Finnish Journal of eHealth and eWelfare https://journal.fi/finjehew <p><em>Finnish Journal of eHealth and eWelfare (FinJeHeW)</em> is a scientific journal maintained 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="https://journal.fi/public/site/images/riaittam/VA_tunnus_tekstein_pieni_netti23.jpg" alt="" /></strong></p> en-US <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> kristiina.hayrinen@gmail.com (Kristiina Häyrinen) antti-jussi.nygard@tsv.fi (Antti-Jussi Nygård) Mon, 09 May 2022 07:55:07 +0300 OJS 3.2.1.4 http://blogs.law.harvard.edu/tech/rss 60 Sotetite-tutkimuspäivät tutkijan ja tutkimusryhmän näkökulmasta https://journal.fi/finjehew/article/view/117854 Virpi Jylhä, Juha Mykkänen, Alpo Värri Copyright (c) 2022 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 https://journal.fi/finjehew/article/view/117854 Mon, 09 May 2022 00:00:00 +0300 Ability of social welfare professionals as users of information systems (IS) and their experiences of IS support for work https://journal.fi/finjehew/article/view/110119 <p>The experiences of social welfare professionals with higher education are examined for the first time as part of the nationwide Monitoring and Evaluation of Social and Health IS Services (STePS 3.0) project. The aim is to provide information about the realisation of the goals defined for social welfare professionals in the Finnish eHealth and eSocial 2020 Strategy. The study asks how experienced and skilled social professionals are as the users of ISs, how ISs support the search and exchange of information by social welfare professionals and how well client ISs support the work of social welfare professionals.</p> <p>The research material consists of the responses of 990 social welfare professionals who responded to the electronic questionnaire in September–October 2020 and who worked in the public, private or third sector in a variety of social welfare positions. The results show that social welfare professionals with a higher education are experienced users of ISs, but the support provided by the systems for work is somewhat weak. Social welfare professionals working in the public sector assessed the support provided by ISs for work more critically than those individuals in other sectors. ISs are utilised as the main source of client information in information retrieval, but old-fashioned and information security-poor methods of information retrieval are still used. The social welfare client data archive is not yet widely utilised in the social welfare sector in information retrieval. The study highlights the need to identify the barriers to the utilisation of ISs and to take better account of the interactional and relational aspects of social welfare practices and the needs of different occupational tasks in the development of ISs so that they can better support social welfare professionals in their daily work.</p> Samuel Salovaara, Sanna Hautala, Marianne Silén Copyright (c) 2021 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 https://journal.fi/finjehew/article/view/110119 Mon, 09 May 2022 00:00:00 +0300 Developing voluntary patient safety incident reporting of high-maturity electronic health records https://journal.fi/finjehew/article/view/110823 <p>Patient safety incident reporting is currently considered a cornerstone of efforts to improve patient safety. For incidents related to high-maturity electronic health record systems (EHRs), there is a need to develop a classification appropriate to clinical operating environment that would benefit the identification of incidents and enhance structured reporting and analysis. The overall aim of the study was to advance use of a voluntary patient safety incident reporting system and to develop the usability of reports in the field of EHR safety. The aim was to categorize and reason patient safety incidents related to high-maturity EHRs so that the classification responds to the characteristics of errors in these systems. Previous research results on the error types in EHRs and incident reports were analyzed and classified for a six-month period immediately after the implementation of the EHRs. The guiding principles of the classification work were based on the features, usage and usability of the classification. The 13 main classes describe the incidents that occur during the clinical use of the advanced EHRs. The largest instance of classes in this dataset were interface, usability, workflow, medication section, and documentation problems. Half of the main classes are supplemented by 2 to 6 subclasses, resulting in 35 classes. The results reflect both theoretical and methodological objectives for the qualitative and contentual development of the classification and practical objectives for the development of reporting. From a clinical point of view, the problem type descriptions are intended to guide the classification of incidents in practice. The study produced a theoretical-practical result in the field of classification research. The classification can be applied to the reporting and analysis of incidents related to high-maturity EHRs. The results highlight the specific features of the category and the distinguishing factors in relation to the other categories, and reasoning for these outcomes. The use of classification is assumed to support incident reporting and use of data. In the future, systematic maintenance and development of the classification based on empirical data will be required in order to further develop the quality of data to support patient safety in the use of EHRs.</p> Sari Palojoki, Noora Skants, Elina Reponen, Anne Vakkuri, Kaija Saranto, Riikka Vuokko Copyright (c) 2022 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 https://journal.fi/finjehew/article/view/110823 Mon, 09 May 2022 00:00:00 +0300 The effectiveness of a web-based education program for nurses’ self-assessed skills concerning the care of alcohol-intoxicated patients in an emergency department https://journal.fi/finjehew/article/view/113450 <p>The aim of this study was to measure the effectiveness of a web-based education program for nurses’ self-assessed skills concerning the care of alcohol-intoxicated patients in an emergency department. A quasi-experimental design with an intervention and comparison group was used. A quantitative approach was utilized to describe the nurses’ self-assessed skills before and after a web-based education program. Within the resources of the organization that participated in this study, it was possible to deliver the intervention to 20 nurses during one year. All ninety nurses working in the emergency department of one central hospital in Finland were randomly assigned to either the intervention group (n=20) or comparison group (n=25); in both groups, baseline (November 2017) and follow-up (December 2018) surveys were conducted before and after the intervention. The intervention group members showed a statistically significant increase in their self-assessed skills in several sections of the competence scale that was used. This may indicate that the web-based education program had a positive effect on the intervention group’s knowledge and improved their skills to care for alcohol-intoxicated patients.</p> Kaisu-Leena Mäkelä, Jari Kylmä, Eija Noppari, Tiina Hakala, Marita Koivunen Copyright (c) 2022 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 https://journal.fi/finjehew/article/view/113450 Mon, 09 May 2022 00:00:00 +0300 Experiences of social and health care information system developers in co-operation with users https://journal.fi/finjehew/article/view/109908 <p>The main task of social welfare and health care is to promote the wellbeing and health of citizens and to treat diseases as well as possible. This is achieved through correct timing and decisions, good care and proper diagnosis. Information systems intended for the management of patient and client information play an important role in the implementation of the above-mentioned main tasks and in enabling activities. Social and health care information systems should support professional work processes and workflows, and the role of end-users in the development of information systems appears differently due to the diversity of the sector than in many other areas. When defining the development needs of information systems, a large group of social and health care professionals should be included. Health care professionals are willing to participate in the development, but they feel that the experiences of end-users are not adequately considered. Problems and technological errors detected in client and patient information systems have also led to a risk to patient safety.</p> <p>The purpose of this study was to find out the experiences and views of software developers developing social and health care information systems on user participation in the development. Factors related to participation were examined and identified through the selected dimensions of the sociotechnical model.</p> <p>The study was carried out as a questionnaire, the results of which were analysed quantitatively. The data collection was done with an electronic questionnaire in Finnish and in English and forwarded to the information system suppliers in the Valvira’s (National Supervisory Authority for Welfare and Health in Finland) information system register (updated 9/2019). A link to the questionnaire was also shared on social media. The research material consists of 87 responses.</p> <p>According to the research findings, software developers developing social and health care information systems want to work actively with end-users and feel that they will benefit from user feedback. However, there is a lack of established methods and the necessary resources to enable cooperation. Developer and user organisations should therefore direct more resources to enable cooperation. The importance of information from users in development work and based on interaction between people and information technology is a prerequisite for the development of a successful social and health care information system.</p> Jenni Rytkönen, Ulla-Mari Kinnunen, Susanna Martikainen Copyright (c) 2022 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 https://journal.fi/finjehew/article/view/109908 Mon, 09 May 2022 00:00:00 +0300 The effectiveness of digital information systems in healthcare on staff and patients: a scoping review from a nursing perspective https://journal.fi/finjehew/article/view/110621 <p>The aim of this scoping review was to gather evidence about the effectiveness of digital information systems on nursing staff and patient outcomes. Inclusion criteria were: information system used in clinical work and covers quality, satisfaction, efficiency, patient outcomes, work processes and costs. Exclusion criteria were: barcode scanning, managerial information systems, mobile devices, artificial intelligence, alert systems, internet of things and robotics. Four databases were searched: CINAHL, the Cochrane Library, PubMed and the Web of Science. The search resulted in 2400 articles of which 16 were included in the review. Included studies were published between the years 1995–2020.The Joanna Briggs Critical Appraisal tools were used for quality evaluation. The results were analyzed with deductive content analysis.</p> <p>Four of the included studies had experimental design and 12 had quasi-experimental design. Quality scores of reported studies were mainly mediocre. The studied digital information systems were categorized as patient record, medication process, health data automation and patient portal. The most studied systems were patient records. Systems mainly focused on a limited part of the medication process and digital nursing documentation. Most studies compared digital information systems to paper-based systems. Data were obtained with questionnaires and by time and motion analysis. Regarding staff outcomes, most studies covered the use of working time and job satisfaction. These outcomes showed inconclusive results. Patient outcomes weren`t studied at length and some studies showed positive while others showed negative outcomes.</p> <p>Based on the findings of this review, the evidence of the effectiveness of information systems on staff and patient outcomes is scarce and the terminology and definitions of the systems is inconsistent. More evidence is needed to show the effectiveness of digital information systems on patient outcomes.</p> Ella Valkeapää, Laura-Maria Peltonen Copyright (c) 2022 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 https://journal.fi/finjehew/article/view/110621 Mon, 09 May 2022 00:00:00 +0300 User-centred design of ehealth solutions for home dialysis: focus on patient experience and clinicians’ needs https://journal.fi/finjehew/article/view/114929 <p>New eHealth solution for home dialysis patients and clinicians aims to support and make the care process more fluent. Taking the end-users into account and involving them in the development process is important for wide adaption and truly useful outcome.</p> <p>In this article, we present research, which aims to identify the needs and experiences of home dialysis patients and their clinicians with a new eHealth solution, which includes different instruments and sensors along with an application. This research is a part of a larger research project called ‘eHealth in Home Dialysis’. Research data was collected from two remote workshops with five patients and four clinicians that were held at the end of 2021. Previous data (interviews and usability evaluations) from the same research project were utilized in the planning of these workshops. The workshop data were analyzed with qualitative methods.</p> <p>Home dialysis patients had some experience with the new eHealth solution, and they saw potential in the unity with different instruments, sensors, and an application. Following up the results of measurements and data-based decision-making regarding own care were seen as the most important features of the eHealth solution. However, continuous measuring and form filling was seen laborious at times. In addition, the usability of the smartwatch was unsatisfactory.</p> <p>Clinicians, on the other hand, had not used the new eHealth solution, but they were aware of it. From the perspective of clinicians, the new eHealth solution should fit their working environment and processes with other IT solutions. Clinicians saw potential in the eHealth solution as it could ease defining the general condition of a patient and following up the patient’s status together with the patient. However, resources and guidance regarding the implementation is needed.</p> <p>The new eHealth solution has potential but planning and designing regarding the principles of the use of eHealth solutions between patients and clinicians is needed before wider implementation. Further development of solutions should focus on usability and integration with current IT systems so that the use of eHealth solutions can be a fluent and easy part of home dialysis care both from patients’ and clinicians’ perspective. eHealth solutions could encourage more patients to choose home care in the future, which compared to hospitalization requires less resources and can better support individualized care.</p> Sini Hölsä, Paula Valkonen, Johanna Viitanen, Virpi Rauta Copyright (c) 2022 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 https://journal.fi/finjehew/article/view/114929 Mon, 09 May 2022 00:00:00 +0300 The dimensions of the data protection and information security competence of healthcare professionals https://journal.fi/finjehew/article/view/109920 <p>For the time being research, on the data protection competence of healthcare professionals has been limited to looking at only one area at a time, without outlining the multidimensional overall picture. In healthcare data protection competence is carried out as information security behavior. Privacy competence manifests itself in the ability to process personal data well. At the heart of data protection competence are properly managed information management, properly processed personal data and information resources. By making sure that employees have proper data protection competency you can avoid data breaches and enhance the performance of employees and organizations.</p> <p>The purpose of this study is to describe the manifestation of the dimensions of learning theory in the data protection and security competence of the employees in Healthcare Services for Prisoners. This study utilizes a cross-sectional survey of data protection competence that was conducted for every employee in Healthcare Services for Prisoners. The results of the study are described using the dimensions of Knud Illeris’ learning theory. The importance of data protection and information security competence in Healthcare Services for Prisoners is emphasized, since in Healthcare Services for Prisoners the processing of patient and personal data is governed not only by health care legislation but also by the Prison Health Care Unit Act, which defines anomalies in patient data disclosure.</p> <p>The results of the study support the view that privacy competence of healthcare professionals is a multidimensional phenomenon. Privacy competence and the implementation of security behaviors in healthcare is not only dependent on the trainings an individual has undergone, but the operating environment and targeted guidance have a significant impact on the realization of data protection. Based on previous studies, the study of health care privacy competencies has placed an emphasis on looking at the work environment and internal incentives of the individual, as well as identifying factors that influence data protection policies. This study supports the view on the multidimensionality of data protection competencies and the national and international research gap on the subject.</p> Anni Taanila, Virpi Jylhä Copyright (c) 2022 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 https://journal.fi/finjehew/article/view/109920 Mon, 09 May 2022 00:00:00 +0300 Social welfare professionals’ experiences on client information systems in 2020 https://journal.fi/finjehew/article/view/113710 <p>This article examines the experiences of client information systems (CISs) used by social welfare professionals with at least a bachelor-level education. The purpose of the article is to evaluate the realisation of the objectives of the eHealth and eSocial Strategy 2020 from the perspective of social welfare professionals and to produce brand-specific information about user experiences to support future development of CISs. The research question is: What kind of assessments do social welfare professionals with at least a bachelor-level education provide about the CISs they used in 2020, based on their user experiences? The study utilises survey data (n=990) gathered in the STePS 3.0 project in September–October 2020 in cooperation with trade unions, using a subpopulation of respondents with an electronic CIS in use (n = 974). The data was analysed by descriptive methods using direct distribution and cross-tabulation. Mean values, standard deviations, 95% confidence intervals of the means and the proportions of poor and commendable grades were presented for school grades 4–10.</p> <p>The results show that there is variance between the brands used in social care in terms of functionality, usability, support for work and cooperation and the perceived benefits. The average ratings of the brands ranged from moderate (6) to good (8). Nappula and Domacare, which are generally used in the limited social care settings, received the best ratings. Of the CISs widely used in social welfare, Pro Consona received the best rating (satisfactory). Designing and adapting CISs to the needs of a smaller and more limited user groups are naturally more straightforward, and users are able to learn a CIS system faster compared to CISs with large user groups and versatile functionalities. The development needs for all CISs were identified as support for cooperation and information exchanges, as well as support in understanding client services and improvements of electronic client services. The identified development areas are significant for future welfare regions. CISs have the potential to support the established objectives for social and welfare reform if they are developed in the future to better meet the needs of professionals.</p> Samuel Salovaara, Katri Ylönen, Marianne Silén, Johanna Viitanen, Tinja Lääveri, Sanna Hautala Copyright (c) 2022 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 https://journal.fi/finjehew/article/view/113710 Mon, 09 May 2022 00:00:00 +0300 DiHECO – Digital healthcare ecosystem research and networking https://journal.fi/finjehew/article/view/114944 <p>The DiHECO project aims at studying the role and potential of digital healthcare platforms in the European, mostly publicly arranged, healthcare service ecosystem. The project, divided into a few subprojects, tries to identify areas of research that can grow into impactful larger European projects with industry co-operation. DiHECO aims also at further developing the capacity of participants, particularly the Kaunas University of Technology, to perform relevant research in this area. In its first year, the project has made progress according to plan through joint research activities and networking events. These include the digital health tracks of the researcher and industry forum of the ICTE 2021 conference and two grant writing workshops and a scientific writing workshop.</p> Alpo Olavi Värri, Hannu Nieminen, Nina Helander, Mark van Gils Copyright (c) 2022 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 https://journal.fi/finjehew/article/view/114944 Mon, 09 May 2022 00:00:00 +0300 Medical and nursing students’ co-learning in digitalized health care eco-system https://journal.fi/finjehew/article/view/114942 <p>The demographic change in Finnish population has forced us to develop digital solutions to meet health care requirements. To respond to the need, we designed and piloted a one-day Multidisciplinary Digital Clinic (MDC) education for medical and nursing students.</p> <p>In this report, we describe our project of the one-day MDC education of digital solutions in primary care for medical and nursing students, and their learning experiences. Additionally, we describe the realization of the intended learning outcomes. The MDC education was conducted by flipped learning method with pre-studying materials. The MDC day was divided into three topical workshops: Remote Care, Digital Symptoms and Health care assessment, and Assessment of Need for care. Students formed three multidisciplinary teams.</p> <p>The students (N=108) valued the opportunity to train with modern technological equipment. Learning in the multidisciplinary teams enabled their knowledge and expertise sharing beyond study field limits, and provided a unique opportunity to discuss together, and thus, helped generate future-proof cooperation skills. The MDC training improved students' understanding of digitally enhanced health care services and increased their understanding of the automated digitalized service pathways, and the continuity of care.</p> <p>In conclusion, the students described MDC as a unique opportunity, and future oriented education. The MDC encouraged students to get involved in the digitally and technologically enhanced health care eco-system in their professional careers.</p> Nina Smolander, Tuomas Koskela, Ilona Jylhäsalo, Taru Manner, Mervi Kautto, Riikka Riihimies Copyright (c) 2022 Finnish Journal of eHealth and eWelfare http://creativecommons.org/licenses/by-nc-nd/4.0 https://journal.fi/finjehew/article/view/114942 Mon, 09 May 2022 00:00:00 +0300