Finnish Journal of eHealth and eWelfare

Hyödynnettävän tiedon edellytyksistä tiedon hyötykäyttöön – takakaarteesta loppusuoralle?

Virpi Jylhä, Alpo Värri, Juha Mykkänen — Mon, 27 May 2024 00:00:00 +0300

Introduction of Kanta services in social welfare is the key for utilising information

Kaisa Hujanen, Erja Ailio, Hanne Laukkanen — Mon, 27 May 2024 00:00:00 +0300

Information management in social welfare is on the verge of a new era when social welfare organisations start using the Client data archive for social welfare services (part of the Kanta services). The objective of the development is to make the client data available where it is needed at any given time. Social welfare clients can view their data through MyKanta and professionals have access to uniform and up-to-date client data. Client data is stored in a comparable format, in which case the data can also be used in service development, research and knowledge management.

The Client Data Act requires that wellbeing services counties start using Kanta services in social welfare. Preparedness in the wellbeing services counties on the eve of the introduction of the Client data archive for social welfare services varies. Almost all counties have started using the Client data archive for social welfare services, but in no region does the information system yet meet all the requirements of the Client Data Act. With the formation of wellbeing services counties, they still have many client information systems in use and in some information systems the implementation schedules may be delayed. The Client Data Act has been proposed to be amended so that the statutory transition periods for introducing the Client data archive for social welfare services would be extended from 6 months to one year. Even longer extensions of the introducing period have been proposed during the consultation round of the Client Data Act. Delaying the periods for introducing the Client data archive for social welfare services would also delay the availability of effectiveness information. Knowledge management is of primary importance in the wellbeing service counties and according to the PM Orpo’s government program information on the effectiveness of healthcare and social welfare is vital. Any delays in introducing the Client data archive for social welfare services threaten to postpone both the availability of effectiveness information and other benefits of Kanta services.

Multilevel modelling for decision support in hypertrophic cardiomyopathy in the SMASH-HCM project

Alpo Olavi Värri, Mark van Gils, Jari Hyttinen — Mon, 27 May 2024 00:00:00 +0300

Hypertrophic cardiomyopathy (HCM) is the most common inherited genetic heart disease, and its most feared outcome is a sudden death even in a young otherwise healthy adult. The EU-funded project SMASH-HCM aims at dramatically improving HCM stratification and disease management, both for clinicians and patients. The project combines data from the patients at multiple levels, from genetic and molecular data to in-silico physiological and family history data and creates in-vitro and computational models of the disease at these various levels. A digital twin of the patient will be formed based on these data modelling tasks. Modelling approaches, data-driven artificial intelligence and knowledge existing in literature will complement each other to provide decision support for the clinicians to optimize interventions, and actionable information about the disease status and development will be offered to the patient.

Lectio praecursoria, Hoitoisuusluokitusjärjestelmä hoitohenkilöstön resursoinnin työkaluna: Tutkimus hoitoisuusluokitusjärjestelmän ennustevaliditeetista sekä sen luotettavuuden ja optimaalisen hoitotyön kuormitustason kalibroinnin haasteista hoitotyön kiireisessä arjessa

Jaana Junttila — Mon, 27 May 2024 00:00:00 +0300

Lectio praecursoria 24.11.2023

Conferences

Pia Liljamo, Miia Jansson — Mon, 27 May 2024 00:00:00 +0300

Digital skills and intention to use digital health care and social welfare services among socially marginalized individuals in Finland: A cross-sectional study

Birgitta Tetri, Teemu Rantanen, Anne Kouvonen — Mon, 27 May 2024 00:00:00 +0300

This article examines the relationship between digital proficiency, trust in service providers, and the intention to use digital health care and social welfare services among prisoners and people with mental health conditions in Finland. Based on cross-sectional data, which includes responses from 225 prisoners and 120 people with mental health conditions between September 2020 and May 2021, a study utilizing latent profile analysis (LPA) reveals that although high digital skills were observed, trust in providers of digital services within the health care and social welfare sector remained low, particularly among younger participants. Despite trust issues, the intention to use digital services remained high, particularly among inmates. This suggests that trust is not the sole factor influencing digital service adoption; age and perceived digital competence also play significant roles. Prisoners demonstrated higher levels of advanced internet skills than individuals with mental health backgrounds, possibly due to overestimating their abilities. Alternative approaches, such as social support and hands-on learning, are vital for enhancing digital skills in socially marginalized groups. Understanding these determinants can guide policymakers and practitioners in developing targeted interventions to promote digital inclusion effectively by considering broadly the factors that promote the accessibility of digital health care and social welfare services. Future research combining objective proficiency testing and self-reported data can offer deeper insights for more successful strategies.

Experiences of people with epilepsy on the use of digital services

Niina Reinikainen, Virpi Jylhä, Milla Rosenlund — Mon, 27 May 2024 00:00:00 +0300

Digital health services have enabled the production of health data and up-to-date monitoring, and have increased interaction between citizens and health care during the treatment process. The purpose of this study was to describe the experiences of people with epilepsy in the use of health services and to find out what kind of development measures increase the citizen's involvement in the use of digital health services. The study was conducted as three focus group interviews for people with epilepsy (N=8) between December 2022 and March 2023. The interviews were recorded, and the material transcribed according to a secure practice. The transcripts were analyzed using inductive content analysis using Atlas.ti software (version 23).

As a rule, digital health services were perceived as easy to use and accessible. Producing and communicating personal health information to healthcare professionals was considered important, as they were seen to promote health and improve the efficiency and quality of care. Health information was communicated to health care personnel using pre-information forms and symptom diaries, while interaction was mainly carried out in the form of messages. Re-requests for prescriptions through the Kanta service seemed to have become an established practice. In addition, information obtained through well-being devices, such as smartwatches and rings, was sometimes stored in the National Kanta Service's Personal Data Repository.

Health services provided by health care organizations showed differences within organizations. The interviewees felt that utilizing their own health data during a visit to the clinic brings added value in monitoring the patient's overall health and care. However, health care professionals make use of digital health services on different levels, which may have left the available information untapped.

The development needs for the usability of digital health services were mentioned to improve the smoothness of logging in and recording information. In addition, to improve availability, there should be one transaction channel covering digital services.

Concrete changes through digital mentoring in elderly care

Eija Kivekäs, Ulla-Mari Kinnunen, Johanna Ikonen, Tanja Miettinen, Kaija Saranto — Mon, 27 May 2024 00:00:00 +0300

The responsibility for organizing social and healthcare services has been transferred to the wellbeing services counties. In the change, strong renewal is expected from the counties. Digitalization in services for the elderly has created an opportunity for efficiency, and digital services have improved the possibilities of living at home for the elderly. In the VaDigi -project (Development of digital capacities and approaches in old-aged care), a model was developed to increase healthcare professionals’ digital skills in the services for the elderly. Staff participation in the implementation of the change was strengthened by using reverse mentoring. This study aimed to produce information about the experiences of reverse mentoring. In addition, the possibilities of exploiting reverse mentoring concretized the knowledge of using information systems in a change in work. The target group in this study was professionals working in the elderly care departments in one wellbeing services county. The survey was based on 184 respondents from 14 municipalities. The reverse mentoring reached more than a hundred employees in seven departments. Qualitative analysis was used for group interviews of students (n = 14) and workshop material of units (n = 5). The respondents assessed their knowledge of information systems as good. The competence of digital devices was assessed as weaker. The reverse mentoring produced concrete changes to guarantee departments’ data protection. In addition, mentoring increased the students’ skill in information processing in social and healthcare services. Reverse mentoring as participatory research should be continued.

Self-evaluated competences of multidisciplinary students before and after professional specialisation education in digital social and health care services

Mon, 27 May 2024 00:00:00 +0300

The integration of separate service systems, digitalisation, demographic changes, and staff shortages has increased the need for systematic and flexible skills development in social and health care services. In today’s working life, learning and development take place in ecosystems. This study aimed to evaluate and identify differences between students’ self-assessed competences and their beliefs about the importance of competence areas before and after professional specialisation education (PSE). The research questions were: 1) Was there any difference in students’ self-evaluated level of multidisciplinary competences before and after professional specialisation education? 2) Based on students’ self-evaluations, was there any difference between the multidisciplinary competences they considered important before and after professional specialisation education?

Analysis of variance (ANOVA) test and paired t-tests were used to examine the differences in the subjects’ spontaneous responses about whether they had experienced a change in their competences after undertaking specialisation education. In the initial survey (N = 274), the student respondent group was 180, and the total number of student pairs was 65. The initial and final measurements of the 65 students who responded to the follow-up survey were therefore comparable. Four-point Likert scales were used in the questionnaires. The modified questionnaire was designed so that students answered each of the competences at two levels from their own perspectives.

First, they described how important the acquisition of the skills described in this sentence would be for their own professional competence. Then, they assessed their current level of competence in relation to the sentence in question. There were no statistical differences (p>0.05) between measurements taken before and after education in most of the qualification statements describing importance. There were statistical differences (p<0.05) between the initial (before education) and post-training measurements (after education) for all statements describing self-assessment competences. According to this study, even micro-credentials promoted learning. In learning, ecosystem and perceived importance support the level of digital maturity of organisations.

Developing and evaluating the feasibility of the Mobile Intervention for Breastfeeding counseling in maternity care

Pirkko Nikula, Outi Kanste, Tarja Pölkki — Mon, 27 May 2024 00:00:00 +0300

Despite the strong evidence of breastfeeding benefits for mothers’ and newborns’ nutrition and health, breastfeeding is not practiced according to current recommendations. Digital solutions such as the mobile applications have produced promising results to promote successful breastfeeding in maternity care. This study aimed to develop and evaluate the feasibility of a Mobile Intervention for Breastfeeding counseling (MIBFc) by collecting information on the usability, utility, and recommendations of the solution from mothers. The MIBFc was based on World Health Organization recommendations for breastfeeding. This study was a cross-sectional descriptive design that used an electronic survey to collect data from sample of 39 Finnish mothers in 2018 (n=13, Group 1) and 2019–2020 (n=26, Group 2). The data were analysed using descriptive statistical analysis, while qualitative responses were grouped into themes based on their similarities of the content. The results showed that most of the mothers (over 92%) felt that the mobile intervention was easy to use and 88% of the mothers felt that the mobile intervention’s content was adequate. Mothers’ experiences with the utility of the mobile intervention were relevant, that is, they felt that the mobile intervention supported their oral guidance (89%) and helped to breastfeed for up successfully exclusively to six months (n=7, 41%). Most of the mothers used the mobile intervention primarily during pregnancy. The mothers were satisfied with the intervention’s layout, and they recommended it to other mothers in same situation, although there were some technical problems with links. This study indicated that the feasibility of the MIBFc, including usability and utility was good, based on the mothers’ overall evaluation. Using the mobile intervention can increase mothers’ knowledge of breastfeeding and support for lactation. The study highlights a need for future evaluations of the effectiveness of MIBFc in large populations.

Utilization of welfare technologies, perceived importance, future plans and information needs: cross-sectional study to welfare, social and healthcare organizations in South Ostrobothnia

Merja Hoffrén-Mikkola — Mon, 27 May 2024 00:00:00 +0300

The utilization of welfare technologies is considered important in social and health services to improve the quality and cost-effectiveness of care. Experiences from the Nordic countries show, however, that there are difficulties in the large-scale introduction of technologies and that the spread of technologies is slow.

The purpose of this study was to investigate the effects of employee status, organizational form, and organization size on the use of welfare technologies in the health and wellness sector organizations operating in South Ostrobothnia. In addition, the purpose was to study the effects of employee status, organizational form, organization size and use of welfare technologies on the perceived importance of welfare technologies, plans to adopt new technologies and need for information about welfare technologies.

The study was carried out as a cross-sectional quantitative e-mail survey. 121 people answered the survey. 45 % of them used welfare technologies at work. Managers or entrepreneurs, large organizations and those who used welfare technologies in their work considered the utilization of welfare technologies to be more important in their services than others and estimated that the organization will adopt more welfare technologies in the near future. The most needed information was about the characteristics of welfare technologies. In addition, those who already used welfare technologies needed knowledge also about the effects and effectiveness of welfare technologies, as well as about cost-effectiveness.

To improve the utilization and perceived importance of welfare technologies in the health and wellness sector, trials and piloting of welfare technologies are important. In addition, the employees should have the opportunity to participate in the decision process of welfare technologies. Organizations should be supported with knowledge about the characteristics, effects, and impacts of welfare technologies, as well as about the cost effectiveness.

3D printing as a part of Finnish practical nurse students’ technological acceptance – a qualitative study

Mon, 27 May 2024 00:00:00 +0300

3D printing is a solid part of the health care environment, and in the future, it could assume a more innovative role in the work carried out by practical nurses. However, the educational context may not support the preparedness to face and adapt new and creative technologies on the part of practical nursing students. This study aimed to describe practical nursing students’ technological acceptance towards 3D printing before and after six hours of 3D printing instruction. The technological acceptance model was used as a framework of the study. The data was collected using focus group interviews that 14 practical nursing students participated in before and after their six-hour 3D teaching course. Along with the thematic analysis, the interview themes were created in accordance with the theoretical elements concerned.

The results showed four narrative themes that described how a six-hour lesson series changed the students’ technological acceptance towards 3D printing, from: 1) professional meaningless to everyday usefulness, 2) resource dominance to a part of working life, 3) special competence to ease of use, and 4) assumptions to limitless possibilities. Every theme consisted of two subthemes. Despite having been a new thing for students, 3D printing could be conceived in terms of having professional significance. The students described 3D printing as being easy to adapt to and they highlighted the meaning of its educational usage, as it could prepare them to be better with respect to applying creative working life-based technological solutions.

As a conclusion, it can be stated that even short educational sessions can promote practical nursing students’ technological acceptance towards 3D technology and the know-how to implement it in working life. This requires educational institutions to target resources to 3D printing and on teacher education.

User experiences of automated dispensing cabinets in hospital wards: recommendations for improved workflows and patient safety

Mon, 27 May 2024 00:00:00 +0300

Medical treatment in hospitals is a complex process in which errors can lead to patient harm and adverse events and additional costs to the healthcare system. In Finland, automated dispensing cabinets have been introduced to an increasing extent, with one of their objectives being to reduce medication errors and thus improve patient safety and streamline the work of the staff. Practical challenges in using them have been identified, especially from the perspective of nurses.

This user experience study aimed to improve the work processes of the professionals and the use of automated dispensing cabinets integrated into patient information systems in hospital wards without endangering patient safety. The qualitative data was collected in spring 2023 by interviewing nurses (N=6), ward pharmacists (N=3) and pharmacy assistants (N=2). The findings were validated and improvement suggestions were produced in a multidisciplinary workshop with about 30 participants.

As a result, seven different themes related to the use of the automated dispensing cabinets were identified: interruption of work and queueing, slowness of the work process, lack of space, human errors and lack of competence, technical challenges, deviation from the medication dispensing process and other challenging features of the automated dispensing cabinets. Based on these, development suggestions were created, which can be categorized into three themes: resources and facilities, orientation and guidance, and medicine storage solutions and work processes.

Further research is needed on the user experiences of automated dispensing cabinets integrated into patient information systems in other wards, as well as the possibilities of unit dose dispensing and storing medicines partly also outside the automated dispensing cabinets.