Finnish Journal of eHealth and eWelfare

Lectio praecursoria, Terveystietojen vaihdon asiakas- ja potilasturvallisuus ja siihen liittyvät tekijät

2024-12-16T12:28:45+02:00

Lectio praecursoria, Innovaatiotoiminnan johtaminen julkisessa yliopistollisessa sairaalassa: ominaispiirteet, vaatimukset ja vaikuttavat tekijät

2024-12-18T16:54:01+02:00

Conferences and events

2024-12-22T13:41:08+02:00

Health professionals’ experiences of group-based cardiac telerehabilitation: A descriptive qualitative study

2024-08-25T14:12:13+03:00

It is estimated that 200 million people worldwide live with coronary artery disease (CAD). Secondary prevention for CAD patients is supported by strong evidence. Group-based cardiac telerehabilitation supervised by health professionals is a type of rehabilitation program that utilizes technologies to deliver rehabilitation services to many patients with CAD. This descriptive qualitative study aims to describe healthcare professionals’ experiences of group-based cardiac telerehabilitation. A purposive sample of healthcare professionals providing group-based cardiac telerehabilitation was interviewed (N=10) from October 2023 to January 2024. The interviews were audio-recorded, translated verbatim and analysed with inductive content analysis. The results were reported according to the Standards for Reporting Qualitative Research- guideline (SRQR). The analysis resulted in six main categories: professional practices and factors contributing to the practices, digital practices in telerehabilitation, manifestations of support in a group telerehabilitation, counselling on self-care engagement in telerehabilitation, manifestations of interaction in a group telerehabilitation and telerehabilitation as an enabler of follow-up care for patients with CAD. According to the health professionals’ experiences, telerehabilitation improves the availability of rehabilitation, creates opportunities for support and peer interactions among rehabilitees, and enhances the accessibility of coronary disease treatment and follow-up care. Given positive experiences, group-based cardiac rehabilitation should be further developed and its availability should be improved.

Telerehabilitation applications could solve the barriers of meaningful rehabilitee pathways in early stage of Multiple Sclerosis – A case study

2024-08-15T10:12:33+03:00

Multiple Sclerosis (MS) is a neurological disease affecting particularly the working age population. The prevalence of MS in Finland is one of the highest in the world. Finnish social, health care and rehabilitation services providers need to solve many complex challenges, for example, how to increase the cost-effectiveness of the services, simultaneously meeting the essential needs of rehabilitees. Physiotherapy is one of the most common rehabilitation modalities for rehabilitees with MS. Telerehabilitation as a novel mode of physiotherapy has been recognized in Finland, but its applicability for successful physiotherapy remains unclear.
This study is part of an interdisciplinary project conducted at the University of Jyväskylä, Finland. The goal of the project has been to develop a tentative prototype application of telerehabilitation for early stage MS rehabilitees. Information search was conducted to proof of concept of the telerehabilitation applications. Professional’s consultations were conducted to understand the applicability and usability of our application. In addition, the application development principles for our development purposes were discussed.
In this study we report the idea of the developed telerehabilitation application as a product of a multi-professional development process. Findings of this study highlights the importance of critical and open reflection at every stage of any application development work to support interdisciplinary product development, cocreation process, as well as research, development and innovation (RDI) activities at various organizations.

Realisation of the goals of digitalisation in disability work: Analysis of the importance of work environment and professionals’ educational background

2024-02-22T08:12:02+02:00

Digitalisation can have significant impacts on services for people with disabilities, where issues of adequacy and timeliness have been observed. To provide an overview of the current state of digitalisation, this study examined the realisation of digitalisation goals in disability work as experienced by professionals. It also examined the associations of work environment factors guiding digitalisation and professionals’ educational background with this realisation to identify opportunities for advancing digitalisation in the disability sector. Multivariable multinomial logistic regression analyses were performed on survey data collected from professionals (N=697) working with people with disabilities in spring 2022. Most respondents felt that digitalisation goals related to information access, progress in service processes, work timeliness, and client agency were not met. Higher education was associated with perceiving the goal of enhanced client agency as achieved, suggesting a need to expand disability work education in secondary schools to promote digital services for clients. The perception of achieving the goal related to timely work was promoted by adequate resourcing for orientation to digital work and digital tools in the workplace, as well as by effective practices in immediate leadership and the work community’s positive attitude towards digital services. Fostering a digital-friendly organisational culture is crucial for providing equitable disability services and adapting to growing digitalisation at work.

School nurses’ evaluations of their competence in counseling adolescents on physical activity and the use of digital technology: a cross-sectional study

2024-09-29T11:23:31+03:00

Most adolescents are insufficiently physically active and technology use has become a crucial part of people's lives. School nurses have a key role in health promotion. The purpose of this study was to determine the associations between school nurses’ lifestyle counseling competence (specifically, their competence in counseling students on physical activity and technology use) and various potentially related factors (including the background of the nurses, the time spent on counseling during a working day, and the nurse’s education on physical activity and technology use). To our best knowledge, there is no up-to-date information about school nurses’ counseling concerning physical activity and technology use. A cross-sectional study design was used. Data were gathered by surveying nurses working in school or student healthcare (n = 116) in Finland during the autumn of 2017. The data were analyzed using descriptive statistics, non-parametric tests, and logistic regression analysis. The survey included one open-ended question which was analyzed by performing inductive content analysis. Over half (58.6%) of respondents assessed that the competence in physical activity and technology use counseling is overall good. 85.3% of the respondents evaluated their physical activity counseling skills and 62.9% technology use counseling skills to be good. Only 33% of the nurses knew how to identify adolescents needing counseling concerning technology use. Education on physical activity and recreational technology use was more relevant than age in explaining nurses' counseling knowledge and skills. School nurses reported that there is a need to develop skills and tools for counseling adolescents about the recreational use of technology. The results highlighted three factors which limited the development of couseling; a lack of resources; a need for more education; and a lack of clear, consistent policies and tools for adolescents’ lifestyle counseling. There is also a need for more multi-professional cooperation and time for counseling. The results presented herein could be used in designing targeted interventions and education in school and student healthcare and with it to improve the lifestyle counseling offered by school nurses.

Insights into digital guidance: Reliability of self-assessment in youth-oriented Zekki Service

2024-08-26T20:59:18+03:00

This study's practical objective was to determine the reliability and feasibility of the service guidance based on the Traffic Light model used in the Zekki digital service. The equivalence between the numerical answers to the 3X10D Survey questions in Zekki and the young people's life situations was studied, revealing how well the Traffic Light model defined by the researchers matched the respondents' views.
The equivalence of people's descriptions of their life situations was compared to their given quantitative assessments (N = 185). Based on written descriptions, the researcher classified each answer as a number. Equivalence was evaluated by cross-tabulating the researchers' and survey respondents' assessments of their life situations and testing the results with a chi-squared test.
The respondents' assessments of satisfaction with different life spheres were compared with those made by the researchers, who read the written descriptions. Overall, the respondents' numerical assessments were slightly more positive than the researchers' assessments. However, two-thirds of the researchers' and respondents' assessments matched exactly within the same Traffic Light category. The assessments differed by no more than one category in about one-third of the cases. Only 3.5% of the assessments were considered completely incorrect.
The 3X10D Survey produces numerical information strongly connected to a respondent's real life, making it a reliable basis for digital service guidance. The Zekki digital service recommends appropriate support for those in need. Based on these findings, other user-oriented digital service guidance platforms can be developed.

Asukaskehittäjien digitaalisten sosiaali- ja terveyspalveluiden käyttö – poikkileikkaustutkimus eräältä Suomen hyvinvointialueelta

2024-08-15T10:19:45+03:00

Digitalization is a key strategy to ensure the availability and quality of healthcare and social welfare services. There is a need for knowledge about how digital services are actually used. This study reports the findings of a survey on resident developers’ use and experiences of digital services in a mid-sized wellbeing services county in Finland.
This cross-sectional study utilized as secondary data an online questionnaire with both fixed and open-ended questions, distributed via email to 310 resident developers, with a response rate of 30% (n=92) in August-September 2023. Quantitative data were analyzed using SPSS 27, while open-ended responses were examined through thematic analysis.
A significant majority (84%) of respondents had used digital services, with 63% having digitally interacted with a healthcare professional. However, newer digital services such as chat, chatbots, and remote appointments were utilized by only 4–13% of respondents. Additionally, 24% of respondents still preferred using the phone for initial contact when facing a new service need. Nearly half (45%) of the respondents requested more user-friendly digital services, and 24% desired an increase in the availability of such services. The primary reason for not using digital services was the lack of services meeting the respondents’ needs (29%). A positive correlation was found between the perceived benefits of digital services and the frequency and diversity of their use.
Compared to general population surveys, resident developers were active users of digital healthcare and social welfare services, though newer digital services were infrequently used. There remain unmet needs for the development of digital services, particularly in terms of their findability, discoverability, and usability. Based on these findings, recommendations are provided for the development of digital services in wellbeing service counties, emphasizing the importance of value co-creation with residents to maximize the benefits of digitalization.

Finnish national patient data repository as data source for FINRISK risk calculator

2024-08-09T08:48:29+03:00

The FINRISK risk calculator is a tool for the evaluation of the 10-year risk of cardiovascular diseases (CVDs). It is based on a Finnish population survey and is frequently used in Finnish healthcare. Currently, risks are calculated manually by inputting the required values. An alternative source of input values could be the Finnish Kanta Patient Data Repository (PDR). Risk calculation based on the Kanta PDR could enable monitoring of predicted CVD risks at the level of the Finnish population and targeting of preventive healthcare to high-risk individuals.
The goal of this study is to assess if the FINRISK risk calculator can be made to work effectively using only structured data available in the Kanta PDR. We approach the issue from two perspectives. The first is the availability of individual inputs, and the second is the ability to categorize people to risk categories used in healthcare.
The study was based on patient histories of roughly 60 000 persons who met the inclusion and exclusion criteria of the FINRISK risk calculator. The data had been recorded into the Kanta PDR between January 2014 and June 2022. To enable risk calculation even when individual input values are missing, we calculated a minimum and maximum risk for each person based on data that was available at a prediction time point. Risks were predicted at seven different time points between the years 2016 and 2022 to analyse the development of categorization performance over the years.
The highest categorization performance was achieved for the year 2022, where we were able to identify the FINRISK risk category of 1.69% of persons. With additional categories for low or moderate and moderate or high risk, 4.15% of persons could be categorized. The risk level of the remaining 95.85% of individuals could not be specified. The reason behind the poor performance was the inadequacy of input values. Namely, family history of CVDs was not available in structured format and smoking information was rarely found. Information about blood pressure, blood cholesterol, and diabetes were more frequent.
We conclude that population level risk assessment is not viable based on only the structured data in the Kanta PDR. Extracting inputs like smoking status from text data could improve the situation. As the FINRISK risk calculator is often used by inputting structured data into an electronic form, the lack of same inputs in the Kanta PDR highlights incomplete flow of data in the Finnish health data infrastructure.

Charting the course: Insights into EMR usability from Australian clinicians – A national survey

2024-08-26T21:21:04+03:00

Electronic Medical Record Systems (EMRs) are integral to the work of nursing, medical and allied health professionals in Australia and other countries. Successful adoption of EMR systems is reliant upon their usability and effective use. Usability issues impact safety and quality, workflow, communication, and collaboration.
The objective of the study was to measure clinician (nurse, medical and allied health professionals) experience of EMR usability in Australia.
We conducted an observational study using a validated, cross-sectional survey, the National Usability-focused Health Information System Scale (NuHISS). Thirteen usability statements collect clinician impressions of EMRs related to ease of use, benefits and collaboration and technical quality. This paper presents responses of Australian clinicians using EMRs in primary care, hospitals and public and private sectors.
In 2023, 534 health professionals from Australia submitted valid survey responses. The largest respondent group comprised nurses and midwives, working in publicly funded hospitals and having over three years of experience with the EMR mainly used. A majority (69%) agreed that the EMR system is stable and does not crash and 62% felt that the system responds quickly to inputs. Regarding ease of use of the EMR, 50% disagreed that the arrangement of fields and functions is logical, while 58% found the terminology clear and understandable. Sixty-two percent (62%) disagreed that routine tasks can be performed without extra steps, and 65% felt that significant training to learn the EMR is required. Although 63% agreed it is easy to obtain necessary patient information, 45% disagreed that entering and documenting data is quick and smooth. There were mixed responses regarding the EMR system's role in preventing medication errors, with 50% agreeing that it helps prevent errors and 27% disagreeing. There was agreement (74%) that the EMR system supports collaboration and information sharing within the same health service. Respectively, 51% and 47% disagreed regarding support of their EMR for collaboration between different health services and between clinicians and patients.
We highlight the importance of understanding clinicians’ experiences with EMR usability. Our findings suggest areas where EMR usability can be strengthened to enhance user experience and support clinicians in delivering high quality, safe care. The study’s findings provide valuable insights for EMR system developers, vendors, and healthcare organisations, emphasising the need to improve usability to realise the full benefits of EMRs and support a digitally enabled healthcare system. Addressing these issues through targeted interventions is essential to enhance clinician satisfaction with the EMRs used, reduce burnout and improve patient care.

15 vuotta terveys- ja sosiaalialan sähköisen tiedonhallinnan erikoislehtenä

2024-12-30T14:19:02+02:00