Made available in DSpace on 2014-06-11T19:27:55Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-05-26Bitstream added on 2014-06-13T19:36:16Z : No. of bitstreams: 1 gomes_ma_me_sjc.pdf: 2531347 bytes, checksum: 65e2c66b01250b07fe5964a358f9c5fb (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O objetivo deste trabalho foi desenvolver um sistema informatizado de laudos histopatológicos baseado na plataforma .NET 2.0. Este software construído para o Sistema Operacional Microsoft Windows® utilizou a plataforma Microsoft Framework® 2.0 com a camada de resistência de dados Microsoft SQL Server® 2005. Outros recursos como Microsoft Report View® foram utilizados como ferramenta para geração de relatórios estatísticos, sócio-epidemiológicos e de gerenciamento do serviço de exames anatomopatológicos da Faculdade de Odontologia de São José dos Campos - UNESP. Para a realização deste software foram levantadas, na literatura, pesquisas nas áreas de Engenharia de Software, Patologia Bucal, Tecnologia da Informação e Comunicação em Saúde, Gestão em Serviços de Saúde, Sistema de Informação em Saúde, Diagnóstico Oral e Técnicas de Programação. O software desenvolvido teve a finalidade de suprir a demanda acadêmica na produção científica e aprimorar o serviço prestado à comunidade, além de constituir-se numa ferramenta pedagógica para os alunos da Pós-graduação em Biopatologia Bucal, Área Patologia. / The objective of this study was to develop a computerized system based on Microsoft NET 2.0, using histopathological examinations.This software built for Microsoft Windows operating system used the Microsoft ® Framework ® 2.0 with a layer of resistance to Microsoft SQL Server ® 2005. Other features like Microsoft Report View ® was used as a tool for generating statistical reports, epidemiological and social-service management of pathological examinations of the Faculty of Dentistry of São José dos Campos - UNESP. For the realization of this software have been raised in the literature research in the areas of Software Engineering, Oral Pathology, Information Technology and Communication in Health, Health Services Management, Information Technology in Health, Oral Diagnosis and Programming Techniques. The developed software was designed to meet the demand in the academic scientific production and improve service to the community, and building up a teaching tool for students of the Postgraduate Dental Biopathology Area Pathology.

Submitted by Viviane Lima da Cunha (viviane@biblioteca.ufpb.br) on 2017-07-06T11:26:20Z No. of bitstreams: 1 arquivototal.pdf: 2621152 bytes, checksum: e02a372dc50ca8879df71843cf79f718 (MD5) / Made available in DSpace on 2017-07-06T11:26:20Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 2621152 bytes, checksum: e02a372dc50ca8879df71843cf79f718 (MD5) Previous issue date: 2017-02-22 / In the last decades, several countries have directed their actions to the incorporation of innovative technologies, applied in the health field, with the purpose of assisting the performance of professionals and users in the promotion of care, strengthened by public policies. In this context, there is a shortage of technological resources, aimed at comprehensive and multidisciplinary care, directed to patients with Multiple Sclerosis, especially of systems that support decision-making, in the follow-up of this clients, in Reference Centers belonging to the Unified Health System (SUS), this study aims to develop an information system (software prototype) to the monitoring of clinical parameters, indicative of impairment of the functionality of individuals with Multiple Sclerosis. This is a methodological study, of the type applied, involving the production of technology, composed by the stage of the software development process followed by the step of applying the decision tree model. The development of the software prototype followed the steps of the generic software engineering process presented by Pressman, which are: Communication, planning, modeling, construction and delivery. Modeling and prototyping took place from January to September 2016, along with the construction of the prototype's working flow diagram and interfaces. The flowchart was built in the Unified Modeling Language (UML) with the aid of the JUDE tool. The system was developed in PHP (Hipertext Processor) language, which is a script open source language, widely used, and is especially suitable for web development. Therefore, was used a Framework PHP (Laravel 5.2 Open Source), the MySQL as a database technology, and for the development of the screens HTML5, CSS3 and JQUERY were used. For the application of the decision tree model, was used the variables of the 50 patients enrolled in the software, in the Waikato Environment Analyis (WEKA) program, in Version 3.8, specifically the J48 algorithm. The results showed that, although the software prototype still has a path to be covered in future studies that will converge in its validation, it has shown a satisfactory performance for the activity of registration of professionals, patients and research instruments. Regarding the generated decision tree model, this contributed to the identification of the epidemiological and clinical variables associated with the worsening of the disability and also allowed the analysis of the differences of these associations in two distinct groups of treatment of Multiple Sclerosis. Considering all phases and tests of the system, the possibility of generating an electronic registry, which provides agility in the information process and contributes to the planning of the actions to the integrated multiprofessional assistance, as well as, the proposal of application of the decision tree model in order to classify the epidemiological variables associated with worsening disability, using the Expanded Disability Status Scale (EDSS) score, it is expected that the development of this study will awaken the need for further research using decision models that gives opportunity to health teams, especially those facing the complexity of assisting individuals with chronic diseases and progressive degeneration of organic functions. / Nas últimas décadas, tem havido uma preocupação dos governos com a incorporação de tecnologias inovadoras, aplicadas no campo da saúde, com o propósito de auxiliar o desempenho de profissionais e usuários na promoção do cuidado, fortalecido por políticas públicas. Nesse contexto, evidencia-se uma escassez de recursos tecnológicos, voltados à assistência integral e multidisciplinar, direcionada a pacientes com Esclerose Múltipla, especialmente de sistemas que deem suporte a tomada de decisão, no acompanhamento dessa clientela, em Centros de Referência pertencentes ao Sistema Único de Saúde. Assim, o presente estudo tem como objetivo de desenvolver um sistema de informação (protótipo de software) para o monitoramento de parâmetros clínicos, indicativos de comprometimento da funcionalidade de indivíduos com Esclerose Múltipla. Trata-se de um estudo metodológico, do tipo aplicado, envolvendo produção de tecnologia, composto pela etapa do processo de desenvolvimento do software seguida da etapa de aplicação do modelo de árvore de decisão. O desenvolvimento do protótipo de software seguiu os passos do processo genérico de engenharia de software apresentado por Pressman. A modelagem e a prototipação ocorreram no período de janeiro a setembro de 2016, juntamente com a construção do fluxograma de funcionamento do protótipo e das interfaces. O fluxograma foi construído na linguagem unificada de modelagem com auxílio da ferramenta JUDE. O sistema foi desenvolvido em linguagem PHP (Hipertext Processor), que é uma linguagem de script open source (código aberto) de uso livre, muito utilizada, e especialmente adequada para o desenvolvimento web. Portanto, utilizou-se uma Framework PHP (Laravel 5.2 Open Source), o MySQL como tecnologia de banco de dados, e para desenvolvimento das telas usou-se o HTML5, CSS3 e JQUERY. Para a aplicação do modelo de árvore de decisão, recorreu-se as variáveis contidas no cadastro de 50 pacientes e o programa Waikato Environment Analyis, na Versão 3.8, especificamente o algoritmo J48. Os resultados apontaram que, o protótipo de software mostrou desempenho satisfatório para a funcionalidade da atividade de cadastro de profissionais, de pacientes e de instrumentos de pesquisa. Quanto ao modelo de árvore de decisão gerado, este contribuiu para a identificação das variáveis epidemiológicas e clínicas associadas à piora da incapacidade e ainda possibilitou a análise das diferenças destas associações em dois grupos distintos de tratamento da Esclerose Múltipla. Considerando todas as fases e testes do sistema, a possibilidade de gerar um registro eletrônico, que proporcione agilidade no processo da informação e que contribua para o planejamento das ações frente à assistência multiprofissional integrada, bem como, a proposta de aplicação do modelo de árvore de decisão capaz de classificar as variáveis epidemiológicas associadas a piora da incapacidade, utilizando-se o escore da Escala Expandida do Estado de Incapacidade (EDSS). Espera-se que o desenvolvimento desse estudo desperte a necessidade de outras pesquisas utilizando modelos de decisão que oportunizem às equipes de saúde, em especial aquelas que enfrentam a complexidade de assistir indivíduos com doenças crônicas e de degeneração progressiva das funções orgânicas.

Submitted by Fernando Souza (fernandoafsou@gmail.com) on 2017-08-21T12:53:30Z No. of bitstreams: 1 arquivototal.pdf: 4888062 bytes, checksum: 31a9043d831c1cae9082ce91f678b978 (MD5) / Made available in DSpace on 2017-08-21T12:53:30Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 4888062 bytes, checksum: 31a9043d831c1cae9082ce91f678b978 (MD5) Previous issue date: 2016-02-29 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Goal: Development of a semantic referatory of learning objects related to Chronic Kidney Disease aimed at primary health care. Methods: Ontology modeling and use of Resource Description Framework (RDF) standard to represent, respectively, Chronic Kidney Disease information and metadata of learning objects, in a legible and machine processable way. Results: A referatory capable of making evident concepts related to the Chronic Kidney Disease and manage and permit access to a learning objects collection categorized by these concepts and described by metadata that exposes their characteristics. Conclusion: Permitting semantic sense to digital resources related to health facilitates standardization, retrieval and sharing of information related to a particular health domain and allows support to a process of self-learning based on Knowledge Representation and Reasoning. / Objetivos: Desenvolvimento de um referatório semântico de objetos de aprendizagem relacionados à Doença Renal Crônica destinado para profissionais de Atenção Primária à Saúde. Métodos: Modelagem de uma ontologia e utilização do padrão Resource Description Framework (RDF) para representar informações sobre a Doença Renal Crônica e metadados de objetos de aprendizagem, respectivamente, de maneira legível e processável por máquinas. Resultados: Referatório capaz de evidenciar conceitos relacionados à Doença Renal Crônica e de gerenciar e fornecer acesso a um acervo de objetos de aprendizagem categorizados de acordo com estes conceitos e descritos por metadados que expõem suas características. Conclusão: O fornecimento de sentido semântico para recursos digitais relacionados à saúde facilita a padronização, recuperação e compartilhamento de informações relacionados a um domínio particular da saúde e permite subsidiar um processo de autoaprendizagem suportado por Representação do Conhecimento e Raciocínio.

Submitted by Ana Caroline Costa (ana_caroline212@hotmail.com) on 2018-11-30T19:09:50Z No. of bitstreams: 2 Dissertação - Hugo de Almeida Ribeiro - 2018.pdf: 2177519 bytes, checksum: fb8741d8762fdd3e58e586442025299e (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2018-12-03T13:16:23Z (GMT) No. of bitstreams: 2 Dissertação - Hugo de Almeida Ribeiro - 2018.pdf: 2177519 bytes, checksum: fb8741d8762fdd3e58e586442025299e (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-12-03T13:16:23Z (GMT). No. of bitstreams: 2 Dissertação - Hugo de Almeida Ribeiro - 2018.pdf: 2177519 bytes, checksum: fb8741d8762fdd3e58e586442025299e (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-11-22 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Healthcare demand is expected to surpass healthcare offer in the next years, encumbering the healthcare system. In one side we have an increase in life expectancy, and therefore the occurrence of chronic diseases, while on the other side we have a shortage of healthcare professionals. Remote patient monitoring systems can be used to continuously keep track of a person health status. When integrated to social networking services, we can build a carer network around the patient. This network is composed of formal (healthcare professionals) and informal carers (family and friends). Information regarding the patient health status can be disseminated within the carer network. Then the remote patient monitoring system may instruct informal carers to assist the patient before recommending formal care. Thus reducing the demands over the healthcare system. There are research initiatives on health information dissemination using social networking. But these initiatives are isolated. This dissertation aims to propose a domain model and an architectural model for remote patient monitoring systems that integrate social networking services unifying concepts found in state-of-the-art literature. The proposed solution is based on three sub-domains: remote patient monitoring systems, enable continuous health status monitoring; social networking services, allow actors to show interest in monitoring other actors health status; and event notification systems, distribute health information among actors. An skeletal system was built to validate the proposal. This skeletal systems consists on modifying an existing system to satisfy restrictions imposed by the proposed models and an usage scenario. / Espera-se que nos próximos anos a demanda por cuidados de saúde supere a oferta, debilitando o sistema de saúde. Os aumentos da expectativa de vida e da ocorrência de doenças crônicas vão de encontro a falta de profissionais de saúde. Sistemas de monitoramento remoto de pacientes podem ser usados para acompanhar continuamente o estado de saúde de uma pessoa. Quando integrados a serviços de redes sociais, uma rede de cuidadores pode ser formada ao redor do paciente. Esta rede é composta por cuidadores formais (profissionais de saúde) e informais (familiares e amigos). Informação a respeito do estado de saúde do paciente pode ser disseminada na rede de cuidadores. Dessa forma, o sistema de monitoramento remoto pode instruir cuidadores informais a auxiliar o paciente antes de recomendar cuidado profissional, reduzindo, portanto, as demandas sobre o sistema de saúde. Existem esforços de pesquisa de soluções que permitam a disseminação de informação de saúde usando abordagem de redes sociais. No entanto, essas pesquisas encontram-se isoladas. Este trabalho tem como objetivo propor um modelo de domínio e um modelo arquitetural que integrem serviços de rede social para disseminar informação de um paciente para sua rede de cuidadores, unificando os conceitos presentes na literatura. A solução apresentada baseia-se em três subdomínios: sistemas de monitoramento remoto de pacientes, os quais permitem o acompanhamento contínuo do estado de saúde dos pacientes; serviços de redes sociais, que possibilitam que os atores do sistema informem ter interesse em acompanhar o estado de saúde de outros atores; e sistemas de notificação de eventos, que distribuem as informações de saúde entre os atores. A validação foi realizada por meio de esqueleto de sistema, consistindo na modificação de um sistema existente, satisfazendo às restrições dos modelos propostos e atendendo a um cenário de uso.

A saúde mental é uma das áreas que envolve mais atenção, visto que as ações tomadas dentro da rede não podem ser reduzidas a sistemas fechados, sem comunicação com outros sistemas, mas a sistemas abertos, heterogêneos e articulados. Dessa maneira, torna-se necessário a busca de novas possibilidades para a realização do trabalho contínuo e articulado entre os diferentes níveis da rede de atenção em saúde mental. Diante deste contexto, o principal objetivo deste projeto é desenvolver e implantar um sistema de informação em saúde para gestão de pacientes que permite realizar o monitoramento do fluxo de pacientes com transtornos mentais. Para tal, o projeto contempla o desenvolvimento de um sistema web utilizando as tecnologias web PHP, HTML, JavaScript e CSS, Sistema Gerenciador de Banco de Dados MySQL e servidor web Apache. Um sistema baseado na arquitetura web, denominado SISAM 13, que permite acompanhar as consultas, solicitações de internação, internações e o movimento de pacientes na rede pública de saúde mental do Departamento Regional de Saúde XIII (DRS XIII), fornecendo relatórios de gestão, foi criado e implementado. Inicialmente, o sistema foi implantando como piloto e, após de 90 dias, entrou em funcionamento definitivo. De novembro de 2012 até outubro de 2014, foram cadastrados 4271 pacientes, 480 profissionais, 1483 agendamentos de consultas, 5938 solicitações de internação e 3239 internações. Evidenciou-se que a maioria dos municípios de procedência da solicitação de internação fazem parte do DRS XIII, confirmando a adequação da regionalização. Verificou-se que a alta proporção de solicitações provenientes dos serviços especializados em saúde mental mostrou a dificuldade de estabilização de pacientes com transtornos mentais por essas unidades, evidenciando a falta de organização desses serviços e a falta articulação com os demais serviços da rede. O sobrecarregamento da rede do DRS XIII pode ser justificado pelo alto tempo de espera por atendimento, e a redução do giro leito, prejudicando o fluxo de pacientes. A maioria da população atendida nos serviços de internação foi masculina, entre 20 a 39 anos, com diagnóstico de transtornos relacionados ao uso de substância(s) psicoativa(s) e internação com duração maior ou igual a 31 dias. O maior tempo de permanência pelas internações compulsórias em comparação com as internações voluntárias e involuntárias, ocasiona em redução no giro leito, refletindo para toda rede de saúde mental. A alta proporção de contrarreferências para serviços especializados em saúde mental pode contribuir para a continuidade do tratamento, todavia, verificou-se que apenas 54,92% das altas foram contrarreferencias. A baixa utilização da funcionalidade de consultas em conjunto com o número de ações de usuários com permissão de solicitadores menor que o de prestadores, sugere o aperfeiçoamento e/ou inclusão de funcionalidades no sistema para os serviços extra-hospitalares. O aumento de 13,16% do número total de ações de um ano para outro pode ser explicado pela incorporação do sistema no processo diário de trabalho, visto que os usuários do sistema foram vistos e reconhecidos como parte integrante na construção do sistema, permitindo o engajamento dos mesmos na sua utilização e melhoria. / Mental health is one of the areas that involves more attention, since the actions taken within the services network cannot be reduced to closed systems without communication with other systems, but with open, heterogeneous and articulated ones. Thus, a search for new possibilities for the realization of continuous and articulated work between different levels of mental health care network is necessary. Given this context, the main objective of this project is to develop and deploy a web based health information system for patient management in order to perform the monitoring of the flow of patients with mental disorders. To this end, the project will include the use of web technologies such as PHP, HTML, JavaScript and CSS, Database Management System MySQL, and Apache web server. A web based system called SISAM 13, that allows appointments, requests for hospitalizations, hospitalizations and the movement of patients in the public mental health network, providing management reports, was created. Initially, the system was implemented as a pilot, and after 90 days, it came into definitive operation. From November 2012 to October 2014, the system registered 4271 patients, 480 professionals, 1483 schedules appointments, 5938 request for hospitalizations and 3239 hospitalizations. Most origin municipalities of the requests was part of the Regional Health Department XIII (RHD XIII), confirming the adequacy of regionalization. It was found that the high proportion of requests from the mental health specialized services, showed the difficulty of stabilizing patients with mental disorders by these units, showing the lack of organization and coordination with other network services. The network overloading can be justified by the high waiting time for hospitalization, and the bed turnover decrease, damaging the network patients flow. It was shown that the majority of the population treated in hospital admissions was male, between 20 to 39 years, diagnosed with disorders related to the use of psychoactive(s) substance(s) use and length of stay more than or equal to 31 days. The longer length of stay by the compulsory admissions compared with voluntary and involuntary admissions, causes reduction in the bed turnover, reflecting on the entire mental health network. The high proportion of counter references to mental health specialist services can contribute to the continuity of care, however, it was found that only 54,92% of the discharges were counter referenced. The low level use of the appointments features along with the low number of user actions by requesters, suggests the improvement and / or inclusion of features in the system for outpatient services. The increase of 13,16% in the total number of actions from one year to another can be explained by the incorporation of the system in the daily working process, since users of the system were seen and recognized as an integral part in the system development, allowing their engagement in its use and improvement.

Abstract The potential of information technologies to enable fundamental and enduring change in individuals’ health and well-being activities has recently gained significant research and policy attention. Moreover, there has been increasing interest in persuasive systems that are designed to induce and influence people to change their attitudes and behaviors. This dissertation consists of five studies, including two qualitative studies and three quantitative field studies (including 616 real users of such persuasive systems), that are closely related and successively build upon each other to jointly address the central research question: To what extent persuasive systems design has an influence on consumers’ intention to adopt health behavior change support systems? The foremost conceptual foundation is the work on persuasive systems design, which further elaborates the features, affordances, and capabilities of systems that can be effective in inducing short-term as well as sustained behavior. The focal point is on the four distinct categories of persuasive systems design: (i) primary task support; (ii) dialogue support; (iii) perceived system credibility; and (iv) social influence. The interplay between the categories and other related constructs, such as unobtrusiveness and design aesthetics, is investigated through rigorous statistical analyses, including partial least structural equation modeling. The results demonstrate that persuasive systems design has a significant impact on consumers’ adoption of health behavior change support systems in different stages of adoption. The work addresses a problem salient to research, policy, and practice and builds upon strong theoretical and conceptual foundations. The research also extends prior technology adoption literature in information systems in a useful way by examining questions related to the design of systems in a novel and consequential domain. / Tiivistelmä Informaatioteknologian rooli ja potentiaali yksilöiden terveyden ja hyvinvoinnin edistämisessä on viime aikoina saanut merkittävää huomiota sekä tutkimuskentällä että julkisessa keskustelussa. Kasvavaa kiinnostusta on osoitettu erityisesti vakuuttaviin tietojärjestelmiin, jotka ovat suunniteltu vaikuttamaan ihmisten asenteisiin ja käyttäytymiseen. Väitöskirja koostuu yhteensä viidestä tutkimuksesta, joista kaksi on laadullisia tutkimuksia ja kolme määrällisiä kenttätutkimuksia. Kenttätutkimuksissa järjestelmiä on tutkittu yhteensä 616 loppukäyttäjällä. Väitöstyön tutkimukset liittyvät läheisesti toisiinsa ja vastaavat yhdessä keskeiseen tutkimuskysymyksen: missä määrin vakuuttavien järjestelmien suunnittelumenetelmillä on vaikutusta kuluttajien aikomukseen ottaa käyttöön terveyskäyttäytymisen muutoksia tukevia järjestelmiä? Työn tärkein käsitteellinen perusta kytkeytyy vakuuttavien järjestelmien suunnitteluun, jossa käsitellään yksityiskohtaisesti järjestelmien ominaisuuksia, käyttömahdollisuuksia ja valmiuksia, jotka voivat olla tehokkaita sekä lyhyen aikavälin että pysyvän käyttäytymisen muutoksen tukemisessa. Väitöstyön keskeinen näkökulma on neljässä vakuuttavan suunnittelun kategoriassa: (i) ensisijaisen tehtävän tukemisessa; (ii) käyttäjän ja järjestelmän välisen vuoropuhelun tukemisessa; (iii) järjestelmän koetussa uskottavuudessa ja (iv) sosiaalisessa vaikutuksessa. Kyseisten kategorioiden vuorovaikutusta ja yhteyksiä on tutkittu tilastollisten analyysien ja rakenneyhtälömallien kautta. Sen lisäksi työssä on paneuduttu aiheeseen tiiviisti liittyvien tekijöiden, kuten teknologian “tunkeilemattomuuden” ja suunnitteluestetiikan merkitykseen teknologian käyttöönotossa. Väitöskirjan tulokset osoittavat, että vakuuttavien järjestelmien suunnittelumenetelmillä on merkittävä vaikutus kuluttajien aikeisiin ottaa käyttöön ja käyttää terveyskäyttäytymisen muutoksia tukevia järjestelmiä. Väitöstyö perustuu vahvaan teoreettis-käsitteelliseen viitekehykseen ja käsittelee tutkimusongelmaa, joka on relevantti tutkimuksen, käytännön sekä julkisen päätöksenteon kannalta. Väitöstutkimus lisää hyödyllisellä ja uudella tavalla tietojärjestelmätieteen tietämystä teknologioiden käyttöönottoon liittyen.

Introduction: The traditional IT investment evaluation methods and/or techniques tend to measure the quantitative value added by eHealth. However, there are contributions brought by innovation which are intangible and sundry, and thus are difficult to identify, measure and manage. A model presented by Vimarlund & Koch (2011) aims for identifying the benefits that IT investments bring to health and social care organizations. It could be used as a tool that identifies and classifies the effects and indicators of IT innovation in-vestments at different organizational levels for different stakeholders. Purpose and research questions: This is an evaluative study with the purpose to validate Vimarlund & Koch’s (2011) evaluation model through practical application. A care study of EIAS (ERAS Interactive Audit System) is conducted. ERAS stands for Enhanced Recovery After Surgery, which is an innovative process aims to enhance patient’s outcome after ma-jor surgery. EIAS is a system that supports the ERAS process. The aim is to achieve a deep understanding of IT investment evaluation. The model will be used in a real case as a guide to evaluate and identify impact that derives from the use and implementation of IT applica-tions. The process of evaluation could also be seen as a process of validation of the model in terms of comprehensiveness, practicality and applicability. Through this study, we aim to find out: 1) What are the possible contributions that EIAS brings to Jönköping County Council? 2) How is the performance of Vimarlund & Koch’s (2011) evaluation model in practical application, in terms of comprehensiveness, practicality and applicability? Method: The purpose of this study is evaluative and it is conducted by using adductive ap-proach. Single case study will be adopted as the research strategy. In this study, qualitative data will be collected through semi-structured interview with key respondents. The data collected will be analyzed qualitatively with a narrative approach. Conclusion: Guided by Vimarlund & Koch’s (2011) evaluation model, the innovations that have been brought into healthcare organizations by EARS are electronic information supply, internal integration of clinical information and possibilities to learn from the system. The model has been validated in terms of comprehensiveness, practicality and applicability. The evaluation model is a generic model to demonstrate the contribution of IT to innovation and change in health care. It could be used in both formative and summative assessment and as well as goal-free and goal-based evaluation. The issue of the productivity paradox has been noticed as some effects are not immediate after introducing of IT. User-participation or not could be considered as an important condition for the validity of the evaluation guided by the evaluation model.

Health information technology (HIT) aims to improve healthcare services by means of technological tools. Patient centered technologies such as personal health records are relatively new HIT tools that enable individuals to get involved in their health management activities. These tools enable the transformation of health consumer behavior from one of passive health information consumers to that of active managers of their health information. This new role is more interactive and engaged, and with such tools, patients can better navigate their lives, and exercise more control over their treatments, hence potentially also leading to improvement in the quality of health services. Despite the benefits of using personal health record systems for health consumers, the adoption rate of these systems remains low. Many free and paid services have not received the uptake that had been anticipated when these services were first introduced. This study investigates some factors that affect the adoption of these systems, and may shed light on some potential reasons for low adoption rates. In developing the theoretical model of this study, social cognitive theory (SCT) and technology acceptance model (TAM) were utilized. The theoretical model was validated through a quantitative survey-based methodology, and the results were derived using structural equation modeling techniques. The key findings of this study highlight the role of individual and environmental factors as determinants of end-user behavior in the adoption of personal health records. The results show that in addition to perceptions of usefulness and ease of use, factors such as social norms and technology awareness are also significantly associated with various factors that directly and indirectly affect intention to use PHRs Based on the results obtained in this study, recommendations are offered for technology providers, and possible directions are proposed for academic researchers.

abstract: Sensitive data sharing presents many challenges in case of unauthorized disclosures, including stigma and discrimination for patients with behavioral health conditions (BHCs). Sensitive information (e.g. mental health) warrants consent-based sharing to achieve integrated care. As many patients with BHCs receive cross-organizational behavioral and physical health care, data sharing can improve care quality, patient-provider experiences, outcomes, and reduce costs. Granularity in data sharing further allows for privacy satisfaction. Though the subjectivity in information patients consider sensitive and related sharing preferences are rarely investigated. Research, federal policies, and recommendations demand a better understanding of patient perspectives of data sensitivity and sharing. The goal of this research is to enhance the understanding of data sensitivity and related sharing preferences of patients with BHCs. The hypotheses are that 1) there is a diversity in medical record sensitivity and sharing preferences of patients with BHCs concerning the type of information, information recipients, and purpose of sharing; and 2) there is a mismatch between the existing sensitive data categories and the desires of patients with BHCs. A systematic literature review on methods assessing sensitivity perspectives showed a lack of methodologies for characterizing patient perceptions of sensitivity and assessing the variations in perceptions from clinical interpretations. Novel informatics approaches were proposed and applied using patients’ medical records to assess data sensitivity, sharing perspectives and comparing those with healthcare providers’ views. Findings showed variations in perceived sensitivity and sharing preferences. Patients’ sensitivity perspectives often varied from standard clinical interpretations. Comparison of patients’ and providers’ views on data sensitivity found differences in sensitivity perceptions of patients. Patients’ experiences (family history as genetic data), stigma towards category definitions or labels (drug “abuse”), and self-perceptions of information applicability (alcohol dependency) were influential factors in patients’ sensitivity determination. This clinical informatics research innovation introduces new methods using medical records to study data sensitivity and sharing. The outcomes of this research can guide the development of effective data sharing consent processes, education materials to inform patients and providers, granular technologies segmenting electronic health data, and policies and recommendations on sensitive data sharing. / Dissertation/Thesis / Doctoral Dissertation Biomedical Informatics 2020

Electronic Dental Records (EDR) are an important part of dental care in Sweden. The usability of these records can affect the workflow in dental care organizations. This study aims to measure the System usability scale (SUS) score of EDRs that are used in dental clinics in Sweden. The study will also investigate the relationship between the SUS score of EDRs and participants’ age, gender, interest in technology, number of patients per workday, professional experience, possible special training to use the EDR, and the period of the training. The study will also rank the most common usability problem in EDRs among the seven possible usability problems included in the questionnaire. The study will present how the participants describe experienced usability problems in the EDRs. The quantitative method constitutes the largest part of this study, while the open-ended questions were used to get a deeper knowledge about some of the usability problems. A digital questionnaire was used in this study to gather data from 115 dentists and 77 dental hygienists who work at various dental clinics around Sweden to get a statistical anchored description about the usability of various EDRs. SUS indicates a low usability level in the EDRs included in the study and a significant negative correlation between the frequency of using EDRs and usability. The males showed better experience with the usability of the EDRs compared to females. The highest-ranked usability problem was the need for users to spend a long time to document patient cases. The usability problems were summarized into three categories which are: an inefficient user interface, lack of semantic interoperability, and users relying on paper. / Elektroniska journalsystem är en viktig del av tandvården i Sverige, då användbarheten av dessa system kan påverka arbetsflödet i tandvårdsorganisationer. Denna studie syftar till att mäta System usability scale (SUS) poäng för olika elektroniska journalsystem som används i olika tandkliniker i Sverige. Studien kommer också att undersöka sambandet mellan SUS-poäng för elektroniska journalsystem och deltagarnas ålder, kön, intresse av teknologi, antal patienter per arbetsdag, yrkeserfarenhet, möjlig specialutbildning för att använda elektroniska journalsystem och perioden för denna utbildning. Studien kommer också att rangordna det vanligaste användbarhetsproblemet i journalsystem bland de sju möjliga användbarhetsproblemen som ingår i frågeformuläret. Studien kommer att presentera hur deltagarna beskriver upplevda användbarhetsproblem i journalsystem. Den kvantitativa metoden utgör den största delen av denna studie, medan de öppna frågorna användes för att få en djupare kunskap om några av användbarhetsproblemen. Ett digitalt frågeformulär användes i denna studie för att samla in data från 115 tandläkare och 77 tandhygienister som arbetar vid olika tandkliniker runt om i Sverige för att få en statistisk förankrad beskrivning om användbarheten av olika elektroniska journalsystem. SUS indikerar en låg användbarhetsnivå i de systemen som ingår i studien. Vi upptäckte också en signifikant negativ korrelation mellan frekvensen av att använda systemen och användbarhetsnivån. Män visade en bättre upplevelse för användbarhet av systemen jämfört med kvinnor. Det högst rankade användbarhetsproblemet var användarnas behov av lång tid för att dokumentera patientfall. Vi sammanfattade hur deltagarna beskriver upplevda användbarhetsproblem i journalsystem under tre kategorier som är: ett ineffektivt användargränssnitt, brist på semantisk interoperabilitet och användare som skriver på en lapp.