Usability of information systems : Experiences of outpatient physicians, outpatient nurses, and open care social welfare professionals from three large cross-sectional surveys in Finland

Background: Many European countries are integrating healthcare and social welfare services; some also include joint information systems (ISs) in this process. Despite this, large national survey studies examining and comparing the experiences of the major professional groups regarding the usability of their health (HISs) and client information systems (CISs) are lacking.Methods: We combined the responses from three national cross-sectional surveys conducted among physicians and nurses in 2017, and social welfare professionals (SWPs) in 2019 in Finland. We selected the responses of 1,826 physicians and 774 nurses working in outpatient clinics in specialized and primary care, and 669 social workers and other SWPs working in open services. The questionnaires were adjusted from a validated instru-ment. In this study, we analyzed 11 usability-related statements.Results: The healthcare professionals (HPs) were more critical of the stability and responsiveness of their ISs than the SWPs (27-48% vs 58-65% agreed). The physicians were most dissatisfied with IS support for routine tasks (24-26% agreed). Less than half of all respondents agreed with statements concerning the ease of documentation, arrangement of fields, and terminology. While the HPs were satisfied with IS support for collaboration and in-formation exchange between professionals in the same organization, all professional groups were dissatisfied with cross-organizational support and communication with patients and clients. Almost half of the HPs considered that HISs improve the quality of care, but 80% of the SWPs disagreed that CISs help improve the quality of services. Conclusions: Overall, the physicians, nurses, and SWPs were dissatisfied with the usability of their HISs and CISs. Based on our findings, ISs should be further developed to support routine tasks, inter-and cross-organizational collaboration, and information exchange. ISs for the integration of care and services should be designed to accommodate various professional groups' different work contexts and needs.Peer reviewe

Intraluminal tracheal lipoma as a rare cause of dyspnoea in a dog

Background: Tracheal tumors are rarely diagnosed in veterinary medicine and the majority of tracheal neoplasia reported in adult dogs are malignant. Intratracheal lipoma has not been previously reported in the veterinary literature. Case presentation: A 7-year-old Briard dog was evaluated for inspiratory dyspnoea and an inspiratory wheeze. Cervical radiographs and tracheoscopic examination revealed an intratracheal mass that was surgically removed. The dog has been asymptomatic after the surgery. Conclusions: Based on histopathology, the mass was diagnosed as lipoma. To the authors' knowledge, this is the first published report of an intratracheal lipoma in the veterinary literature.Peer reviewe

Improving children’s patient experience with a mobile hospital clowning application – Initial user experiences from the clowns’ perspective

eHealth solutions are increasingly being developed to support patient care and improve patients’ experiences (PXs). Recently, the coronavirus disease 2019 (COVID-19) pandemic and the shortage of nurses in several countries, including Finland, have further underscored the need for new digital services. In the context of children’s hospitals, care-supporting services include hospital clowns who work to provide emotional support for children and improve their PXs. Hospital clowns are known to have a positive impact on children’s PX. The Finnish hospital clown organization Sairaalaklovnit ry has published its first mobile application Sairaalaklovnit to provide a digital contact platform to reach patients remotely via messages. The application is mainly targeted at child patients and includes both entertainment and messaging facets for communication between child patients and hospital clowns. The two main user groups for this application can be considered to be child patients and hospital clowns. This article presents the data and results found during a study related to the user experience (UX) of the Sairaalaklovnit application. With the research questions, “Which aspects influence the UX of the hospital clown application?” and more specifically, out of the two user groups, “How do Finnish hospital clowns experience the new hospital clown mobile application?”, this study aims to gain an understanding of how Finnish hospital clowns experience the newly developed application for expanding physical contact with patients into a digital form. The qualitative data used in this article were collected in the summer of 2022 through an online questionnaire (n = 5) and semi-structured interviews (n = 3) with hospital clowns. The hospital clowns were mostly satisfied with the published application, but some deficiencies were mentioned. Most of the complaints were related to technical issues. However, the application was seen as a useful tool that can bridge physical and digital contact with children. The developer has been made aware of the technical issues and fixes expected in the future. For future research, it can be beneficial to rerun the UX study for the hospital clowns and possibly with a larger sample to see whether there have been any changes after the technical issues have been solved. Moreover, studying how child patients, which constitute the other user group, experience the new application, can prove to be beneficial for possible future development

Terveydenhuollon tietojärjestelmien käytettävyys

Terveydenhuollon tietojärjestelmiin liittyvät ongelmat ja käytettävyys ovat nousseet esiin sekä julkisissa keskusteluissa että akateemisissa tutkimuksissa. Keskusteluissa käytettävyyden käsite on saanut erilaisia painotuksia ja merkityksiä. Terveydenhuollon tietojärjestelmien tutkimusalueella käytettävyyden mielletään liittyvän läheisesti yksittäisten järjestelmien arviointiin. Tässä artikkelissa kuvataan käytettävyys laaja-alaisena kokonaisuutena ja avataan keskustelua siitä, miten käytettävyys voitaisiin operationalisoida terveydenhuollon tietojärjestelmä-suunnittelun yhteydessä. Laaja näkökulma käytettävyyteen huomioi käyttö-tilanteen ja siihen liittyvät osa-alueet kokonaisuutena. Käytettävyyssuunnittelun avulla järjestelmälähtöisestä kehittämisestä voidaan edetä kohti erilaisten käyttäjäryhmien tarpeita huomioivia ja vaihteleviin käyttötilanteisiin soveltuvia ratkaisuja. Käytettävyyden hahmottaminen laaja-alaisena kokonaisuutena auttaa paitsi tarttumaan nykyisiin ongelmakohtiin, myös ymmärtämään terveydenhuollon tietojärjestelmäkehityksessä tapahtuvia muutoksia

Kohti käyttäjälähtöisiä kotidialyysin sähköisiä terveyspalveluita : potilaskokemus ja ammattilaisten tarpeet suunnittelun lähtökohtana

Vertaisarvioitu. English abstract.Peer reviewe

Lääkärien kokemuksia ja näkemyksiä terveydenhuollon tietojärjestelmien kehittämisestä

Tutkimuksen tavoitteena oli selvittää lääkärien kokemuksia ja näkemyksiä terveydenhuollon tietojärjestelmien kehittämistyöstä ja ‐tarpeista. Aineisto kerättiin keväällä 2010 osana valtakunnallista ”Tietojärjestelmät lääkärin työvälineenä” kyselytutkimusta. Kyselyyn vastasi kolmannes kaikista potilastyötä tekevistä lääkäreistä (n=3929). Tulokset osoittavat, että lääkärien kokemukset kehittämistyöstä, erityisesti vaikutus‐ ja osallistumismahdollisuuksien puuttumisesta, ovat hyvin kriittisiä. Valtaosa kehittämistoiveista liittyi järjestelmien käytettävyyden parantamiseen ja nykyisistä potilastietojärjestelmistä puuttuviin toiminnallisuuksiin. Merkittävä osa lääkäreistä oli kiinnostunut osallistumaan tietojärjestelmien kehittämistyöhön. Tutkimuksen perusteella järjestelmien käytettävyydessä sekä loppukäyttäjien ja kehittäjien välisessä yhteistyössä on paljon kehitettävää. Tulevaisuudessa tulisi panostaa käyttäjälähtöisten ja käyttäjien osallistumista tukevien kehittämismenetelmien ja ‐käytäntöjen kehittämiseen ja käyttöönottoon

Kohti käyttäjälähtöisiä kotidialyysin sähköisiä terveyspalveluita : potilaskokemus ja ammattilaisten tarpeet suunnittelun lähtökohtana

Vertaisarvioitu. English abstract.Peer reviewe

Recurrent bacterial pneumonia in Irish Wolfhounds: Clinical findings and etiological studies

Background: Increased incidence of bacterial pneumonia (BP) has been reported in Irish Wolfhounds (IWHs), and recurrence of BP is common. The etiology of recurrent pneumonia in IWHs is largely unknown. Objectives: To describe clinical findings in IWHs with recurrent BP and investigate possible etiologies. Animals: Eleven affected IWHs, 25 healthy IWHs, 28 healthy dogs of other Sighthound breeds, and 16 healthy dogs of other breeds. Methods: Prospective cross-sectional observational study. All affected IWHs underwent thorough clinical examinations including thoracic radiographs, thoracic computed tomography, electron microscopic evaluation of ciliary structure, and bronchoscopy and bronchoalveolar lavage fluid (BALF) cytology and culture. Serum and BALF immunoglobulin concentrations were measured using an ELISA method, and peripheral blood lymphocyte subpopulations were analyzed using flow cytometry. Esophageal function was assessed by fluoroscopy (n = 2). Results: Median age of onset was 5.0 years (range, 0.4-6.5 years), and when presented for study, dogs had experienced a median of 5 previous episodes of BP (range, 2-6). The following predisposing factors to BP were detected: focal bronchiectasis (10/11), unilateral (2/9) and bilateral (1/9) laryngeal paralysis, and esophageal hypomotility (2/2). Local or systemic immunoglobulin deficiencies or primary ciliary defects were not detected. Conclusions and Clinical Importance: Recurrent BP affects mostly middle-aged and older IWHs without any evident immune deficit or primary ciliary defects. Focal BE was a frequent finding in affected dogs and likely contributed to the development of recurrent respiratory infections. Laryngeal and esophageal dysfunction identified in a minority of dogs may contribute to recurrent BP.Peer reviewe