Yes / To evaluate a 24/7, nurse led telephone and video-consultation support service for patients thought to be in the last year of life in Bradford, Airedale, Wharfedale and Craven. Method: Activity and other data recorded at the time of calls were analysed. Interviews with 13 participants captured patients and carers perspectives. Results: Between April 1st 2014 and March 31st 2015, 4648 patients were registered on the Gold Line. 42% had a non-cancer diagnosis and 46% were not known to specialist palliative care services. The median time on the caseload was 49 days (range 1-504 days). 4533 telephone calls and 573 video consultations were received from 1813 individuals. 39% of the 5106 calls were resolved by Gold Line team without referral to other services. 69% of calls were made outside normal working hours. Interviews with patients and carers reported experiences of support and reassurance and the importance of practical advice. Conclusion: A nurse led, 24/7 telephone and video consultation service can provide valuable support for patients identified to be in the last year of life and their cares. The line enabled them to feel supported and remain in their place of residence, reducing avoidable hospital admissions and use of other services. Providing this service may encourage health care professionals to identify patients approaching the last year of life, widening support offered to this group of patients beyond those known to specialist palliative care services. / Health Foundation adn Shared Purpose

Abstract Older adults with complex memory problems benefit when they have the opportunity to consult with a specialist for a comprehensive cognitive assessment. Specialists such as geriatricians, psychogeriatricians or neurologists often work in major cities or large metropolitan towns. Travelling to see a specialist either alone or with a carer is complicated for an older person because of medical issues or disability. The use of videoconferencing may provide a way to link a specialist with a patient without the need for the patient, or the specialist, to travel long distances. Two literature reviews were carried out. The initial review identified studies of the diagnosis of cognition via telemedicine. Thirty-two studies were identified which assessed cognition via telephone or video conference. The focus of the study was either the administration of a standardised cognitive assessment tool (n=30) or an unstructured comprehensive cognitive assessment interview (all via video conference) (n=2). The sample sizes were small but the levels of agreement were high, suggesting that further work in this area may identify that diagnosis of dementia via video conference is reliable. There has been limited work in the area of diagnostic agreement when a specialist is assessing a patient for the first time via video conference, even less work in the area of mental health assessment of older people. The second literature review identified 19 studies of diagnostic agreement using video conference with a sample size of 20 or more. The fields of research were: Dermatology (n=10); Mental Health (n=4); Minor Injuries (n=2); Neurology (n=2); and Rheumatology (n=1). Of the four studies in the area of mental health, one focused on the diagnosis of dementia with the publication of a protocol for assessing Alzheimer’s disease (AD) via video conference. The review highlighted that diagnosis via video conference in other medical fields had been shown to be reliable but that limited work was evident regarding the reliability of diagnosing dementia via video conference. A range of statistical analyses have been used to measure agreement in studies of diagnosis via VC. Overall Proportional Agreement (Po) and Cohen’s kappa (K) are the two most common calculations. There was little uniformity of reporting in the studies identified in the literature review. The variation in reporting made it difficult to compare results or provide data for a meta-analysis of similar studies. Consideration of the methods for analysing diagnostic agreement was undertaken using the approaches identified in the literature review as a starting point. The aim of this research was to identify if a diagnosis of the presence of dementia in an older adult by a specialist is reliable when the assessment interview occurs via video conference. A pilot study was carried out prior to the implementation of a National Health and Medical Research Council (NHMRC) funded multi-site project to test inter-rater agreement for the diagnosis of dementia and subsidiary questions. The candidate is a Chief Investigator (CI) on the NHMRC project grant and participated in writing the grant submission. A pilot study was completed for the purpose of refining the research protocol and establishing preliminary data for the calculation of sample size. A geriatrician carried out a cognitive assessment via video conference with the patient and the carer. The doctor had access to the patient’s chart and the results of a battery of standardised cognitive assessments administered face-to-face (FTF) by the clinic nurse earlier in the day. A second interview was carried out, face-to-face, by a second doctor on the same day. Inter-rater reliability was assessed between doctors. To place the level of agreement in context, inter-rater reliability between paired face-to-face assessments was also measured. Forty-two participants were divided into two groups: paired face-to-face assessments (FF, n=22) or paired video conference and face-to-face assessments (FV/VF, n=20). Twenty-two participants were male. Their average age was 70 years (SD=11.1, Range 50-90). The mean Standardised Mini-Mental State Examination (SMMSE) score was 23.93 (SD=5.42, Range 8-30)[1]. The outcome of agreement was measured using PO and Cohen’s K. FF group (PO=0.636; K=0.430, p=0.005) and the FV/VF group (PO=0.650; K=0.650, p=0.004) showed similar levels of agreement. The main study was a non-inferiority, prospective cohort study following a similar format as the pilot. Patients were randomised to two groups. The first group participated in two interviews; one via VC, the other was face-to-face (FV/VF). The second group was subjected to dual face-to-face assessments (FF). The video conference interview consisted of real-time video conference with the doctor interacting with both the carer and the patient. A battery of standardised assessments, a medical history, imaging and blood tests were prepared before hand and available to the doctor for use in the interview. One hundred and fifty-five participants were divided into two groups: paired face-to-face assessments (FF, n=73) or paired video conference and face-to-face assessments (FV or VF, n=82). Seventy-five of the participants were male. The average age was 76-years (SD=9, Range 54-95). The mean SMMSE was 23.8 (SD=4.4, Range 8-30). Overall proportional agreement (Po) and Weighted K were calculated as a measure of agreement for the presence of dementia. The FF group (Po=0.740; K=0.57, p<0.0001) and the FV/VF group (Po=0.780; K=0.64, p<0.0001) showed similar levels of agreement. Using the same study cohort, additional data were collected to identify the significance of the physical examination (PE) for diagnosing dementia. One of two doctors was allocated the task of completing a physical examination of the patient following initial assessment interview and after the diagnosis decisions had been recorded. Following the physical examination a second record of diagnosis decisions were recorded by the same doctor. The doctor was asked to identify if the diagnosis, formulation, treating options or additional investigations had altered as a result of the in-person physical examination. The physical examination supported clarity of the diagnosis particularly if a vascular element was involved. This dissertation provides evidence of the reliability of a diagnosis of dementia obtained via video conference. Furthermore, the work detailed in this dissertation represents the largest international study on assessing diagnostic accuracy of cognition and makes a significant contribution to the work in telemedicine in the area of mental health. This dissertation provides generalisations that can impact the use of video conference for diagnosis across a range of specialities, with the ultimate goal of improving access to specialist advice for people living in rural areas.

Background: The endeavour for more effective and personalised health care requires exploration and implementation of new methods. Digital technology solutions may offer increased accessibility and efficiency and have already been proven to be both time- and cost-effective. Increased knowledge of the use and experience of e-health tools among physiotherapists may lay the ground for further development. Objective: To explore and describe the usage and experiences among Swedish physiotherapists' regarding e-health tools and evaluate which are the most used technologies. Method: A digital survey translated with cross-cultural adaptation was sent out to physiotherapists in Sweden invited to participate through digital platforms. Data were descriptively analysed and presented in tables, box diagrams, and statistical analysis was performed in Jamovi with Fisher's exact test. Results: 111 physiotherapists responded to the digital survey, but only 72 completed all of it because of a technical error. One of the most common digital tools to use was technological communication where 70% used it for their patients. The attitudes towards digital tools were generally positive among the respondents, but about 20% was however neutral in their attitude. No significant relationship was found between the variables dependent on digital tools and professional experience (p = 0.61) or to workplace (p = 0.11), respectively. Conclusion: Swedish physiotherapists in this pilot study have a positive attitude towards digital health tools. However, different tools are used to different extents, and many physiotherapists do not consider themselves dependent on them in their professional life. Further investigation is needed about opinions and experiences in the field of e-health, as well as regarding advantages and disadvantages of digital tools for further development and implementation in the clinics. / Bakgrund: Strävan efter mer effektiv och personcentrerad sjukvård kräver kartläggning och implementering av nya metoder. Digitala lösningar kan erbjuda ökad tillgänglighet och effektivitet och har redan visat sig vara både tids- och kostnadseffektiva. Ökad kunskap om användning och erfarenhet av e- hälsoverktyg bland fysioterapeuter kan lägga grunden för vidare utveckling. Syfte: Att utforska och beskriva användning och erfarenheter av e-hälsoverktyg bland svenska fysioterapeuter, och vilka de mest använda verktygen är. Metod: En digital enkät översatt och med tillämpad kulturell anpassning skickades ut till fysioterapeuter i Sverige genom digitala plattformar. Data analyserades och presenterades i tabeller, stapeldiagram och statistisk analys utfördes i Jamovi version 1.6.23.0 med Fishers exakta test. Resultat: 111 fysioterapeuter besvarade den digitala enkäten, men endast 72 genomförde hela pga ett tekniskt fel. Ett av de mest använda digitala verktygen var teknologisk kommunikation, där 70 % använde den till sina patienter. Attityderna till digitala verktyg var generellt positiva bland respondenterna i undersökningen, men ett ungefär 20% var neutrala inom ämnet. Inget signifikant samband hittades mellan variablerna beroende av digitala verktyg och arbetslivserfarenhet (p = 0,61) eller arbetsplats (p = 0,11). Slutsats: Svenska fysioterapeuter i denna pilotstudie har en positiv inställning till digitala verktyg. Olika verktyg används dock i olika utsträckning och många anser inte sig vara beroende av dem i sitt verksamma yrkesliv. Fortsatt forskning behöver göras om åsikter och erfarenheter inom området e-hälsa, samt vad som är fördelar och nackdelar med digitala verktyg. Detta för att möjliggöra att de kan utvecklas vidare och bli mer implementerade i det kliniska arbetet.

Die Kommunikation mit den Kunden und insbesondere die Kundenberatung sind in Zeiten permanent hohen Drucks am Markt durch Mitbewerber wichtiges Marketinginstrument, mit dem die Kunden möglichst dauerhaft an das eigene Unternehmen gebunden werden können. Auslöser für die vorliegende Arbeit war die Idee zur Realisierung einer Kundenberatung mittels Videokonferenzsystemen im Jahr 2000 im Zusammenhang mit dem durch das Bundesministerium für Bildung und Forschung (BMBF) geförderte Forschungsprojekt „intermobil Region Dresden“. Durch diese Implementierung sollten Internet-Informations- und Vertriebssysteme durch eine Funktion der Individualberatung ergänzt werden und damit ein persönliches Beratungsgespräch möglichst realitätsnah abbilden. Da im B2C-Bereich die Echtzeitberatung über das Internet eine bis jetzt weitgehend ungenutzte Beratungsform ist, obwohl die dafür notwendigen Technologien schon seit Jahren zur Verfügung stehen, verspricht eine wissenschaftliche Untersuchung dieses Gegenstandes neuen Erkenntnisgewinn und ist gleichzeitig wichtigste Motivation für diese Arbeit. Hauptziel und somit grundlegende wissenschaftliche Fragestellung ist es zu untersuchen, ob synchrone Videokommunikation ein geeignetes Echtzeit-Beratungsmittel für die Kundenberatung (in diesem Zusammenhang als Videoberatung bezeichnet) sein kann. In der vorliegenden Arbeit werden über die Planung eines Video Call Centers und den damit verbundenen Modellbetrachtungen Einsatzszenarios für die Videoberatung entwickelt. In diese Entwicklung fließen die Ergebnisse aus der Einzelfallanalyse des implementierten Videoberatungssystems ein. Diese Ergebnisse werden auf Basis der durchgeführten Labor- und Feldforschung gewonnen. Die Wirksamkeit des analysierten Video Call Centers in Bezug auf die Kundenzufriedenheit wird abschließend durch eine Evaluation unterstrichen.

The Telemedical Assistance Service (TMAS) plays a vital role in medical care at sea by linking the medically responsible officers (MROs) on board with onshore physicians. This project aims to investigate telemedical providers’ perceptions of maritime health care quality today, as well as future potential improvements in this field. A qualitative methodology was chosen as its strength lies in focus on the processes – the people, situation and events that lead to certain outcomes. Semi-structured interviews with TMAS professional staff focused on current communication limitations, perceptions of overall care quality, and what developments, technological or otherwise, might improve healthcare at sea. Following interview transcription and coding against the aims, results with a good degree of consensus were as follows. Poor communication is clearly an issue. High speed data transmission would allow TMAS medical staff to directly observe and evaluate injured crew, and to direct MROs with greater certainty. A touchpad-based system to codify onboard pharmaceuticals was recommended. Standardised initial communication templates would save time and uncertainty and are congruent with how ship’s officers deal with many other situations. Given the difficulty MROs have with IV placement, a shift to intraosseous delivery was recommended. A smaller, more focused and integrated TMAS physician cohort in Sweden was suggested. Pulse oximeters, glucometers and defibrillators were seen as ‘must have’ items on board. Developments in point of care blood analysis, especially for detection of inflammation and infection, were seen as important to evaluate. As a general conclusion, progress could be made in improving onboard medical care via a collaboration between TMAS personnel, MROs, and maritime training staff. This would allow for dialogue on what changes to training and onboard equipment might be agreed now; what should be further evaluated; and a mechanism by which developments in communication, techniques, and portable analytic devices might be effectively implemented in the future. / Telemedical Assistance Service (TMAS) spelar en viktig roll i sjukvård till sjöss genom att sammanföra sjukvårdsansvariga sjöbefäl (MROs) med sjukvårdspersonal iland. Denna rapport syftar till att undersöka uppfattningar hos landbaserad personal i TMAS-funktionen angående dagens vårdkvalitet inom sjöfarten, samt potentiella förbättringar inom området. En kvalitativ metod valdes då denna lämpar sig väl med hänsyn till att den fokuserar på processerna, vilka inbegriper individer, situationer, och händelser som leder till vissa utfall. Semistrukturerade intervjuer med TMAS-personal inriktades på rådande begränsningar inom kommunikation, vårdkvalitet ombord, samt hur framtidens teknik kan förbättra sjukvård till sjöss. Efter intervjutranskribering och kodning mot tre huvudfrågor har resultat med en hög grad av samstämmighet utkristalliserats. Bristfällig kommunikation är ett uppenbart problem. Dataöverföring med hög hastighet skulle tillåta konsulterande läkare att själv observera och utvärdera skadade besättningsmedlemmar, samt att instruera MROs med högre noggrannhet. Ett system baserat på pekplattor för effektiviserad hantering av mediciner ombord rekommenderades. Standardiserade mallar som stöd för initial patientrapportering skulle spara tid och förebygga osäkerhet, och skulle ligga väl i linje med hur fartygsbefäl hanterar många andra situationer ombord. Mot bakgrund av ombordanställdas besvär med att sätta intravenösa infarter, rekommenderades en övergång från intravenös till intraosseös läkemedelsadministrering. En mindre och mer integrerad arbetsgrupp på TMAS-avdelningen i Sverige föreslogs. Syremättnadsmätare, glukosmätare, och defibrillatorer ansågs vara oumbärliga tillbehör ombord. Utrustning för patientnära blodanalys, i synnerhet för att upptäcka inflammation och infektion sågs som viktigt att utvärdera vidare. Sammanfattningsvis pekar resultaten mot att framsteg inom sjukvård till sjöss kan främjas genom samarbete mellan TMAS-personal, sjukvårdsansvariga ombord, och kursansvariga för sjöfartsutbildningar. Ett sådant samarbete skulle möjliggöra en dialog om vilka förändringar avseende utbildning och utrustning ombord som kan implementeras i dagsläget, och vilka som kräver vidare granskning. Det hade även utgjort ett forum för vad som kan realiseras i framtiden beträffande kommunikation, tillvägagångssätt, och portabla analysverktyg.

Die Kommunikation mit den Kunden und insbesondere die Kundenberatung sind in Zeiten permanent hohen Drucks am Markt durch Mitbewerber wichtiges Marketinginstrument, mit dem die Kunden möglichst dauerhaft an das eigene Unternehmen gebunden werden können. Auslöser für die vorliegende Arbeit war die Idee zur Realisierung einer Kundenberatung mittels Videokonferenzsystemen im Jahr 2000 im Zusammenhang mit dem durch das Bundesministerium für Bildung und Forschung (BMBF) geförderte Forschungsprojekt „intermobil Region Dresden“. Durch diese Implementierung sollten Internet-Informations- und Vertriebssysteme durch eine Funktion der Individualberatung ergänzt werden und damit ein persönliches Beratungsgespräch möglichst realitätsnah abbilden. Da im B2C-Bereich die Echtzeitberatung über das Internet eine bis jetzt weitgehend ungenutzte Beratungsform ist, obwohl die dafür notwendigen Technologien schon seit Jahren zur Verfügung stehen, verspricht eine wissenschaftliche Untersuchung dieses Gegenstandes neuen Erkenntnisgewinn und ist gleichzeitig wichtigste Motivation für diese Arbeit. Hauptziel und somit grundlegende wissenschaftliche Fragestellung ist es zu untersuchen, ob synchrone Videokommunikation ein geeignetes Echtzeit-Beratungsmittel für die Kundenberatung (in diesem Zusammenhang als Videoberatung bezeichnet) sein kann. In der vorliegenden Arbeit werden über die Planung eines Video Call Centers und den damit verbundenen Modellbetrachtungen Einsatzszenarios für die Videoberatung entwickelt. In diese Entwicklung fließen die Ergebnisse aus der Einzelfallanalyse des implementierten Videoberatungssystems ein. Diese Ergebnisse werden auf Basis der durchgeführten Labor- und Feldforschung gewonnen. Die Wirksamkeit des analysierten Video Call Centers in Bezug auf die Kundenzufriedenheit wird abschließend durch eine Evaluation unterstrichen.

Utvecklingen av digital vård sker i en snabb takt vilket bland annat informations- och kommunikationsteknik (IKT) och Covid-19 pandemin tillsammans ligger till grund för. Litteratur inom området lyfter att digital vård ökar arbetsbelastningen inom vården då det bland annat sätter högre krav på vårdpersonals tekniska kunskap och medicinska bedömning. Syftet med denna studie är att bidra med kunskap om vårdpersonals upplevelser av användningen av videosamtal i digitala patientmöten. Vi har använt en kvalitativ forskningsansats grundad i litteratur som behandlar digital vård där åtta semistrukturerade intervjuer med legitimerad vårdpersonal genomförts. I analysen av dessa åtta intervjuer framkom det fyra teman med tillhörande subteman, nämligen flexibilitet (individanpassad vård och digifysiskt arbetssätt), tillgänglighet (jämlik vård och tidsschema), effektivitet (arbetsbelastning och tid &amp; rum) och teknik (personlig inställning, användning av systemen och digital kvalitet). De fyra temana har delats in i tre kategorier av upplevelser: moraliskt ansvar, dynamisk tidsbalans och mottaglighet. Slutsatsen som denna studie drar är att vårdpersonal inte upplever att fysisk eller digital vård är optimal som solitär, utan att digifysisk vård är det mest gynnsamma alternativet för samhället i stort. Det vill säga för såväl individ i form av både patient och vårdpersonal som för organisationer. Studien bidrar därför med kunskapen om att digital och fysisk vård kompletterar varandra och att systemen bör sammanflätas för att en sådan kombination skulle vara optimal. / The development of digital healthcare is happening at a rapid pace which Information and Communication Technologies (ICT) along with the Covid-19 pandemic is the main reason for. Existing literature highlights that digital care increases the workload within health care because the demand and requirements on the healthcare workers technical knowledge and medical assessment is elevated. The purpose of the study is to contribute with knowledge of health care workers experiences in the use of video consultations in digital healthcare. This was done through a qualitative research approach based on existing litteratur where eight semi structured interviews with legitimised healthcare workers were performed. The analysis of the interviews resulted in four themes with sub themes, which were flexibility (individualised care and digiphysic work method), accessibility (equal care and time schedule), efficiency (workload and time &amp; space) and technology (personal attitude, use of systems and digital quality). The themes have been categorised into three categories of experiences: moral responsibility, dynamic time balance and receptiveness. In conclusion the health care workers do not experience either physical care or digital care to be optimal individually, but that a combination of the two would be the most favourable alternative for society as a whole. That is, for both the individual in the form of both patient and health care workers as well as health organisations. The study therefore contributes with the knowledge that digital and physical care complements each other and that the systems should be intertwined for such a combination to be possible and optimised.

Utvecklingen av digitala kontaktvägar har ökat inom primärvården i Sverige. Detta har lett till att antalet digitala vårdbesök har stigit där fler vårdgivare erbjuder möjligheten för patienter att söka vård digitalt. Telemedicin, medicinsk vård på distans, ökade under Covid-19-pandemin och har visat sig kan hjälpa med förkortning av vårdköer och minska spridning av virus, vilket kan minska belastningen på vården. Samtidigt visar forskning att kommunikation mellan patient och vårdpersonal försvåras vid videosamtal samt att videosamtal kan försvåra diagnossättning för vårdpersonal. Denna studie syftar till att genom åtta semi-strukturerade intervjuer med svenska allmänläkare vidare utforska deras upplevelser och attityder av hur digitala vårdbesök påverkar mötet och relationsbyggandet mellan läkare och patient samt hur det påverkar allmänläkares möjligheter till diagnossättning och upprätthållande av patientsekretess. Resultatet av de transkriberade intervjuerna visar att digitala patientmöten inte kan mäta sig med fysiska när läkare ska bygga en relation med nya patienter samt att fysiska patientmöten ger läkare mest information att använda sig av vid diagnossättning. Det framgår även att läkare upplever att de kan hantera och upprätthålla patientsekretessen vid digitala vårdbesök lika bra som vid fysiska vårdbesök och att den tillgänglighet som digitala patientmöten erbjuder kan användas som komplement till traditionella, fysiska möten. / The development of digital contact routes has increased within primary healthcare in Sweden. This has led to an increase in the number of digital healthcare visits, where more healthcare providers offer the opportunity for patients to seek healthcare digitally. Telemedicine, the provision of remote clinical services, increased during the Covid-19 pandemic and has been shown to help shorten healthcare waiting time and reduce the spread of viruses, which can reduce the burden on healthcare. Simultaneously, research shows that communication between patient and healthcare staff is made more difficult during video calls and that video calls can make diagnosis difficult for healthcare staff. This study aims to, through eight semi-structured interviews with Swedish general practitioners, further explore their experiences and attitudes of how digital healthcare visits affect the meeting and relationship building between doctor and patient, as well as how it affects general practitioners' opportunities for diagnosis and maintaining patient confidentiality. The results of the transcribed interviews show that digital patient meetings cannot measure up to physical ones when doctors have to build a relationship with new patients and that physical patient meetings give doctors the most information to use when making a diagnosis. It also appears that doctors feel that they can manage and maintain patient confidentiality during digital healthcare visits as well as during physical healthcare visits and that the accessibility that digital patient meetings offer can be used as a supplement to traditional, physical meetings.

Hintergrund: Die Digitalisierung der Patientendokumentation und die Einführung der elektronischen Patientenakte (ePA) stellen den klinischen Alltag vor große Herausforderungen. - Fragestellung:Wir untersuchten die Akzeptanz und den Stand der Digitalisierung von Patientendaten sowie die Einführung der ePA bei den deutschen Urologen. Material und Methoden: Nach einem iterativen Entwicklungsprozess erhielten wir einen Fragebogenmit 30 Items,welcher über den Forschungsnewsletter der Deutschen Gesellschaft für Urologie e.V. versendet wurde. - Ergebnisse: Insgesamt beantworteten 80 Urologen den Fragebogen (Rücklaufquote 2%). Digitale Plattformen wie Urotube oder Researchgate wurden von 63% der Teilnehmer verwendet. Die komplette Einführung der digitalen Patientendokumentation erfolgte bei 72% der ambulant Tätigen und bei 54% der in der Klinik Tätigen (p= 0,042). 76%der Befragten sahen den Digitalisierungsprozess als sinnvoll an. 34% äußerten teilweise oder starke Bedenken bzgl. einer kompletten Digitalisierung der Patientendokumentation. Nur 14% der Teilnehmer haben eine Videosprechstunde angeboten. Als Vorteile für die ePA wurden u. a. die bessere Vernetzung des Gesundheitswesens 73%), die Verbesserung der Diagnose, der Indikations- (41%) und der Behandlungsqualität (48%) sowie die Vermeidung von Fehlmedikation (70%) gesehen. - Schlussfolgerung: Die deutschen Urologen stehen der Digitalisierung der Patientendokumentation und der ePA insgesamt offen gegenüber. Insbesondere jüngere Urologen nutzen digitale Medien. Die Vorteile der Digitalisierung sind insbesondere eine Verbesserung der Behandlungsabläufe. Für eine reibungslose Einführung sind eine bereichsübergreifende Etablierung und ggf. eine Anpassung der Behandlungsprozesse notwendig.

I takt med digitalisering och IKTs (informations- och kommunikationsteknik) framväxt skapas nya vårdlösningar för både patienter och vårdgivare. Under Covid-19 pandemin har behovet för alternativa vårdlösningar lett till en ökad användning av digitala vårdtjänster som MinDoktor, Kry och 1177s vårdapp. Dessa digitala vårdtjänster har erbjudit patienter vård på distans då fysiska vårdcentraler inte varit ett lättillgängligt alternativ. Syftet med studien är att undersöka vad som krävs för att patienter ska uppleva digitala vårdtjänster som förtroendeskapande och -stärkande. En studie med elva medverkande respondenter som använt sig av digitala vårdtjänster genomfördes. Empiri från intervjuerna analyserades och utvärderades för att möjliggöra en representation av de medverkande respondenternas åsikter. Studien bidrar med insikter till hur förtroende för digitala vårdtjänster kan skapas och stärkas för patienter genom tillgång till personlig kontakt, videomöten och företagsrykten. / With the continued growth of digitalization and ICT (Information and communicationtechnology) new healthcare solutions for both patients and healthcare providers have been made readily available. During the recent outbreak of the Covid-19 virus the necessity for digital healthcare options have been made apparent. Services such as MinDoktor, Kry and 1177’s healthcare app have all seen an increase in use. In this study we have conducted research on what patients on digital healthcare apps thought was necessary for them to create and strengthen trust for these applications. The study was conducted with eleven participating respondents who had previously used a digital healthcare app. The empirical data was then analyzed to enable a representation of the participants opinions and thoughts. This study contributes with insights on how trust for digital healthcare can be created and strengthenedfor patients through access to personal contact, video consultations and company reputation.