Finnish Journal of eHealth and eWelfare https://journal.fi/finjehew <p><em>Finnish Journal of eHealth and eWelfare (FinJeHeW)</em> is a scientific journal established by the Finnish Social and Health Informatics Association (FinnSHIA) and the Finnish Society of Telemedicine and eHealth (FSTeH).<strong><br></strong>ISSN 1798-0798</p> <p><strong><img src="/public/site/images/riaittam/VA_tunnus_tekstein_pieni_netti23.jpg" alt=""></strong></p> Finnish Social and Health Informatics Association en-US Finnish Journal of eHealth and eWelfare 1798-0798 <p>Authors transfer copyright to the Finnish Journal of eHealth and eWelfare (FinJeHeW). The CC-BY-NC-ND license allows users to copy and distribute the Article, provided this is not done for commercial purposes and further does not permit distribution of the Article if it is changed or edited in any way, and provided the user gives appropriate credit (with a link to the formal publication through the relevant DOI) and information about authors, title of the article, title of journal, journal volume and issue.</p> <p>Please read https://creativecommons.org/licenses/by/4.0/legalcode&nbsp;</p> Sosiaali- ja terveydenhuollon tietojenkäsittelyn 23. tutkimuspäivät https://journal.fi/finjehew/article/view/108083 Kristiina Häyrinen Copyright (c) 2021 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 2021-06-18 2021-06-18 13 2 96–97 96–97 Call for abstracts: eHealth2021, the 26th Finnish National Conference on Telemedicine and eHealth https://journal.fi/finjehew/article/view/108082 Kristiina Häyrinen Copyright (c) 2021 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 2021-06-18 2021-06-18 13 2 98–99 98–99 Ovatko asiakkaat mukana sähköisten palvelujen kehittämisessä? https://journal.fi/finjehew/article/view/109361 Kristiina Häyrinen Copyright (c) 2021 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 2021-06-18 2021-06-18 13 2 92–93 92–93 10.23996/fjhw.109361 Are customers involved in the development of electronic services? https://journal.fi/finjehew/article/view/109362 Kristiina Häyrinen Copyright (c) 2021 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 2021-06-18 2021-06-18 13 2 94–95 94–95 10.23996/fjhw.109362 Usability of online symptom checkers https://journal.fi/finjehew/article/view/97020 <p>Municipalities are reforming their health and social care services and creating online services to support patient self-treatment and self-care (The Omaolo-project). These include 15 symptom checkers which provide triage. As a result of the completed individual symptom assessment, the patient receives an assessment of the need for treatment of the corresponding symptom, instructions for a treatment site and, if necessary, self-care instructions. This study examines the usability of symptom checkers from the perspective of the patient and the study assistant.</p> <p>This is a mixed methods study that used data collected in the Omaolo project’s validation of symptom checkers study. Data were collected from 18 primary health care emergency centers throughout Finland. The user answered the questions posed by the symptom checker, after which a nurse familiar with triage assessed the need for treatment of the symptom of the user. The study assistant monitored the completion of the study user's symptom checker. The findings of 350 patient users, nurses, and study assistants were analyzed based on separate completed research forms. Thematic analysis was used to create research themes from the recorded observations of the individuals followed by the preparation of a thematic summary.</p> <p>The usability of symptom checkers was mainly assessed as good. However, there were challenges in usability. Relevant concepts (codes) describing the challenges were formed from the free text observations of the research forms. 59 codes were classified under two main themes; user-related challenges and issues related to the symptom checkers. The user-related challenges were divided into a) difficulties in understanding the symptom checkers and their questions, b) poor competence to use online tools, and c) ability to assess one’s health. The issues related to the symptom checkers were divided into a) a need to clarify the terms and questions used in the symptom checker, and b) a need to improve the visual layout and provide better instructions for the user.</p> <p>Symptom checkers are acceptable, easy to use, and understandable to most patients. The study identified themes that may impair the availability of symptom checkers. Improving the availability of symptom checkers is likely to improve the process of triage as well as its success. In addition, usability issues can impair a patient's willingness to use symptom checkers.</p> Ville D Liu Lasse Sellgren Minna Kaila Tuomas Koskela Copyright (c) 2021 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 2021-06-18 2021-06-18 13 2 100–112 100–112 10.23996/fjhw.97020 The skill gap and polarization of the software labour force https://journal.fi/finjehew/article/view/82689 <p>The demand for high-skill and deep knowledge is a key characteristic for modern-day software business. In addition, the whole impact of information and communication technology (ICT) is seen as a cross-cutting element in different industries. The software industry in Finland is suffering from a severe labour shortage and the estimations of needed labour are ranging from 7,000 to 15,000 software professional. However, despite all development and research done, the question, whether the software companies are requesting more employers or are they looking for more diverse skills, remains unanswered. Furthermore, previously there has little if any discussion, on whose responsibility is to ensure that future software experts have the right kinds of skills and competencies to secure their successful work career. This study focuses on the skill polarization between software professionals, referred to as the ‘<em>War of Talents’ </em>in this study, by using data collected by a survey (n=90) from Finnish software businesses. The results reveal some indication of ongoing skill polarization in the field and its possible impacts are discussed. Furthermore, the potential threatening impacts of the polarization process on the well-being in the information society are observed and reported. In addition, the paper proposes adding skill development applications among the offering of eWellbeing services due to the importance of work-related competencies to the self-image – and therefore also wellbeing – of individuals.</p> Sonja Hyrynsalmi Minna M Rantanen Sami Hyrynsalmi Copyright (c) 2021 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 2021-06-18 2021-06-18 13 2 113–123 113–123 10.23996/fjhw.82689 Validation of the wearable sensor system - MoveSole® smart insoles https://journal.fi/finjehew/article/view/95776 <p>Biomechanical analysis of gait is commonly used in physiotherapy. Ground reaction forces during phases of gait is one element of kinetic analysis. In this article, we analyze if the MoveSole® smart insole is valid and accurate equipment for measuring ground reaction forces in clinical physiotherapy. MoveSole® StepLab is a mobile measurement system for instant underfoot force measurements during gait. Unique electromagnetic film (EMFI) based sensor technology and printed electronics production technology is integrated in the MoveSole® StepLab measurement system. The MoveSole® StepLab measures plantar ground reaction force distribution over the sensors and provides an estimation of the maximum total ground reaction force.</p> <p>We developed a two phase validation process to extract relevant parameters and compared the results to a Kistler force plate using the BioWare® analyzing program as a reference method. Our results show that MoveSole® smart insoles reach the strong level of accuracy needed in clinical work concerning highest ground reaction forces during step (Pearson correlation .822 - .875). The correlation of the time when the maximum ground reaction force occurred was moderate, e.g. during heel strike or toe-off (Pearson correlation natural gait speed .351 - .462, maximum gait speed .430). Our conclusion is that MoveSole® smart insoles are a potential tool for analyzing and monitoring gait ground reaction forces during physiotherapy processes.</p> Antti Alamäki Elina Nevala Juha Jalovaara John Barton Salvatore Tedesco Joan Condell Karla Muñoz Esquivel Daniel Kelly David Heaney James Gillespie Shvan Karim Richard Davies Anna Nordström Markus Åkerlund Larsson Copyright (c) 2021 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 2021-06-18 2021-06-18 13 2 124–132 124–132 10.23996/fjhw.95776 Considering the informational needs of social work in the information system Apotti https://journal.fi/finjehew/article/view/100692 <p>Information systems have become a key part of social work. Social work information systems are used to produce information for different parties, such as clients, employees, managers and decision makers. Considering the different informational needs in the information system is a challenging task that requires both knowledge of social work and of the operating environment of the information system.</p> <p>The study examines how social work informational needs have been interpreted, identified and resolved during the development phase of the information system. The subject of the study was the social welfare application of the Apotti information system. The research data consist of focus group interviews of specialists who participated in the development of Apotti social welfare application. The data were analysed using a theory-guided content analysis.</p> <p>The results describe how the requirements set by the informational needs of social work for the information system identified in the Apotti project emphasise the utilisability, comprehensiveness and timeliness of information from the perspectives of client-oriented social work, work process management, knowledge management and knowledge-based social work. The information system must support the perception of relevant information, the monitoring of work tasks, data-driven management and the strengthening of the knowledge basis of social work, as well as secure communication between clients and professionals. The competent and coherent use of the information system is a critical factor for the realisation of the intended benefits and emphasises the importance of adequate training of the users of the information system.</p> Susi Salovaara Copyright (c) 2021 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 2021-06-18 2021-06-18 13 2 133–146 133–146 10.23996/fjhw.100692 The definitions of health care and social welfare informatics competencies https://journal.fi/finjehew/article/view/100690 <p>Digital transformation is changing the ecosystem and at the same time professionals’ competencies worldwide. Minimising health care and social welfare costs while increasing citizens’ health and well-being is challenging. Technology and digital tools play an important role in reaching this goal. However, there are inequalities concerning technology, and this has many impacts. Digitalisation brings challenges not only to health care and social welfare professionals but to citizens, too. Working with or using services in digital environments demands new skills. This has social and ethical impacts, e.g. how is equal access to services ensured. Health and social care professionals should have different competencies to respond to this, such as societal competencies. The purpose of this article is to describe how the definition of competencies in health care and social welfare version 1.0 (developed in the national SotePeda 24/7 project) was finalised as the final version 2.0 for <em>Finnish healthcare and social welfare education</em> by experts’ evaluation.</p> <p>Data was collected through an electronic questionnaire administered to selected experts (N=140) during January 2020. The number of experts who responded to the study was 52. These experts (social and health, business and IT) work or have worked in tasks related to the digitalisation of social and health care. The questionnaire was based on version 1.0 of the definition of digital competencies of health care and social welfare informatics. The questionnaire was mainly quantitative, but it also included open-ended qualitative questions. The experts agreed to a large extent on the version 1.0 definition, but some adjustments were made to the definition based on our study. The resulting definition is intended for use in the planning, implementation and evaluation of health care and social welfare education, but it can also be used for polytechnic education. The aim is to develop the digital skills of educators, degree students and in-service trainees in a multidisciplinary way (social and health, business and IT) to meet the needs of working life.</p> Minna Tiainen Outi Ahonen Leena Hinkkanen Elina Rajalahti Alpo Värri Copyright (c) 2021 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 2021-06-18 2021-06-18 13 2 147–159 147–159 10.23996/fjhw.100690 Customer value creation in the development of digital health services: discourse analysis https://journal.fi/finjehew/article/view/101343 <p>The study’s aim was to describe how customer value creation is reflected in the development of digital health services. To this end, we used discourse analysis to evaluate documentation from the ODA (Self-Treatment and Digital Value Services) project, which provides national-scale digital health services.</p> <p>Three main discourses emerged: 1) a discourse on the active role of the customer, 2) a discourse on technology that activates the customer to create value, and 3) a discourse on the benefits of customer value creation.</p> <p>The research provided new insight into customer value creation in digital health service development. Speech about customer value creation was a part of the social reality of the digital health service’s development. The customer appeared as an active player and a key resource within the service. The role of the active customer was considered demanding and responsible. Our findings suggest that the new digital service changed customer behavior, with technology acting as an enabler of this change. Customer activity and information sharing were seen as enablers of value creation and the associated benefits, and there was a willingness to strengthen the customer’s role as a need determiner.</p> Paula Vieresjoki Laura Kämäräinen Elina Laukka Marjo Suhonen Outi Kanste Copyright (c) 2021 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 2021-06-18 2021-06-18 13 2 160–172 160–172 10.23996/fjhw.101343 Experiences of Navigator, a Finnish patient-segmentation service, in primary care: A mixed-methods study https://journal.fi/finjehew/article/view/107245 <p>Aging and multimorbid populations burden health services worldwide. Segmenting patients with similar health service needs into different groups and guiding care providers to tailor services to these groups could reduce this burden. Methods of patient segmentation have been based on, e.g., databases. However, the Finnish patient-segmentation innovation Navigator (Suuntima) considers patients’ perspectives on their coping in everyday life, as well as professionals’ views of the patients’ state of health. The segmentation is based on questions. The resulting care pathway related to the group helps professionals to coordinate patients’ health care and patients to utilize appropriate services.</p> <p>This first part of Navigator’s validation study evaluates its feasibility and content and face validity. We assess the web-service’s user experiences at nurses’ appointments with diabetic patients, time consumption, and Navigator’s question relevance, comprehensiveness, and comprehensibility.</p> <p>This mixed-methods study uses user experience questionnaires for both patients and professionals, and semi-structured focus-group interviews for professionals. We used descriptive statistics in the quantitative data analysis of the questionnaire study and thematic analysis to identify the codes and themes in the interview data.</p> <p>All 304 Navigator queries were completed at appointments. Most patients found Navigator easy to use. It helped in considering their situation better and from new perspectives. Most patients did not find it too time-consuming. Most professionals found it easy to use and suitable for appointments and patient segmentation. The questions were easy and unambiguous, and they assisted in discussing new or sensitive issues. Most queries were completed in less than 19 mins and less time was used if the patient was assigned to the nurse. Thematic analysis raised five main themes: 1) Well-functioning web-service, 2) Stimulus for conversation and action, 3) Rationale to complete Navigator with a professional, 4) Training and experience ease the use of Navigator, and 5) Navigator's room for improvement. Subthemes were identified for three main themes.</p> <p>We consider Navigator’s feasibility and face validity to be favorable. We suggest user instructions and the clarification of concepts to support the questions’ comprehensibility. Some patients may benefit from a nurse’s presence when responding to Navigator’s questions.</p> Riikka Riihimies Elise Kosunen Tuomas Koskela Copyright (c) 2021 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 2021-06-18 2021-06-18 13 2 173–188 173–188 10.23996/fjhw.107245