Yes

Yes

Yes

The Vision for eHealth infers that Sweden should be best in the world to utilize the opportunities of the digitization by 2025. One of three particularly important areas of action to realize the vision is standardization of e.g. exchange of information. HL7 FHIR is a modern standard for interoperability within e-health. HL7 FHIR enables the exchange of information between different healthcare information systems in an easy way. The basic building blocks in HL7 FHIR are called resources. These represent healthcare entities of some kind, e.g. Patient, Medication, Care plan, and Device. A base set of resources should either together, or by themselves, be able to satisfy the most common use cases in healthcare. A set of rules about a resource's content is called a profile, which is used for defining extensions and constraints on a resource. Profiles can be used to customize the standard to everything from a small local use-case to characteristics common for a whole country, so-called national profiles. This master thesis project sought to investigate the opportunities and restrictions with HL7 FHIR profiling by mapping the outlook of e-health stakeholders in Sweden. The project conducted a mixed method approach. Surveys were sent out to regions, county councils and private caregivers and interviews were held with national stakeholders, industry suppliers, HL7 Sweden and subject experts. The qualitative data was processed through a thematic analysis and the quantitative data was processed through a descriptive analysis. The results showed that there were positive views on governing and maintaining HL7 FHIR and FHIR profiling on a national level and to the establishment of national FHIR profiles. However, questions remain on how it shold be done. Among caregivers there were in general positive attitudes towards HL7 FHIR as a standard for interoperability and towards a possible implementation. However, the implementation level was low and specific knowledge of HL7 FHIR profiles is yet needed. / Vision e-Hälsa 2025 innebär att Sverige ska vara bäst i världen på att utnyttja möjligheterna med digitaliseringen år 2025. Ett av tre särskilt viktiga handlingsområden för att förverkliga visionen är standardisering, t.ex. av utbyte av information. HL7 FHIR är en modern standard för interoperabilitet inom e-hälsa och möjliggör utbyte av information mellan olika hälsoinformationssystem på ett enkelt sätt. De grundläggande byggstenarna i HL7 FHIR kallas resurser. Dessa representerar hälso- och sjukvårdsentiteter av något slag, t.ex. Patient, Medicin, Vårdplan och Apparat. En basuppsättning av resurser ska antingen tillsammans eller i sig själva kunna tillgodose de vanligaste användningsfallen inom hälso- och sjukvård. En uppsättning regler om en resurs innehåll kallas för profil och används för att definiera tillägg och begränsningar på en resurs. Profiler kan användas för att anpassa standarden till allt från ett litet lokalt användningsfall till egenskaper som är gemensamma för ett helt land, så kallade nationella profiler. Detta masterexamensarbete ämnade undersöka möjligheter och begränsningar med HL7 FHIR-profilering genom att kartlägga utsikterna för ehälso-aktörer i Sverige. I projektet genomfördes en mixad metodinriktning, i vilken enkäter skickades ut till regioner, landsting och privata vårdgivare och intervjuer hölls med nationella intressenter, leverantörer, HL7 Sverige och ämnesexperter. Kvalitativ data genomgick en tematisk analys och kvantitativ data genomgick en deskriptiv analys. Resultatet visade på en generellt positiv attityd gentemot ett framtagande och förvaltande av HL7 FHIR och FHIR-profiler på nationell nivå och införande av nationella FHIR-profiler. Däremot kvarstår frågor om hur det ska realiseras. Bland vårdgivare var det generellt positiva attityder gentemot HL7 FHIR som en standard för interoperabilitet och en eventuell implementation. Däremot var den generella implementationsnivån låg och ytterligare kunskap om HL7 FHIR-profiler behövs.

Doctor Legum - LLD / This thesis considers two jurisdictions, namely Malawi and South Africa, and attributes the problem to the lack of appropriate national implementation of the applicable human rights law by these states. Consequently, the study is based on the underlying assumption that one of the main ways of addressing this problem is for African states to undertake measures that comply with international standards for ensuring the appropriate national implementation of the applicable international human rights law.

The Swedish government and the Swedish Association of Local Authorities and Regions, cametogether on a vision that Sweden will be the most advanced country in offering opportunities fordigitalization and e-health by the year of 2025. Self-monitoring is one aspect that can digitizeworkflow in healthcare. This master thesis sought to investigate the opportunities and restrictions when implementingself-monitoring for heart failure patients in Swedish healthcare. Starting from the holisticperspective as an analysis of the clinician’s interest and the need for self-monitoring systemsby conducting a mixed method approach. Surveys were sent out to different county councilsin Sweden working with heart failure patients, and interviews were conducted withrepresentatives from primary care, specialist care, and advanced home health care. Secondly,interviews were conducted with stakeholders from the field of implementation in order togather qualitative results on the organizational, legal, and technical influencing factors,challenges, and requirements in Swedish healthcare. The qualitative data were processedthrough thematic analysis and the quantitative data was processed through descriptive analysis. The results gathered from clinicians consisted of three areas regarding functionality demandsin self-monitoring systems. The results gathered in the aspect of implementation consisted ofthree main organizational influencing aspects, three solution models from a legal perspective,as well as three aspects related in the field of technology and IT. / Sveriges regering och SKR gick samman om en vision om att Sverige ska vara det land somhar kommit längst med att erbjuda möjligheter till digitalisering av vård till år 2025. Egenmon-itorering är en aspekt som kan digitalisera arbetsflöden i vården. Detta masterarbete ämnade att undersöka möjligheter och begränsningar vid implementeringav egenmonitorering för hjärtsviktspatienter i svensk sjukvård. En mixad metodinriktninggenomfördes, som delades upp i två huvudsakliga delar. Första delen ämnade sig till kliniker,där enkäter skickades ut till olika landsting i Sverige som arbetar med hjärtsviktspatienter,samt intervjuer som genomfördes med representanter från primärvård, specialistvård ochavancerad hemsjukvård. Den första delen ämnade till att undersöka klinikers intresse ochbehov av egenmonitorering. Den andra delen bestod av intervjuer med ämnesexperter inomimplementation och digitalisera system för svensk sjukvård. Intervjuerna medimplementationsexperterna genererade kvalitativa resultat utifrån ett organisatoriskt, juridisktoch tekniskt perspektiv. Den kvalitativa datan bearbetades genom en tematisk analys och den kvantitativa datanbearbetades genom en deskriptiv analys. Resultaten som samlats in från kliniker bestod av treområden avseende funktionalitetskrav i egenmonitoreringssystem. Resultaten som samladesin gällande implementationen i svensk sjukvård bestod av tre huvudsakliga organisatoriskapåverkande aspekter, tre lösningsmodeller ur ett juridiskt perspektiv, samt tre aspekterrelaterade till teknik och IT.

The aim of this study was to investigate the management of the function shift of Technical and Vocational Education and Training Colleges at the Department of Higher Education and Training. When the function shift of TVET Colleges took place, it provided an opportunity to research a phenomenon and obtain data that were not previously researched, as this was the first ever function shift or migration of colleges from the Department of Basic Education to the Department of Higher Education and Training. As such, this research not only explores a new phenomenon but also contributes to the body of knowledge regarding TVET in South Africa. This research was conducted at a TVET College in Newcastle, Kwa-Zulu Natal, South Africa. A qualitative, phenomenological study was conducted. The instruments for collecting data were individual and focus group interviews. Field notes were compiled during the various interviews, as deemed necessary by the researcher. All interviews were recorded digitally. The said digital recordings were transcribed and emanating themes were identified. Managers were selected as the interviewees. As this research was based on the management of the function shift, they were the most appropriate choice. A sample of staff was also interviewed, as two separate focus groups, to balance the scope and extent of the data, thus attempting to not only view the managerial paradigm as the sole reality. Findings made from the data were that the function shift was preceded by a previous migration of staff. That migration, however, saw colleges remaining in the same educational stream or level namely that of basic education. The staff at colleges, or technical colleges as they were called at the time, were previously employed by the State. This changed when the State created governing bodies for colleges or college councils, as they are known. Technical Colleges were then renamed Further Education and Training Colleges. These colleges were reporting to the Department of Education which saw a name change to the Department of Basic Education, as explained above. Employees were given the opportunity to migrate from State employment to council employment, which most staff members did. These college councils were later found to be dysfunctional, and the State arranged for colleges to be returned to the auspices of the State, but this time round they were usurped in the newly formed Department of Higher Education and Training. From a management perspective, the function shift was successful with minor challenges. Thus the staff felt that they did not receive adequate communication, thereby adversely affecting their financial positions. The researcher recommends further research among TVET Colleges regarding the management of this function shift. It is also recommended that all current channels of communication with staff be revisited, and improvement therein pursued, where possible. A final recommendation is that managers involved in a function shift be subject to a refresher course in change management before a function shift is implemented. / Educational Leadership and Management / M. Ed. (Education Management)