Finnish Journal of eHealth and eWelfare

Uudistuva tieto – kehittyvät teknologiat

Juha Mykkänen — 2025-05-05

User experiences of a mobile hospital clowning application: User-based evaluation with hospitalized children

Eira Erola — 2025-05-05

When developing digital health (eHealth) services targeted for pediatric patients, it is important to consider the needs and experiences of children as the end-users of the applications. However, hospitalized pediatric patients constitute a unique and vulnerable user group, and involving them in user-based evaluation studies presents specific challenges. Our aim was to study hospitalized pediatric patients’ user experience (UX) of a recently launched mobile hospital clowning application and to increase understanding of challenges related to studies with this special user group. Thus, we designed and conducted a user-based evaluation study with pediatric patients. The study data was gathered using remote interviews (n=3 participants) and an online questionnaire (n=6 respondents) in spring 2023.
Based on the initial evaluation findings, the participants had positive UX with the application and found it easy to use. However, technical difficulties and improvement requests, particularly regarding the child-clown messaging and communication features, were also identified. Based on the reported study, our key learnings and recommendations for conducting user-based evaluations with hospitalized pediatric patients include: careful planning of ethical approval and a research permit for a non-medical study, employing multiple approaches for recruiting participants, adjusting research methods to suit for children, pilot testing the methods, and involving parents to help and assist the child participants.
Despite challenges in study set-up, our evaluation resulted in usability and UX findings as well as areas for development for the hospital clowning application. This indicates that valuable insights on UX can emerge even from a small number of pediatric patients. Future work should focus on establishing sound practices for involving hospitalized pediatric patients in user-based evaluations of digital services and enhancing collaboration between researchers and children’s hospitals.

Kuntoutuksen ammattihenkilöiden huolet digitaalisessa asiakastyössä

Venla Karikumpu — 2025-05-05

The use of digital services in rehabilitation is expanding within the social and healthcare service system alongside national strategies. The increased digital client work imposes new requirements on clients and rehabilitation professionals. Therefore, more information is needed about the role of digital services in rehabilitation. Timely and pathway-integrated digital services can achieve multiple benefits. The purpose of this qualitative study was to investigate the concerns experienced by rehabilitation professionals regarding digital client work.
The expert informants in the study were rehabilitation professionals at the Wellbeing Services County of North Savo. The data consisted of responses to an open-ended question about concerns related to digital client work, which was included in an information system survey. The electronic survey was open from December 2024 to January 2025, and 61 rehabilitation professionals responded to the open-ended question. The analysis was carried out using data-driven content analysis. Four unifying categories were formed from the analysed simplified expressions (n=162), each containing 3–4 main classes.
The results indicate that rehabilitation professionals have concerns about digital client work. The concerns identified in the results related to technology and devices, digitally conducted assessment, the implementation of digital rehabilitation work, and user-related issues reflect the specific characteristics of rehabilitation work. Healthcare organizations should particularly consider the difficulties in assessing clients’ functional capacity and the interaction in digital rehabilitation services. The best way to achieve this is by involving rehabilitation professionals in developing digital services and digital client work, ensuring that the services are targeted at situations where they provide benefits.

The secondary use of the Finnish national health data repository Kanta – opportunities and obstacles

Emmi Eronen — 2025-05-05

The Finnish law about the secondary use of health data has made it possible to use also the data in the Kanta national health and social welfare data repository, the Kanta Services for secondary purposes such as scientific research, innovation and development, education, statistics and information management. The Kanta Services contain also a personal health record data repository, the Kanta PHR. The large amount of health data in the Kanta Services makes it an interesting source for various secondary purposes.
This paper studies the opportunities, but also obstacles to the secondary use of Kanta data. The study focuses on two use cases, the Kanta PHR data use and the Patient Data Repository use for disease risk predictor development. The topic is studied by analysing laws, Kanta system documents, scientific literature, current discussions of the topic in public and three expert interviews. The literature search analysed for relevance all articles with keyword Kanta in the Finnish Journal of eHealth and eWelfare since year 2024 and also other scientific literature discussing Kanta Services and secondary use.
The result of the Kanta PHR use case study was that although the EU General Data Protection Regulation would allow the secondary use of the Kanta PHR data based on consent, the current Kanta Services applications do not support this at all. Disease risk predictor development is possible with Kanta patient data repository data in scientific research, but innovation and development activities face administrative difficulties because only aggregated Kanta data is allowed to use for these purposes. Information management can make use of aggregated Kanta Services data and it can be used for benchmarking the quality of a health delivery unit to other similar units in Finland.
While protecting the privacy of the individuals’ data in the Kanta Services, improvements to the secondary use law are suggested. These include the easier access to non-aggregated health data for research and development, possibilities to individuals to consent the secondary use of their Kanta PHR data and allowing the use of risk calculations for automatically inviting persons at risk to health check-ups. It is also recommended that lessons are learned from the Finnish secondary use law and the European Union European Health Data Space law allows more flexible use of health data for secondary purposes from those individuals that allow it.

Walking detection for Parkinson’s disease patients and healthy control subjects measured with a smartphone accelerometer using mean amplitude deviation algorithm

Milla Juutinen — 2025-05-05

Parkinson's disease is a neurodegenerative disorder that affects mobility, leading to a decline in the patient's quality of life. Analyzing gait for these patients aims to improve the mobility of the Parkinson’s disease patients. The goal of this study was to validate mean amplitude deviation for detecting gait in Parkinson’s disease patients and healthy controls. This method is robust and orientation-independent and has accurate results on physical activity detection for different study populations. The novelty of this study is to use and evaluate a previously validated method with Parkinson’s disease patients instead of healthy young subjects as in earlier studies. We utilized inertial measurement unit data measured using smartphones from pre-existing datasets with pre-defined and labeled activities and free-living data containing continuously collected over three consecutive days. One dataset included 30 healthy adults, and the other two included in total of 62 and 68 Parkinson’s disease patients and 40 and 39 healthy controls, respectively. The sensitivity of the algorithm in a controlled measurement setting was 100% and 98.7% for healthy adults and a combined dataset of Parkinson’s disease patients and control subjects, respectively. Correspondingly, the specificity was 74.9% and 81.6%. Visual inspection of the free-living data showed that the algorithm provided durations and timings of walking activities, and walking took place during the daytime as anticipated for subjects with a typical daily rhythm. Median walking times were under ten minutes per hour. The results reached the same performance range as earlier studies with an orientation-independent approach, justifying the feasibility of this method. Therefore, this study validated the use of mean amplitude deviation for walking detection in Parkinson’s disease patients and healthy adults. Future research will utilize the detected walking segments in analyzing the motor symptoms of the disease aiming to improve patient well-being through identifying the needs for additional healthcare interventions.

Kohti parempaa käyttäjäkokemusta: pre- ja kotidialyysihoidon sähköisten ratkaisujen käyttäjäkeskeinen suunnittelu

Johanna Viitanen — 2025-05-05

Terveydenhuollon sähköisiä palveluita suunniteltaessa haasteena on huomioida palvelujen käytettävyyden ja käyttäjäkokemuksen suunnittelussa sekä ammattilaiset että potilaat. Tässä hanke-esittelyssä kuvataan "Käyttäjäkeskeinen suunnittelu ja potilaskokemus" -tutkimushanke, jossa tavoitteena on selvittää, miten sähköisten palvelujen avulla voidaan parantaa kotidialyysipotilaiden potilaskokemuksia ja helpottaa heitä hoitavien ammattilaisten työtä hoidon eri vaiheissa. Tutkimuksessa keskitytään palvelujen käytettävyyteen ja käyttäjäkokemukseen. Tutkimus on osa laajempaa Suomen Akatemian rahoittamaa ”Parempaa hoitoa kotona – optimoitu ihmiskeskeinen predialyysi- ja kotidialyysihoito” -hanketta (2022-2026), joka on jatkoa aiemmalle eCare4Me-projektille. Tutkimus sisältää kolme työpakettia ja tutkimuksessa hyödynnetään potilaskokemusten tutkimiseen, sähköisten palveluiden käytettävyyden arviointiin ja yhteissuunnittelun soveltuvia käyttäjäkeskeisen suunnittelun menetelmiä. Tavoitteena on kehittää uusia menetelmiä sähköisen palvelukokonaisuuden kuvaamiseen suunnittelutyön tueksi, sekä kuvata suunnitteluohjeita sähköisten terveyspalvelujen suunnitteluun ja suosituksia kotidialyysihoitoa tukevien palvelujen räätälöimiseksi eri käyttäjäryhmien tarpeisiin.

Skilled knowledge formation and innovative technologies in social and health care – a socio-technical systems perspective

Samuel Salovaara — 2025-05-05

Advancing information management in social and health care requires theoretical frameworks that integrate the examination of technology, expertise, and organizational context. This article explores the utilization of innovative technologies, such as artificial intelligence, in social and health care information management from the perspective of socio-technical systems theory. In socio-technical systems theory, the social and technical elements of an organization form a unified systemic whole, where knowledge formation is based on both technology and human expertise.
In a sociotechnical system knowledge formation extends beyond the technical collection and management of information; it also involves the meaningful interpretation and utilization of information through collaboration between people and technology. Consequently, technology supports professionals' critical evaluation and decision-making without mechanically directing their actions. The exchange of information among different professional groups and interdisciplinary collaboration enable the structured formation of shared interpretations, thereby supporting high-quality and client-centered service delivery. Ethical and transparent knowledge formation, on the other hand, requires acknowledging clients' experiences and reinforcing their participation. User-centered and agile design ensures the practical functionality of technology.
Effective knowledge formation necessitates a shift in thinking, where professionals are not viewed as machine-like components serving technology but as skilled experts whose human capabilities and professional competence are strategically utilized. Applying socio-technical systems theory to information management in social and health care integrates the potential of technology, human expertise, and organizational culture into flexible, ethical, and client-oriented decision-making. This represents a dynamic and multidimensional process in which technology, professional competence, and client participation form a cohesive whole that supports the objectives of the service system and well-being of the professionals.

Safety of the use of digital services and technology - Project description

Heli Kumpulainen — 2025-05-05

Due to rapid technological advances, digital technology and services have changed the way that health care consumers and providers communicate and receive and deliver care. Further, they play a significant role in ensuring the quality and accessibility of social and health care services. Digital technology and services in social and healthcare context cover various methods, such as telemedicine and eHealth interventions, mobile health applications and remote monitoring devices. However, their implementation and use also presents unexpected challenges and risks that need to be identified to ensure proper implementation of client and patient safety and to eliminate avoidable harm. As safety in social and healthcare context is the product of many interrelated parts that change over time, efforts to improve safety should be targeted to evolve and identify emerging and unexpected challenges and risks.
By analyzing the incident reports, it is possible to identify underlying factors and generate actionable knowledge to mitigate risks. Further, the data they provide enable researchers to categorize, and analyze it for quality improvement, care enhancement and development of patient safety supportive practices in a timely manner. Therefore, it is essential to utilize the information produced by incident reports of digital technology and services to identify the risks and preventive measures related to them.

Harmonised standards to the AI Act – for medical devices, too

Alpo Olavi Värri — 2025-05-05

The European Union artificial intelligence act (AI Act) establishes the rules for the application of artificial intelligence (AI) systems within the European Union. The AI Act is to be complemented with the harmonised standards that provide the presumption of conformity to the AI Act if implemented fully in the organisation that provides the AI system. The joint technical committee 21 (JTC 21) of CEN and CENELEC has been assigned the responsibility to prepare these standards. Work is under way to develop standards for AI risk management, AI cybersecurity, AI quality management, Quality and governance of datasets in AI, AI trustworthiness framework and AI conformity assessment. As medical devices incorporating an AI component are also within scope of the AI Act, these standards apply to medical devices, too. For this reason, medical device experts need to contribute to the AI standardisation work so that the resulting standards will be feasible in the health sector. The challenge in the work is to make several standards good and compatible with each other in the presence of a plurality of opinions and a hurry to produce the standards in time.

Development of self-rehabilitation technology as a interdisciplinary multi-method study

Sanna Laine — 2025-05-05

The Personalized Human Dignity centered Rehabilitation (HuDiRe) -framework has been designed with a foundation in research to acknowledge and uphold human dignity and the importance of a meaningful life. This framework originated from systematic literature reviews and metasynthesis of physiotherapy experiences shared by individuals undergoing rehabilitation for stroke and Multiple sclerosis. Over time, it has been further enhanced to include not only the key elements essential to rehabilitation but also the prerequisites for effective self-rehabilitation technology. Built upon this framework, the self-rehabilitation model is versatile, and it can be applied to both in-person rehabilitation sessions and remote self-rehabilitation, leveraging various technological solutions. The unique value of this model lies in its ability to spotlight meaningful aspects of the rehabilitation journey from the perspective of the individual in rehabilitation. Collaboration with IT-professionals enables the development of self-rehabilitation technology model on the HuDiRe-framework, considering the user experiences of different end users.

Quality of recording has an impact on the quality and safety of care

Ulla-Mari Kinnunen — 2025-05-05

Nursing documentation is an essential part of nursing and necessary to ensure safe and high-quality care. It ensures that patient care information is up-to-date and accessible to all members of the healthcare team, guaranteeing continuity of care. The information produced in patient records about events during patient care serves as legal documents that protect both patients and healthcare staff. Additionally, documentation allows for monitoring the patient's condition and the progress of care, helping to make informed care decisions and improve the quality of care and patient safety.
The national nursing documentation model consists of key structured nursing data elements (nursing diagnosis, interventions and outcomes, nursing care intensity, and nursing summary), the nursing process, and the Finnish Care Classification (FinCC). By documenting nursing according to the national nursing documentation model, the legal requirement for planning, implementing, monitoring, and evaluating patient care, as well as providing a nursing summary, is fulfilled. The entries must indicate how the care was carried out, whether anything special occurred during the care, and what care-related decisions were made during it. At the same time, information is produced about the content of nursing in operational units, which also describes the competence requirements, training needs, and provides feedback on the performance of nursing staff in clinical nursing.
Structured data and consistent terms bring structure and clarity to documentation and support the secondary use of information to enhance organizational efficiency and decision-making, including in management, research, and education. However, it has been noted nationally that social and healthcare information is not optimally utilized for prevention, improving care quality, or achieving cost-effectiveness and impact.
The maintenance and development of FinCC is the responsibility of the Department of Health and Social Management at the University of Eastern Finland, under the name Nursing Terminology Project. According to the cooperation agreement, the Finnish Institute for Health and Welfare is responsible for publishing the FinCC classification system for national use. The FinCC expert group continuously works on development.

Lectio praecursoria, Rintasyövän arviointi mammografia-aineistosta lääketieteellisen kuva-analyysin ja laskennan avulla

Antti Isosalo — 2025-05-05

Conferences

2025-05-05