As the bulk of medical health records shift from paper-based file systems to electronic formats, the promise of the transformation process called healthcare reform included adding efficiencies to medical practice workflows, lower costs, improved quality of care and most important, and the freeing of patient information from traditional propriety silos. With this incoming largess of protected health information data now viewable through online patient portals, patients can be empowered to become educated and active in their own health care decisions, but only if they have admission to their information. A digital divide currently exists in many medical practices where only a very few patients have access to their personal health information. The primary goal was to facilitate organizational change needed for physician-managed practices to increase patient adoption and meaningful use of patient portals for secure communication, wellness education, review of labs and other tests, and receipt of clinical summaries. The methodology utilized the appreciative inquiry 4-D model as the underlying basis of three phases: Phase 1-fundamental study, Phase 2-strategic action plan, and Phase 3 supporting organizational change. The physicians or providers in independent medical practices are the key determinate of the organizational workflows. The results have added significantly to the understanding of organizational change as related to patient engagement and the adoption and meaningful use of patient portals in independent physician-managed clinics. As medical practices and their physician leaders raise patient portal workflow processes to a higher level of importance, it is expected that patients will begin to adopt these procedures as their preferred methods and bring about a change in the patient-provider relationship.

Bakgrund: Den tekniska utvecklingen går snabbt framåt och kan innebära en utmaning för många grupper i samhället, framförallt äldre. Sverige har som mål att år 2025 vara bäst på eHälsa och som ett delmål har ett register i form av Nationella Läkemedelslistan tagits fram. Registret ska ge patienter, vård- och apotekspersonalen tillgång till samma information med målet att öka patientsäkerheten och patienters delaktighet i vården. För att komma åt den här information krävs inloggning till eHälsomyndighetens tjänst Läkemedelskollen. Äldre personer har ofta mindre datorvana och väljer i många fall papper framför digitala tjänster. Apotekslistan är den analoga tjänsten som just nu erbjuder receptinformation i pappersform till patienterna. Syfte: Studiens syfte var att beskriva äldre patienters upplevelser av att använda receptinformation i analog form och deras uppfattning om digitala alternativ. Material och metod: En kvalitativ semistrukturerad intervjustudie har genomförts och urval har skett strategiskt och målstyrt för att fånga respondenter med olika nivå av teknikvana och på olika demografiska platser i Sverige. Rekrytering skedde med snöbollsurval och resulterade i 9 respondenter. Resultatet tolkades sedan med hjälp av UTAUT och TTF. Resultat: Den fysiska Apotekslistan fyller en viktig funktion i patientens läkemedelsprocess och skapar trygghet för individen. Många respondenter har svårt att se fördelarna med en digital version och upplever att den fysiska listan är tillförlitlig och uppfyller alla krav och behov som finns. Slutsats: En del av den åldrande befolkningen vill ha tillgång till det fysiska pappret som ett alternativ till digitala tjänster och upplever att den skapar trygghet och förenklar vardagen. För att locka fler äldre att testa Läkemedelskollen kan utbildningar tas fram för att minska äldre personers teknostress. En utveckling av tjänsten skulle kunna öka intresset och tillföra ett mervärde som förenklar livet med läkemedel. / Background: Technical development is advancing rapidly and entails a need for skills development for many groups in society, especially the elderly. Sweden aims to be the best in eHealth by 2025, and as an intermediate goal, a register in the form of the “National Medication List” has been introduced. The register will give patients, care and pharmacy staff access to the same information with the aim of increasing patient safety and patients' participation in care. To access this information, login to the eHealth Authority's service Läkemedelskollen is required. Older people often have less computer skills and, in many cases, choose paper over digital services. Apotekslistan is the analogue service that currently offers prescription information on paper to patients. Purpose: The purpose of the study was to describe elderly patients' experiences of using prescription information in analog form and their attitude to digital alternatives. Material and method: A qualitative semi-structured interview study were conducted and selection has been made strategically and goal-oriented to capture participants with different levels of technical knowledge and in different demographic locations in Sweden. Recruitment took place with a snowball selection and resulted in 9 participants. The result was interpreted using UTAUT and TTF. Result: The physical list Apotekslistan fulfills an important function in the patient's drug process and gives the patient a feeling of security. Many people find it difficult to see the benefits of a digital version and feel that the physical list is reliable and meets all the requirements and needs that exist. Conclusion: Part of the aging population wants access to the physical paper as an alternative to digital services and feels that it creates security and simplifies everyday life. To attract more elderly people to try Läkemedelskollen, training can be developed to reduce older people's technology stress. A development of the service could increase interest and add value that simplifies living with chronic disease.