Finnish Journal of eHealth and eWelfare

Announcements and conferences

Pia Liljamo — 2024-04-11

DIGIDIA-project: Experiences of video-enabled receptions for prevention of type 2 diabetes

Elisa Airikkala — 2024-04-11

The time of the COVID-19 epidemic emphasized the need for the development and implementation of remote receptions and digital services, as preventive work was reduced, and people decreased their in-person visits in health care due to fear of infections. In 2020, the diagnoses of type 2 diabetes (T2D) decreased, despite the fact that diabetes is known to be increasing. DIGIDIA (Promoting Digital Skills in the Low Labour Market-Driven Diabetes Patients) project aimed to respond to this need. The project focused on developing digital health competence, health literacy, and practices that enable preparation for future unforeseen events.

The project recruited adults from Tampere who were at risk of T2D, had prediabetes, or recently received a diagnosis of type 2 diabetes (n=60). Participants were provided with a digital learning environment, workshops, and video-enabled receptions. This article presents the use of video reception and user experiences (n=52) in the project.

The participants appreciated all organized activities. All but one participant felt that video-enabled reception suited them well. The majority of participants (87%) expressed a desire for using video reception again in health care settings. However, it was pointed out that this form of telemedicine might not be suitable for everyone, and concerns about data security were also raised.

As a conclusion, citizens were ready to use video-enabled services in healthcare settings. The use of video receptions should be increased in the management of type 2 diabetes (T2D).

Balancing stakeholder interests and paradoxes in health data sharing within health ecosystems

Fan Wang — 2024-04-11

Personal health data sharing can facilitate value co-creation between multiple stakeholders, including individuals, public organisations, private companies, research institutes, and policymakers. Yet, when companies are involved in sharing health data to develop health-related solutions, it can lead to conflicts and contradictions between stakeholders. We apply a qualitative research approach over two cases in the Finnish healthcare sector to explore the tensions and contradictions in sharing personal health data that companies can utilise in the development of new products/or services in the healthcare sector. We identify the tensions and paradoxes from multiple stakeholders’ perspectives and provide management approaches on three levels: (I) The micro-level focusing on individuals as users, (II) The meso-level concerns businesses operating within the digital health ecosystem. (III) The macro-level addresses broader societal impact and policies governing the secondary use of health data.

Tailored 3D breast models for development of microwave based breast tumor screening

Mariella Särestöniemi — 2024-04-11

Portable breast monitoring devices, which could be used outside the hospital and even for self-monitoring of risk groups, are considered as promising eHealth applications for future telemedicine. Microwave technique is one of the most promising emerging techniques for portable monitoring devices since it enables low-cost, high accuracy, and user-friendly devices. The technique is based on detecting differences in radio channel responses since tumors have different dielectric properties than the breast glandular or fat tissues. Breast density categories affect the detectability of the tumors with also microwave technique. This paper presents a study on breast tumor detectability with different simulation and measurement models tailored to correspond different breast types. The simulations are carried out using electromagnetic simulation software with human voxel models as well as developed breast models. The evaluation results show that even small-sized breast tumors can be detected with microwave technique within all the breast density categories. Differences in channel responses caused by tumors are breast-type dependent. The results highlight the importance of developing extensive reference databank covering all the breast density categories for microwave-based breast tumor detection applications.

Telephone consultation as a sustainable method of service delivery in occupational medicine: results of a qualitative study

Abigail O'Reilly — 2024-04-11

Since the pandemic, telephone consultation is still widely used in Occupational medicine practice, but with a seemingly huge variety depending on the different occupational medicine departments and companies. Telephone consultation could be considered a sustainable alternative to face-to-face consultation in the long term. The aim of this research project was to start an evidence base for the opinions of Occupational Health Physicians (OHPs) regarding telephone consultation. This study also sought to gather further information on the perceived benefits and limitations of telephone consultation as per its current users (OHPs) and identify ways to improve the practice of telephone consultation.

This research project involved interviewing Occupational Health Physicians and analysing the data collected (using thematic analysis) so that the utility of telephone consultation as a means of consultation could be reviewed [12-16]. Semi-structured interviews were carried out with eighteen specialist occupational medicine physicians in Ireland. Data was initially coded and then organised into themes.

The main findings from this research project identified five themes: Quality of Care, Professional Standards, Barriers to Telephone Consultation, Optimal Use of telephone Consultation, and Potential Improvements and Useful Change for Telephone Consultation. Some of these themes have previously been identified in research from other medical specialities.

Upon consideration of the themes and subthemes identified in this study, telephone consultation could be used by Occupational Health Physicians as an adjunct to face-to-face consultations and in some cases as a direct alternative. Further research into this area with pilot studies or comparative trials will provide definitive answers as to the role of telephone consultation in occupational medicine into the future. Telephone consultation would appear to be a sustainable method of service delivery in occupational medicine. Clinical governance for telephone consultation in Ireland is currently lacking with no clinical guidance available specific for occupational medicine. If telephone consultation is to be considered a sustainable method of service delivery in Occupational medicine, a solid foundation of clinical guidance and governance will be required.

Co-creating a service ecosystem for supporting digitalization in health and welfare

Hannu Tikkanen — 2024-04-11

Health and welfare services are increasingly striving towards data-driven, digital and patient-centric approaches to service management and delivery. The growing digitalization and amount of eHealth services introduced are part of a sociotechnical change in health and social care, where different sectors collaborate in ecosystems.

This study focuses on ecosystemic collaboration in health and welfare and its potential in value creation, with a particular interest in how multistakeholder co-creation can be enabled and orchestrated. The study draws on research on service ecosystem design, open innovation and co-creation.

The aim of this study is to explore how service ecosystems are co-created by public, private and third-sector organizations in the health and welfare sector. To achieve this aim, our study has two research objectives. First, the study explores current ecosystemic practices in health and welfare. Second, the study identifies factors that affect these practices.

This study presents the findings of a qualitative study conducted in Finland in spring 2023 with key informants from the health and welfare sector. The study context revolves around a HEI that provides university level teaching in social and health care and adopts a problem-based pedagogy that is firmly grounded in working-life collaboration with cross-sectoral actors and professional practice in the field. The findings reveal different factors that have an effect on ecosystem collaboration.

The findings support the argument that working in ecosystems is beneficial and digitalization has been a key driver of innovation in the health care and welfare sector in Finland. Based on these findings, we discuss the potential of orchestrators, such as HEIs, to co-create service ecosystems that enable digitalization of health and welfare.

E-leadership in nursing – a systematic review

Vanesa Numanovic — 2024-04-11

Nurses and nurse leaders play a key role in healthcare digitalisation. While the volume of nursing leadership research has increased dramatically, empirical research on e-leadership in nursing remains limited. We believe this is the first systematic review of e-leadership among nurse leaders. Our purpose is to synthesise and describe existing research knowledge on e-leadership in nursing and to identify gaps in research knowledge.

We conducted a systematic literature review guided by the framework suggested by Holly et al. (2017). We searched the CINAHL, Scopus, Web of Science, PubMed, Business Source Premier and Medic databases. The search yielded 1,968 records. We excluded 656 duplicates and 1,125 records by reference to the title and read 187 abstracts. We read 51 full texts, resulting in 12 records; we screened the reference lists of each of those and detected one more relevant record.

The review includes 13 studies. Qualitative content analysis was utilised to analyse the data, leading to three main themes being identified: i) interpersonal relationships, ii) e-leadership and coping and iii) readiness for e-leadership and remote work. The main themes incorporated 12 sub-themes.

The paper concludes by presenting several practical implications for nurse leaders and their organisations. The findings indicate a readiness for e-leadership among nurse leaders and for remote work among employees. There are several advantages but also many disadvantages regarding e-leadership in nursing. Nurse leaders need sufficient training in e-leadership as digitalisation is progressing in healthcare.

The association of implementation time, skills, and education with registered nurses evaluation of a client information system and electronic health record

Maiju Kyytsönen — 2024-04-11

The electronic health records and client information systems have been under pressure for change in Finnish social welfare and healthcare which continues after the responsibility for organizing social welfare and healthcare services has been taken up by wellbeing service counties. From the perspective of the end-users, the decision to change the main electronic health record and client information system is big and therefore implementing new systems should be executed with care in organizations.

This study focussed on registered nurses’ evaluation of an electronic health record and client information system from the perspective of implementing a new system. The aim of the study was to establish using logistic regression analysis which factors related to background variables, competence, or training (at the workplace) are associated with a good grade given by registered nurses for the electronic health record and client information system and does the implementation time affect the possible detected associations. The study data was based on answers gotten to the Information System Survey of Registered Nurses in Spring 2023 given by 18 to 65-year-old registered nurses.

From the background variables working in inpatient ward of a health and social services centre, community nursing, home hospital, or housing services were associated with a good grade to the electronic health record and client information system. As far as the competence and training factors were concerned, registered nurses, who evaluated their experience as a user of electronic health record and client information system as still insufficient and who had insufficient documentation skills, gave a good grade more rarely. A good grade was also more rarely given by registered nurses who did not think that the support of their colleagues increases their competence as a system user. The implementation time of the electronic health record and client information system affected registered nurses’ evaluation of their primary electronic health record and client information system. When an electronic health record and client information system had been implemented within the last 12 months compared to that the implementation had occurred at least a year ago, the significance of the working environment, experience as a system user, and continuous training were highlighted.

Organizing continuous training can therefore be considered as recommendable so that the electronic health records and client information systems can be harnessed to support the work of registered nurses and good care of clients. After the implementation there is also reason to follow registered nurses’ self-evaluated competence level in documenting into electronic health records and client information systems and generally as system users.

The use of digital occupational health services among employer customers: A cross-sectional study

Erja Sormunen — 2024-04-11

Occupational health (OH) service providers, together with their client organizations co-operate in promoting health and work ability. Alongside with the so-called traditional services, more and more digital services are offered by OH service providers. However, little is known how the employer customers experience and use digital OH services.

This study evaluates the types of digital OH services employer customers use and how they assess the usefulness and ease of use of these digital services. Furthermore, the aim is to find out factors associated the usefulness and ease of use. To determine these features of usefulness and ease of use of digital services the Technology Acceptance Model was utilized. A cross-sectional, electronic survey was carried out to the members of human resources (HR) and entrepreneur associations between December 2022 and January 2023. The survey was in Finnish. The research material consisted of the employer customers’ answers to the multiple-choice questions of the use, usefulness and ease of use of digital OH services. The data was analyzed by quantitative statistical analysis.

A total of 455 respondents took part in the study, comprising 198 representatives of HR professionals and 257 entrepreneurs. Most of the respondents were women (65%) and over 50 years old (61%). HR professionals rated their information and communications technology skills significantly more often good or really good compared to the entrepreneurs, being 92 % and 62 %, respectively. The most frequently utilized digital OH services were the ability to update personnel’s information in the OH patient registry (48.0%) and remote action plan negotiations (37.1%). Less than one-third of the respondents (29.9%) took part in remote work ability negotiations, while approximately one-fifth (20.8%) participated in remote workplace surveys. In general, the HR professionals used digital OH services more frequently and estimate the usefulness and the use of digital OH services more positively compared to the entrepreneurs (p<0.05).

The study produced new information of the use and experiences of using digital OH services among the employer customers. The findings can be used to optimize the delivery and effectiveness of digital OH services for all employer customers, especially for the entrepreneurs who seemed be less used to utilize digital services.

Professionals – developers of digital social and healthcare

Pirkko Kouri — 2024-04-11