Mediator – enabler for successful digital health care

It is no news that as in any other field of industry, digitalization is changing health care. This change is ongoing and profound as it affects every aspect imaginable; from provisioning to funding, and from roles to responsibilities. The magnitude of this change is such that some label it as the ‘health care revolution’. Not all individuals are ready for this ‘revolution’. Some rebel against it while others are simply not able to cope with it. Regardless of the underlying reason, it can be estimated that in the near future, roughly 10 % of the population in the OECD countries will drift outside the reach of the modern electronic health care services. These individuals, the digital orphan, need to be brought back in order to prevent the future of health care from becoming more marginalized and discriminatory than it is today. Mediators, individuals in the crux of health care and technology, are one way to prevent this unwelcome eventuality from coming true. In the following, the focus of examination is on the mediators and mediation. The role of a mediator is critically examined from different perspectives, and a framework for mediation is presented. &nbsp

Newborns, infants and epilepsy – the missing piece of software

Diagnosing epilepsy on a small child is a challenge. A child’s brain undergoes tremendous changes during the first years, creating new neural connections every second. It follows from this that what the parents and the physician may regard as abnormal behavior, can be perfectly normal. However, in some cases the abnormal behavior may be caused by epilepsy. In that case, either a detailed description of the seizure or, preferably, an eye-witness’ recording of it is invaluable in terms of making an accurate diagnosis. Naturally, an EEG is also needed. Obtaining relevant, detailed information from parents is not always a straightforward matter. In order to enable collecting more accurate information about episodes that are potentially epileptic, new practices and technologies are needed. In the following viewpoint we present what can be called the missing piece of software

Mediator - enabler for successful digital health care

It is no news that as in any other field of industry, digitalization is changing health care. This change is ongoing and profound as it affects every aspect imaginable; from provisioning to funding, and from roles to responsibilities. The magnitude of this change is such that some label it as the ‘health care revolution’. Not all individuals are ready for this ‘revolution’. Some rebel against it while others are simply not able to cope with it. Regardless of the underlying reason, it can be estimated that in the near future, roughly 10 % of the population in the OECD countries will drift outside the reach of the modern electronic health care services. These individuals, the digital orphan, need to be brought back in order to prevent the future of health care from becoming more marginalized and discriminatory than it is today. Mediators, individuals in the crux of health care and technology, are one way to prevent this unwelcome eventuality from coming true. In the following, the focus of examination is on the mediators and mediation. The role of a mediator is critically examined from different perspectives, and a framework for mediation is presented.</p

Maturity of health care testbeds – A qualitative mapping at the Nordic context

This qualitative mapping aimed to report health care testbed activities in Finland and two other Nordic countries and describe the maturity of these testbeds. The data were collected in 2021 with semi-structured interviews from twelve organizations, of which seven were university hospitals, four universities of applied sciences and one primary health care organization. The data were analyzed using deductive content analysis based on previously identified maturity factors: resources, facilities, marketing and communications, repeatability, contract models, certification and standards compliance and time at the market area. According to the results, there were testbed activities in all participating organizations. The testbed activities mainly were funded from various projects, and the staff mainly consisted of single employees. The testbed facilities were both real-life environments and test or simulation labs. The marketing and communications were based on web pages, social media, events and networks. The repeatability was ensured primarily with usability testing, and the contract models were under development in most organizations. Certification and standards of compliance were rare. Time at the market area was relatively short in many organizations as the activities were mainly testing single products or services rather than continuous co-creation. Testbed activities in the health care and higher education organizations are merging with the daily operations in Nordic countries. Specialization within the organizations was seen, for example, robotics, rehabilitation or medical devices. Testbed organizations highlighted the need for more structured and coordinated processes and activities in order to ensure the management, quality and effectiveness of their testbed services

Electronic health services for cardiac patients: a salutogenic approach

Patient‐centricity is a name given to the on‐going transformation in health care delivery. The term is widely used and it has been given different interpretations in relation to the context of its use. These interpretations emphasize aspects such as empowerment, seamless chain of care, and even responsibility; how it is divided amongst the service provider and the patient. Regardless of the interpretation and the context of use, one thing is constant; a genuine desire to support the patient’s health related endeavours in a field that is fragmented and becoming increasingly technology‐oriented. In order to support the patient in this field, a comprehensive approach to health is needed to capture nuances of everyday life outside singular health related transactions (such as appointments, laboratory visits, etc.) and technology. This article looks into some well‐established theories used in depicting such a comprehensive view to health and well‐being, and conceptualizes their applicability to real‐world electronic health services. The article reports preliminary results in the form of proposed new functions, ideas on the applicability of the theories and describes the outline of the iterative development process. The findings of this article base on development of electronic health services for cardiac patients performed in an on‐going project, which is executed during 2011–2013

Newborns, infants and epilepsy - the missing piece of software

Diagnosing epilepsy on a small child is a challenge. A child’s brain undergoes tremendous changes during the first years, creating new neural connections every second. It follows from this that what the parents and the physician may regard as abnormal behavior, can be perfectly normal. However, in some cases the abnormal behavior may be caused by epilepsy. In that case, either a detailed description of the seizure or, preferably, an eye-witness’ recording of it is invaluable in terms of making an accurate diagnosis. Naturally, an EEG is also needed. Obtaining relevant, detailed information from parents is not always a straightforward matter. In order to enable collecting more accurate information about episodes that are potentially epileptic, new practices and technologies are needed. In the following viewpoint we present what can be called the missing piece of software.</p

Maturity of health care testbeds – A qualitative mapping at the Nordic context

This qualitative mapping aimed to report health care testbed activities in Finland and two other Nordic countries and describe the maturity of these testbeds. The data were collected in 2021 with semi-structured interviews from twelve organizations, of which seven were university hospitals, four universities of applied sciences and one primary health care organization. The data were analyzed using deductive content analysis based on previously identified maturity factors: resources, facilities, marketing and communications, repeatability, contract models, certification and standards compliance and time at the market area. According to the results, there were testbed activities in all participating organizations. The testbed activities mainly were funded from various projects, and the staff mainly consisted of single employees. The testbed facilities were both real-life environments and test or simulation labs. The marketing and communications were based on web pages, social media, events and networks. The repeatability was ensured primarily with usability testing, and the contract models were under development in most organizations. Certification and standards of compliance were rare. Time at the market area was relatively short in many organizations as the activities were mainly testing single products or services rather than continuous co-creation. Testbed activities in the health care and higher education organizations are merging with the daily operations in Nordic countries. Specialization within the organizations was seen, for example, robotics, rehabilitation or medical devices. Testbed organizations highlighted the need for more structured and coordinated processes and activities in order to ensure the management, quality and effectiveness of their testbed services.</p

Kansalaislähtöisyys sähköisissä terveyspalveluissa: Sydänpotilaan arki

Siirretty Doriast

New and Emerging Challenges of the ICT-Mediated Health and Well-Being Services

This monograph dissertation looks into the field of ICT-mediated health and well-being services. Through six chapters that extend the work done in the reviewed and published articles, the dissertation focuses on new and emerging technologies, and to impact of their use on the beneficiary; the individual who eventually derives advantage from the services. As the field is currently going through major changes particularly in the OECD countries, the focus is on shortterm developments in the field and the analysis on the long term developments is cursory by nature. The dissertation includes theoretical and empirical elements. Most of the empirical elements are linked to product development and conceptualization performed in the national MyWellbeing project that ended in 2010. In the project, the emphasis was on conceptualization of a personal aid for the beneficiary that could be used for managing information and services in the field of health and well-being services. This work continued the theme of developing individual-centric solutions for the field; a work that started in the InnoElli Senior program in 2006. The nature of this thesis is foremost a conceptual elaboration based on a literature review, illustrated in empirical work performed in different projects. As a theoretical contribution, this dissertation elaborates the role of a mediator, i.e. an intermediary, and it is used as an overarching theme. The role acts as a ‘lens’ through which a number of technology-related phenomena are looked at, pinned down and addressed to a degree. This includes introduction of solutions, ranging from anthropomorphic artefacts to decision support systems that may change the way individuals experience clinical encounters in the near-future. Due to the complex and multiform nature of the field, it is impractical and effectively impossible to cover all aspects that are related to mediation in a single work. Issues such as legislation, financing and privacy are all of equal importance. Consideration of all these issues is beyond the scope of this dissertation and their investigation is left to other work. It follows from this that the investigation on the role is not intended as inclusive one. The role of the mediator is also used to highlight some of the ethical issues related to personal health information management, and to mediating health and well-being related issues on behalf of another individual, such as an elderly relative or a fellow member of a small unit in the armed forces. The dissertation concludes in a summary about the use and functions of the mediator, describing some potential avenues for implementing such support mechanisms to the changing field of ICT-mediated health and well-being services. The conclusions also describe some of the limitations of this dissertation, including remarks on methodology and content.Siirretty Doriast