EVICARE Sluttrapport: Fra forskning til praksis – fra praksis til kunnskap

EviCare var det første, offentlige innovasjonsprosjektet innen IKT i Norge som fikk støtte fra Norges Forskningsråd. Hovedmålet med prosjektet var å utvikle metoder og teknologi som leverer forskningsbasert kunnskap der behandling og omsorg gis, integrert i elektronisk pasientjournal (EPJ). Forventede effekter er at behandlingen får høyere kvalitet og at dokumentasjonen av arbeidsprosessene blir mer forståelig

Reaching Optimal Health: the Voice of Clinicians from a Roleplay Simulation

Helping patients to reach optimal health entails a holistic approach of complex interventions including clinical decision support systems, patient decision aids, and self-management tools. In real-world settings, understanding the human factors in technological interventions is the core of HCI research; however, it requires a considerable amount of time to run experimental procedures, especially for patients with mental disorders. We conducted a roleplay simulation over a period of two weeks that comprised observations, and semi-structured interviews with eight health care professionals participated in the simulated use of a health optimization system. The study revealed the SWING model of enabling interventions towards optimal health as i) Sharing feelings, ii) Weaving of information, iii) Improving awareness, iv) Nurturing trust v) Giving support. This model establishes a common path from research to practice for researchers and practitioners in eHealth and HCI

Prosedyrearbeid – meningsløst mangfold?

NORSK: Bakgrunn Fagprosedyrer skal være en støtte for helsepersonell i det daglige arbeidet og bidra til god og forutsigbar kvalitet av tjenesten. Antall fagprosedyrer i norske helseforetak og måten de blir produsert på, er ukjent. Materiale og metode Vi gjennomførte en spørreundersøkelse med 25 spørsmål om omfang, kvalitet og koordinering av fagprosedyrer, sommeren 2009. 29 av 30 helseforetak svarte på spørsmålene. Resultater Mer enn 4700 ansatte i norske helseforetak er involvert i utvikling og håndtering av fagprosedyrer. Det totale antallet fagprosedyrer er over 45 000. De fleste foretakene koordinerer ikke prosedyrearbeidet med andre helseforetak. To foretak formidler foretakets praksis over internett. 15 av de 29 foretakene oppgir at de systematisk kvalitetssikrer fagprosedyrene. Fortolkning Det foregår trolig mye dobbeltarbeid knyttet til utvikling av fagprosedyrer ved norske foretak. Prosedyrene blir i regelen ikke delt med andre fagfolk og med befolkningen. Kvaliteten er ofte uviss, og bør undersøkes nærmere

Rapid methods including network meta-analysis to produce evidence in clinical decision support: a decision analysis

Abstract Background Conducting systematic reviews is time-consuming but crucial to construct evidence-based patient decision aids, clinical practice guidelines and decision analyses. New methods might enable developers to produce a knowledge base more rapidly. However, trading off scientific rigour for speed when creating a knowledge base is controversial, and the consequences are insufficiently known. We developed and applied faster methods including systematic reviews and network meta-analyses, assessed their feasibility and compared them to a gold standard approach. We also assessed the feasibility of using decision analysis to perform this comparison. Methods Long-term treatment in bipolar disorder was our testing field. We developed two new methods: an empirically based, rapid network meta-analysis (NMA) and an expert NMA, and conducted a patient survey. We applied these methods to collect effect estimates for evidence-based treatments on outcomes important to patients. The relative importance of outcomes was obtained from patients using a stated preference method. We used multi-criteria decision analysis to compare a gold standard NMA with the rapid NMA in terms of the ability of the gold standard NMA to change the ranking and expected values of treatments for individual patients. Results Using rapid methods, it was feasible to identify evidence addressing outcomes important to patients. We found that replacing effect estimates from our rapid NMA with estimates from the gold standard NMA resulted in relatively small changes in the ranking and expected value of treatments. The rapid method sufficed to estimate the effects of nine out of ten options. To produce a ranking of treatments accurate for more than 95% of patients, it was necessary to supplement systematic with rapid methods and to use relative importance weights in the analysis. Integrating estimates of the outcome “treatment burden” had a larger impact on rankings than replacing rapid with gold standard methods. Using patients’ importance weights only modestly affected results. Conclusions The transfer of knowledge to practice could benefit from faster systematic reviewing methods. The results in this preliminary assessment suggest that an improved rapid NMA approach might replace gold standard NMAs. Decision analysis could be used to compare evidence summarisation methods

Gamification design framework for mobile health: designing a home-based self-management programme for patients with chronic heart failure

Gamification is the design nexus between psychology and technology; thus, the ensemble of game design concepts and mobile health is promising for a far-reaching impact in public health. This paper presents a gamification design framework for mobile health as a unified, structured representation of activity systems aiming towards better health-related outcomes. It provides a valuable guideline for researchers and designers to model and gamify complex interventions into mobile health design with four steps: (i) defining activity systems, (ii) modelling, (iii) transforming, and (iv) designing. The framework is demonstrated for gamification of a home-based self-management programme for patients with chronic heart failure

Gamified mobile health interventions for mental well-being of older adults

Population ageing has raised major concerns about the prevalence of age-related mental health deterioration which is further intensified amid the COVID-19 pandemic. Mobile health (mHealth) interventions bear promising impacts on alleviating the mental health burden of this vulnerable group. However, mHealth solutions often report a high drop-out rate suggesting a lack of motivation and engagement among users. Also, the limited number of clinically validated mHealth applications indicates an urgent demand for empirical evidence on the subject. This paper proposes a design framework for gamified mHealth activities to enhance mental and cognitive well-being of the elderly. Further, the paper outlines a research protocol to investigate the impacts of the framework on a cohort of 250 older adults in a developing country under a single-subject experimental design. Our social experiment may reveal valuable insights into the potential of mHealth solutions and gamification in this domain

Additional file 7: of The development and feasibility of a personal health-optimization system for people with bipolar disorder

Module uses. Use of the system modules in different contexts. The first figure shows which modules of the system are integrated using MCDA, the second modules relevant in n = 1 trials, the third the modules relevant in one-off decisions as opposed to ongoing follow-up, and the forth the modules relevant when the system is used without predefined evidence. (PDF 1978 kb

Statusbericht aus Norwegen: Implementierung von Patientenbeteiligung im norwegischen Gesundheitswesen

Norway has traditionally high standards regarding civil rights particularly emphasizing equal access to societal resources including health care. This background and the health care system’s centralized national organization make it perfectly suited for implementation of shared decision making (SDM). In recent years, great efforts have been made by policy- makers, regional health authorities and not least the patients to facilitate a process of change in health communication culture. SDM is currently even given highest priority in health care strategies on all system levels. SDM has been structurally implemented, e.g. by including corresponding guidance in the standard patient pathways. Moreover, SDM is established as an element of service on the national health portal hosting a constantly increasing number of decision aids. Essentially the Norwegian Knowledge Center for Health Services contributes by searching and providing information for use in decision aids. Implementation is now being rolled out unit by unit for a list of medical problems as a series production of SDM using decision aids and health professional training. Importantly, production of SDM begins and succeeds as a soundly structured communication with both clinical environments and patients. However, as communication training has not been implemented before now, there are no data demonstrating sufficient realization of SDM in current health care. Beyond making reasonable use of scientific achievements, the Norwegian movement’s secret of success is the simultaneous commitment of all actors of the health system to a common idea