase eHealth initiative to reach their Vision 2025. To investigate how implementing eHealth strategies have been experienced in Sweden, this research has conducted a case study on a specific intervention implemented in the Southern Region of Skåne that incorporated an eHealth tool to aid in the intervention called “health discussions with 40-yearolds” aimed to address the NCD burden. A qualitative case study methodology was taken to investigate how was implementing a new eHealth tool within a prevention and screening of NCDs intervention in the healthcare setting experienced by the project implementation team during its pilot phase. Key challenges and factors for implementing the eHealth tool were extracted from the four interviews and reportcollected on the case to increase understanding of how the implementation was experienced by the program implementors. By focusing on the organizational level of the implementation only, the results from this study aimed to provide insights to key aspects in implementing new eHealth tools within interventions in the healthcare settings with similar organizational structures. Results from the qualitative thematic analysis led to a series of categories subcategories and themes to describe the experiences from the interviewees. The theme to describe the overall experiences was labeled positive but demanding, while the theme for challenges was labeled dintricacies of the health system structure, and the theme for factors was eHealth contingent on the human-social interaction. Core components were summarized for future eHealth implementation implications in this setting and/or similar settings. Challenges faced in this case reflect similar challenges in implementing eHealth in Sweden due to the complex fragmented health system structure. Business modeling and agile project management approaches may aid future health organizational settings eHealth implementation process. Future research isrequired to provide clear frameworks that can be applied in more local fragmented healthsystems

Under senare tid, säkerligen tack vare eller på grund av pågående Corona-pandemi har digitalisering inom sjukvården fått en extra skjuts, blivit mer legitim och utvecklats enormt. När patienten involveras mer i sin vård genom tillgång till digital journal, möjlighet till tidsbokning via nätet och kommunikation med sjukvårdspersonal via digitala chattfunktioner förbättras tillgängligheten. I yrkesrollen som sjuksköterska är det viktigt att man känner trygghet som yrkesutövare för att kunna bemöta patienten på ett professionellt sätt. En litteraturöversikt med syftet att sammanställa tidigare forskning kring sjuksköterskors upplevelser av att använda digitala verktyg i patientarbetet har genomförts. Tio vetenskapliga kvalitativa artiklar analyserades vilket resulterade i tre huvudkategorier och sex subkategorier. De tre huvudkategorierna är; Förtroende på avstånd, Stå på gemensam grund och Utveckla den professionella rollen. Sjuksköterskor upplever brist på utbildning och tid till att använda systemen optimalt. Det är flera system som används parallellt och som ska loggas in i vilka inte alltid är synkroniserade med varandra och inte alltid användarvänliga. De olika systemen skapar stress i arbetet som skulle kunna förhindras om sjuksköterskor gavs möjlighet att vara mer delaktiga i att utveckla och utforma vårdsystem utifrån sjuksköterskans behov. Resultatet i studien visar att användning av digitala verktyg inom sjukvården går framåt och att sjuksköterskor är positiva till att delta i den fortsatta digitala utvecklingen inom hälso- och sjukvården för att skapa en god och säker vårdmiljö.

Background: Tobacco use is one of the key problems that public health has to face. Tobacco smoking is among the main causes of morbidity and preventable mortality that can be effectively avoided. The eHealth approach uses information and communication technologies to improve the quality of health and healthcare. EHealth interventions delivered through technologies and the Internet are an effective therapeutic tool which contributes to behaviour change, including smoking cessation. This paper presents the results of continuous research on fully automated online eHealth intervention for smoking cessation. Aims: The main objective of this study was to identify the effect of the form of reminders (SMS vs. email) in eHealth smoking cessation intervention using the Endre eHealth program in the population of Czech tobacco smokers. Materials and methods: This research consists of two studies. First, a pilot study on user- acceptance of eHealth intervention was performed in a sample involving 30 respondents. This was followed by a randomized two-arm controlled study comparing the effect of a predictor in the form of eHealth intervention reminders for smoking cessation. Adult tobacco smokers were recruited based on advertising through a variety of online channels. 158 respondents were randomised for the...

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.