To illustrate the intersection of ethical language and ethical frameworks within technical communication, this dissertation analyzes the history and documentation of the human radiation experiments of the 1940s through the 1970s. Research propositions included clarifying the link between medical documentation and technical communication by reviewing the literature that links the two disciplines from the ancient period to the present; establishing an appropriate historiography for the human radiation experiments by providing a context of the military, political, medical, and rhetorical milieu of the 1940s to the 1970s; closely examining and analyzing actual human radiation experiment documentation, including proposals, letters, memos, and consent forms, looking for established rhetorical constructions that indicate a document adheres to or diverts from specific ethical frameworks; and suggesting the importance of the human radiation documents for studying ethics in technical communication. Close rhetorical analysis of the documents included with this project reveals consistent patterns of metadiscourse, passive and nominal writing styles, and other rhetorical constructions, including negative language, redundancies, hedges, and intensifiers, that could lead a reader to misunderstand the writer's original ethical purpose. Ultimately this project finds that technical communicators cannot classify language itself as ethical or unethical; the language is simply the framework with which the experimenters construct their arguments and communicate their work. Technical communicators can, however, consider the ethical nature of behavior according to specific ethical frameworks and determine whether language contributes to the behavior.

O registro eletrônico do paciente (REP) está sendo gradativamente implantado no meio médico hospitalar. Grande parte das informações essenciais do REP está armazenada na forma de texto narrativo livre, dificultando operações de procura, análise e comparação de dados. O processamento de linguagem natural (PLN) refere-se a um conjunto de técnicas computacionais, cujo objetivo é a análise de texto através de conhecimentos léxicos, gramaticais e semânticos. O presente projeto propõe a criação de uma ferramenta computacional de investigação clínicoepidemiológica aplicada a textos narrativos médicos. Como metodologia propomos a utilização do processador de linguagem natural especializado em medicina MEDLEE desenvolvido para textos em Inglês. Para que seu uso seja possível textos médicos em Português são traduzidos ao Inglês automaticamente. A tradução automatizada (TA) é realizada utilizando o aplicativo baseado em regras SYSTRAN especialmente configurado para processar textos médicos através da incorporação de terminologias especializadas. O resultado desta seqüência de TA e PLN são informações conceituais que serão investigadas à procura de achados clínicos pré-definidos, atrvés de inferência lógica sobre uma ontologia. O objetivo experimental desta tese foi conduzir um estudo de recuperação de informações em um conjunto de 12.869 relatórios de radiografias torácicas à procura de vinte e dois achados clínicos e radiológicas. A sensibilidade e especificidade médias obtidas em comparação com referência formada pela opinião de três médicos radiologistas foram de 0,91 e 0,99 respectivamente. Os resultados obtidos indicam a viabilidade da procura de achados clínicos em relatórios de radiografias torácicas através desta metodologia de acoplamento da TA e PLN. Conseqüentemente em trabalhos futuros poderá ser ampliado o número de achados investigados, estendida a metodologia para textos de outras modalidades, bem como de outros idiomas / The Electronic Medical Record (EMR) is gradually replacing paper storage on clinical care settings. Most of essential information contained on EMR is stored as free narrative text, imposing several difficulties on automated data extraction and retrieval. Natural language processing (NLP) refers to computational linguistics tools, whose main objective is text analysis using lexical, grammatical and semantic knowledge. This project describes the creation of a computational tool for clinical and epidemiologic queries on narrative medical texts. The proposed methodology uses the specialized natural language processor MEDLEE developed for English language. To use this processor on Portuguese medical texts chest x-ray reports were Machine Translated into English. The machine translation (MT) was performed by SYSTRAN software, a rule based system customized with a specialized lexicon developed for this project. The result of serial coupling of MT an NLP is tagged text which needs further investigation for extracting clinical findings, whish was done by logical inference upon an ontolgy. The experimental objective of this thesis project was to investigate twenty-two clinical and radiological findings on 12.869 chest x-rays reports. Estimated sensitivity and specificity were 0.91 and 0.99 respectively. The gold standard reference was formed by the opinion of three radiologists. The obtained results indicate the viability of extracting clinical findings from chest x-ray reports using the proposed methodology through coupling MT and NLP. Consequently on future works the number of investigated conditions could be expanded. It is also possible to use this methodology on other medical texts, and on texts of other languages

Denna studie undersöker användarupplevelsen av utbildning i journalsystemet Cosmic i Region Jönköpings län. Utbildning är av största vikt för personalens välmående samt för optimal användning av systemet. Syftet med undersökningen är att utforma en enkät för kontinuerligt förbättringsarbete inom området. Enkäten undersöker både kvantitativa och kvalitativa element hos ett urval som stratifierats utifrån användarnas yrkesroller. Enkäten skickades till deltagarnas respektive arbetsmejl, och svaren samlades in och bearbetades med hjälp av enkätprogrammet EsMaker. Ordinalskalor användes som mätverktyg i många av enkätens kvantitativa frågor, medan de kvalitativa frågorna analyserades med hjälp av The constant comparative method.  Studiens resultat visar en godtycklighet gentemot det material som finns samt med kollegor som instruktörer. Dock framkommer starka önskemål om organiserade utbildningar. Ett tydligt mönster är att användarna föredrar utbildningsmetoder som bygger på synkron kommunikation, samt att metoder som bygger på demonstration av programvaran är mer uppskattade än andra. Resultaten visar dock att dessa metoder bör kombineras med övningar för bästa effekt.  Slutsatser som undersökningen genererat är att kommande utbildningsinsatser bör innebära organiserade utbildningar på arbetsplatsen. Vidare forskning kopplat till Ställföreträdande lärande och Aktivitetsbaserat lärande skulle kunna användas för att optimera utbildningens resultat samt användarnas nöjdhet. En djupare analys av enkätresultatet med avseende på yrkesrollernas respektive behov skulle ytterligare kunna höja kvalitén och effektivisera utbildningarna. Studiens absolut viktigaste fynd är vikten av att chefer avsätter tid för sina medarbetare att ta del av de utbildningsmöjligheter som finns. Detta är kärnan i allt, för utan tid till utbildning spelar utbildningsmaterialets kvalitet ingen som helst roll. / This study investigates the end-user experience of education in Cosmic, a system for electronic health records, in Region Jönköping County. Training is of paramount importance for the well-being of the staff and for optimal use of the system. The purpose of the survey is to design a questionnaire that can be used for continuous improvement of the end-user training in the county.  The survey examines both quantitative and qualitative elements of a sample that is stratified based on the end‑users' professions. The survey was sent to the participants' work emails, and the responses were collected and processed using the EsMaker survey program. Ordinal scales were used as a measurement tool in many of the survey's quantitative questions, while the qualitative questions were analyzed using The constant comparative method.  The results of the study show an arbitrary attitude towards the available training material as well as towards colleagues as instructors. However, there are strong desires for organized training. A clear pattern is that users prefer training methods based on synchronous communication, as well as methods based on demonstration of the software. However, the results show that these methods should be combined with individual tasks for the best effect.  Conclusions generated by the survey are that future training efforts should involve organized training at the workplace. Further research linked to vicarious modeling and enactive learning could be used to optimize the results of the education as well as end-user satisfaction. A deeper analysis of the survey results regarding the respective needs of the professional roles could further increase the quality and streamline the education. The study's most important finding is the importance of managers to dedicate time for their employees to use the training opportunities available. This is the essence of everything, because without time for training, the quality of the educational material does not matter whatsoever. / <p>Examensarbete i vårdadministration, YH-utbildning: 20 Yh-poäng.</p>

Epidemiological trends in mental disorders are shown against a background governed by medical aid health policy. The study quantitatively analyzed a dataset of mental disorders for South Africa’s leading medical aid scheme. South Africa’s leading medical aid scheme has been in operation for almost three decades. This degree of longevity allows for a reliable longitudinal analysis of diagnostic trends. Through consent of the Scheme, a database was provided, which lists mental disorder diagnoses over seven years from 2008 to mid-way through 2015. Data from this source were analyzed and interpreted. Data fields provided and made use of from the raw medical scheme database are: Date of admission (Year, Month); Patient gender; Database population per year; Patient diagnosis (DEG Description); Total per DEG Description. Each diagnosis (mental disorder) is presented in the following ways: 1. Bar charts showing the volume of specific mental illnesses each year. 2. Bar charts showing fluctuations of occurrence of a specific mental illness over time. 3. Frequency of specific mental illnesses over time, relative to the entire database population. 4. Male:Female ratio per mental disorder. 5. Female Outpatient vs. Inpatient volumes across each mental disorder and across all years (2008 – 2015).v 6. Male Outpatient vs. Inpatient volumes across each mental disorder and across all years (2008 – 2015). 7. Total number of patients per mental disorder across time (2008 – 2015). 8. Frequency polygons showing the fluctuation of a selected mental disorder over time as compared to other selected mental disorders. It is found that there are changes in prevalence rates of mental disorders over time and that these fluctuations are attributed to an economic factor within medical aid scheme cost-driven policy. The effect of cost-driven policy is that members diagnosed with a mental disorder may not be granted provision of adequate treatment because diagnosis is in part, determined by economic structures. Costs for mental illness treatment programmes are curtailed by keeping patient numbers significantly low, by radically over-diagnosing certain mental illnesses treated with comparably cheaper pharmaceuticals or by drastically curbing time spent in a mental health facility. Some members of the medical aid scheme have been deliberately misdiagnosed. Alternatively, those, correctly diagnosed, do not receive the treatment required of such an illness. The scenario then is of thousands of mentally ill people, who are not treated effectively. Members continue to pay fees, paying under the illusion that medical cover ensures effective treatment / Psychology / M.A. Psychology

Medication adherence in patients with asthma and chronic obstructive pulmonary disease (COPD) is notoriously low and is associated with suboptimal therapeutic outcomes. To intervene effectively, family physicians need to assess medication adherence efficiently and accurately. Otherwise, failure to detect nonadherence may further reduce patient disease control and result in unnecessary treatment escalation that can increase the risk of adverse events and lead to more complex and costly drug regimens. The overarching goal of this thesis was to investigate how the use of secondary healthcare data can be leveraged to optimize medication adherence in clinical practice. Methodological considerations to facilitate our understanding of treatment escalation in asthma using secondary healthcare data were also examined. In the first part of my doctoral research program, I led a project which aimed at developing e-MEDRESP, a novel web-based tool built from pharmacy claims data that provides to family physicians with objective and easily interpretable information on patient adherence to asthma/COPD medications. This tool was developed in collaboration with family physicians and patients using a framework inspired by user-centered design principles. As part of a feasibility study, e-MEDRESP was subsequently implemented in electronic medical records across several family medicine clinics in Quebec (346 patients, 19 physicians). Findings showed that its integration within physician workflow was feasible. Physicians reported that the tool helped to: 1) better evaluate their patients’ medication adherence; and 2) adjust prescribed therapies, with mean ± sd ratings (5-point Likert scale) of 4.8±0.7 and 4.3±0.9, respectively. A pre-post analysis did not reveal improvement in adherence among patients whose physician consulted e-MEDRESP during a medical visit. However, significant improvements in adherence for inhaled corticosteroids (Proportion of days covered (PDC): 26.4% (95% CI: 14.3-39.3%)) and long-acting muscarinic agents (PDC: 26.4% (95% CI: 12.4-40.2%)) were observed among patients whose adherence level was less than 80% in the 6-month period prior to the medical visit. The second part of this research program consisted of two studies which laid the groundwork to estimate the association between medication adherence and treatment escalation in asthma using Canadian healthcare administrative data, a phenomenon that is currently under-explored in the literature. Prior to embarking in this study, it is important to ensure that healthcare administrative databases can be used to identify asthma patients and treatment escalations in an adequate manner. First, a systematic review was conducted to obtain an overview of the available evidence supporting the validity of algorithms to identify asthma patients in healthcare administrative databases. The algorithm developed by Gershon et al. (Canadian Respiratory Journal, 2009;16(6):183-188) comprising ≥2 ambulatory medical visits or ≥1 hospitalization for asthma over two years had the best trade-off between sensitivity (84 %) and specificity (77%). Second, an operational definition of treatment escalation was developed through a Delphi study that incorporated an expert consensus process. This definition includes 7 steps and was inspired by the 2020 Global for Initiative for Asthma treatment guidelines. I plan to integrate the definitions obtained from these two studies in a future cohort study which aims to examine the association between medication adherence and treatment escalation in asthma. My research provides compelling evidence on the importance of developing and evaluating the feasibility of implementing tools which can aid physicians in assessing medication adherence in clinical practice and extends the literature on treatment escalation in asthma. / L’adhésion aux médicaments chez les patients présentant un asthme ou une maladie pulmonaire obstructive chronique (MPOC) est reconnue pour être faible. Pour intervenir efficacement, les médecins de famille doivent évaluer de manière précise l’adhésion aux médicaments. Ne pas détecter la non-adhésion peut réduire davantage la maîtrise de la maladie, entraîner une intensification non-nécessaire du traitement, mener à des schémas pharmacologiques plus complexes et coûteux et par conséquent, augmenter le risque d’événements indésirables. La présente thèse vise à approfondir les connaissances sur l'usage secondaire des données médico-administratives afin d’optimiser l’adhésion et l’usage des médicaments chez les patients atteints de maladies respiratoires chronique, au moyen d’une approche méthodologique mixte de recherche. Plusieurs questions méthodologiques cruciales concernant l’étude de l’intensification du traitement en asthme ont également été abordées. Le premier axe porte sur le développement de l’outil e-MEDRESP, qui s’appuie sur les renouvellements d’ordonnances et qui est conçu pour donner rapidement accès aux médecins de famille à une mesure objective et facilement interprétable de l’adhésion aux médicaments utilisés dans le traitement de l’asthme et de la MPOC. L’outil a été développé en collaboration avec des médecins de famille et des patients à l’aide de groupes de discussion et d’entrevues individuelles. Dans le cadre d’une étude de faisabilité, l’outil e-MEDRESP a été par la suite implanté dans les dossiers médicaux électroniques de plusieurs cliniques de médecine familiale au Québec (346 patients, 19 médecins). Les résultats ont montré que l’intégration de d’e-MEDRESP dans le flux de travail des médecins était faisable. Les médecins ont indiqué que l’outil leur a permis de : 1) mieux évaluer l’adhésion aux médicaments de leurs patients (cote moyenne et écart-type sur une échelle de Likert à 5 points [perception d’accord] de 4,8±0,7); et 2) ajuster les traitements prescrits (4,8±0,7 et 4.3±0,9). Une analyse pré-post n’a pas révélé d’amélioration au niveau de l’adhésion aux médicaments chez les patients dont le médecin a consulté e-MEDRESP lors d’une visite médicale. Toutefois, une amélioration statistiquement significative a été observée chez les patients dont le niveau d’adhésion était inférieur à 80 % au cours de la période de six mois précédant la visite et qui étaient traités par des corticostéroïdes inhalés (Proportion of days covered (PDC) = 26,4 % (IC à 95 % : 14,3-39,3 %) ou des antagonistes muscariniques à action prolongée (PDC = 26,9 % (IC à 95 % : 12,4-40,2 %)). Le deuxième axe présente des travaux préparatoires à la conduite d’une cohorte qui sera réalisée à partir de bases de données médico-administratives et qui aura comme objectif d’estimer l’association entre l’adhésion aux médicaments et l’intensification du traitement de l’asthme, une question peu explorée à ce jour. Avant de débuter une telle étude, il est important de s’assurer que les bases de données médico-administratives peuvent être utilisées pour identifier de manière adéquate les patients asthmatiques et l’intensification du traitement. Dans un premier temps, une revue systématique a été effectuée pour identifier les données probantes disponibles concernant la validité des algorithmes permettant d’identifier les patients asthmatiques dans les bases de données médico-administratives. L’algorithme qui a été développé par Gershon et coll. (Revue canadienne de pneumologie, 2009; vol. 16, no 6, p. 183-188), qui comprenait deux visites médicales ambulatoires ou une hospitalisation pour asthme sur deux ans, présentait le meilleur compromis entre la sensibilité (84 %) et la spécificité (77 %). Dans un second temps, une définition opérationnelle de l’intensification du traitement a été élaborée dans le cadre d’une étude Delphi qui incorporait un processus consensuel d’experts. Cette définition comprend sept étapes et s’inspire des lignes directrices 2020 de l'initiative mondiale de lutte contre l'asthme. Les définitions obtenues à partir de ces deux études seront intégrées dans l’étude de cohorte. Les études constituant cette thèse démontrent l’importance de développer des outils qui permettent aux médecins d’évaluer l’adhésion aux médicaments dans leur pratique clinique, en plus d’enrichir la littérature scientifique médicale sur l’intensification du traitement chez les patients asthmatiques.

Indiana University-Purdue University Indianapolis (IUPUI) / Healthcare data visualization presents challenges due to its non-standard organizational structure and disparate record formats. Epidemiologists and clinicians currently lack the tools to discern patterns in large-scale data that would reveal valuable healthcare information at the granular level of individual patients and populations. Integrating geospatial and temporal healthcare data within a common visual context provides a twofold benefit: it allows clinicians to synthesize large-scale healthcare data to provide a context for local patient care decisions, and it better informs epidemiologists in making public health recommendations. Advanced implementations of the Scalable Vector Graphic (SVG), HyperText Markup Language version 5 (HTML5), and Cascading Style Sheets version 3 (CSS3) specifications in the latest versions of most major Web browsers brought hardware-accelerated graphics to the Web and opened the door for more intricate and interactive visualization techniques than have previously been possible. We developed a series of new geotemporal visualization techniques under a general healthcare data visualization framework in order to provide a real-time dashboard for analysis and exploration of complex healthcare data. This visualization framework, HealthTerrain, is a concept space constructed using text and data mining techniques, extracted concepts, and attributes associated with geographical locations. HealthTerrain's association graph serves two purposes. First, it is a powerful interactive visualization of the relationships among concept terms, allowing users to explore the concept space, discover correlations, and generate novel hypotheses. Second, it functions as a user interface, allowing selection of concept terms for further visual analysis. In addition to the association graph, concept terms can be compared across time and location using several new visualization techniques. A spatial-temporal choropleth map projection embeds rich textures to generate an integrated, two-dimensional visualization. Its key feature is a new offset contour method to visualize multidimensional and time-series data associated with different geographical regions. Additionally, a ring graph reveals patterns at the fine granularity of patient occurrences using a new radial coordinate-based time-series visualization technique.

Indiana University-Purdue University Indianapolis (IUPUI) / There has been vast and growing amount of healthcare data especially with the rapid adoption of electronic health records (EHRs) as a result of the HITECH act of 2009. It is estimated that around 80% of the clinical information resides in the unstructured narrative of an EHR. Recently, natural language processing (NLP) techniques have offered opportunities to extract information from unstructured clinical texts needed for various clinical applications. A popular method for enabling secondary uses of EHRs is information or concept extraction, a subtask of NLP that seeks to locate and classify elements within text based on the context. Extraction of clinical concepts without considering the context has many complications, including inaccurate diagnosis of patients and contamination of study cohorts. Identifying the negation status and whether a clinical concept belongs to patients or his family members are two of the challenges faced in context detection. A negation algorithm called Dependency Parser Negation (DEEPEN) has been developed in this research study by taking into account the dependency relationship between negation words and concepts within a sentence using the Stanford Dependency Parser. The study results demonstrate that DEEPEN, can reduce the number of incorrect negation assignment for patients with positive findings, and therefore improve the identification of patients with the target clinical findings in EHRs. Additionally, an NLP system consisting of section segmentation and relation discovery was developed to identify patients' family history. To assess the generalizability of the negation and family history algorithm, data from a different clinical institution was used in both algorithm evaluations.

Indiana University-Purdue University Indianapolis (IUPUI) / Living donors have contributed about 6,000 kidneys per year in the past 10 years, but more than 100,000 individuals are still waiting for a kidney transplant. Living kidney donors undergo a major surgical procedure without direct medical benefit to themselves, but comprehensive follow-up information on living donors’ health is unfortunately limited. Expert recommendations suggest capturing clinical information beyond traditional sources to improve surveillance of co-morbid conditions from living kidney donors. Currently the United Network for Organ Sharing is responsible for collecting and reporting follow-up data for all living donors from U.S. transplant centers. Under policy implemented in February of 2013, transplant centers must submit follow-up date for two years after donation, but current processes often yield to incomplete and untimely reporting. This dissertation uses a statewide Health Information Exchange as a new clinical data source to 1) retrospectively identify a cohort of living kidney donors, 2) understand their follow-up care patterns, and 3) observe selected clinical outcomes including hypertension, diabetes and post-donation renal function.

M. Tech. (Department of Process Control and Computer System, Faculty of Engineering and Technology), Vaal University of Technology. / Personal health record system (PHRS) is a tool that is used in maintaining the health and wellness of an individual as well as helping with illness of an individual. PHRS gives the individual access to a wide range of credible health information, data, and knowledge. Individuals can use that access to improve their health and manage their diseases. Patients with chronic illness can track and manage their health in conjunction with their health provider, this will promote early intervention when they encounter an abnormality or complications. Continuous monitoring and storing of health information has been a challenge for patients and health providers. Personal health data monitoring and retrieval system for health providers was designed and implemented. The main aim of this study was to develop an accurate, secure and flexible personal health data monitoring and retrieval system for health providers (PHRS). This was achieved. The research showed that when a patient health information (Electrocardiogram (ECG) and temperature) was monitored, the heartbeat (ECG) sensor output the value as an analog value to the signal processing (NodeMCU) which was then converted to a digital value. The temperature sensor used in this research is a digital sensor which lowers the amount of ADC conversion that was done. The digital values are displayed on LCD, its send to a personal health data storage system which was designed for health information storage purposes. It also sends the value to a retrieval system which is an android application that is connected to the data storage system to display health information to the health providers from a remote location. Personal health data storage and the retrieval system are secure due to the Message queuing telemetry transport (MQTT) protocol used in the application layer. The MQTT protocol is secure due to the secure socket layer (SSL) which is an encryption based on presentation layer embedded inside the MQTT protocol. After the comparison of the software simulation and the prototype test, the differences in the value for the heartbeat and temperature sensor indicate 0.04 BPM and 0.04 oC which shows the accuracy of the sensing circuit. Personal health data monitoring and retrieval system developed is applicable and useful to multiple entities in and around South Africa such as; Ministry of health, hospitals, sport and recreations.

Det svenska vårdsystemet står inför en rad utmaningar relaterade till de journalsystem som används idag. Sjukvårdspersonalen upplever svårigheter med systemen vilket påverkar det dagliga arbetet inom vården. Undersökningar visar att personal behöver använda sig av flera olika system för att få en helhetsbild över en patients situation, vilket försvårar en fungerande vårdkedja. Kommunikationen mellan utvecklare och sjukvården är komplex eftersom de inte är insatta i varandras arbetssätt och det saknas även enheter som ansvarar för att föra samman sjukvårdspersonalens behov på ett strukturerat sätt. Denna rapport syftar till att undersöka om och i så fall hur sjukvårdspersonalens behov och upplevelser integreras vid utveckling av journalsystem samt om detta har resulterat i att systemet uppfyller användarnas behov. Fokus för studien har varit på journalsystemet TakeCare vilket är det dominerande journalsystemet inom Region Stockholm. Arbetet som denna rapport består av utgörs delvis av en litteraturstudie för att bygga en teoretisk bakgrund om användarcentrerade produktutvecklingsprocesser, analysmetoder för behovsidentifiering, hur användarinvolvering kan bedrivas och svårigheter som kan finnas. Rapporten utgörs även av en empirisk studie bestående av semistrukturerade intervjuer där totalt sex respondenter har medverkat. Dessa respondenter utgörs av en produktägare för ett utvecklingsteam, en chef på ett förvaltningsföretag, en vårdadministrativ chef på ett akutsjukhus samt sjukvårdspersonal. Vidare så genomfördes en analys, jämförelse och diskussion gällande den information som erhållits från teorin och den empiriska studien. Resultatet av studien visar att det sker användarinvolvering under produktutvecklingen av TakeCare men inte i den omfattning som behövs för att uppfylla användarnas behov. Det framgår att detta inte beror på en ovilja till involvering, utan främst på att det finns en avsaknad av struktur i processen och kommunikation mellan utvecklare och användare. Det behov som återkommande uttrycks av användarna och som inte uppfylls är avsaknaden av tillräcklig kompatibilitet mellan journalsystemet och andra system inom vården. Avsaknad av kompatibilitet gör att användarna måste utföra dubbelt arbete vilket både har en inverkan på patientsäkerheten och tar tid från att vårda patienter. / The swedish healthcare system is facing some challenges related to the electronic medical records that are being used. The healthcare personnel are experiencing some difficulties with the systems, which affects their daily work in a negative aspect. Studies have shown that the personnel actively must use different systems in parallel to get a complete understanding of a patient's status. Furthermore, this makes the care system as a whole more complicated and inadequate.The communication between developers and healthcare can be seen as a complex process since they do not have an complete understanding of each others ways of working. Also, units for bringing together user needs in a structured manner does not exist. This study aims to examine if, and if so, how the needs of healthcare personnel are being involved in the development process of electronic medical records and if this has resulted in a more user adaptive system. The study will focus on the electronic medical record named TakeCare, which is the most used electronic medical record system inside Region Stockholm. This report partly consists of a literature study that aims to establish a theoretical background focusing on user-centered processes of product development, methods for analysing user needs, how user involvement can be conducted and what kind of difficulties that can be identified. The report also consists of an empirical study with focus on semi structured interviews with six different respondents. These respondents are both healthcare personnel, a product owner for a development team, a chief from a company that specializes in managing the electronic medical record TakeCare and a chief specialized in administrative healthcare. Furthermore, an analysis, a comparison and a discussion were followed out concerning the information gained from the theory and empirical study. The results from the study shows that user involvement during the product development process of TakeCare exists, but not to an enough extent that fulfills the user needs. This is not caused by unwillingness to adapt user involvement in the process, but a lack of structure and inadequate communication between developers and users. One particular user need that repeatedly has been expressed by the healthcare personnel, but not been fulfilled, is the lack of software compatibility between the electronic medical record and other electronic systems within the healthcare sector. The lack of software compatibility have resulted in that the users having to perform the same task repetitively, which has an impact on patient safety but also results in reduced time spent on the patients.