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Background Having online access to electronic health records (EHRs) may help patients become engaged in their care at an early age. However, little is known about adolescents using patient portals. A national survey conducted within the Nordic eHealth project NORDeHEALTH provided an important opportunity to advance our understanding of adolescent users of patient portals. The present study explored reasons for reading the EHRs, the perceived usefulness of information and functions in a patient portal and the association between frequency of use and encouragement to read the EHR. Methods Data were collected in a survey using convenience sampling, available through the Swedish online health portal during 3 weeks in January and February 2022. This study included a subset of items and only respondents aged 15-19. Demographic factors and frequencies on Likert-style questions were reported with descriptive statistics, while Fisher's exact test was used to explore differences in use frequency based on having been encouraged to read by a healthcare professional (HCP). Results Of 13 008 users who completed the survey, 218 (1.7%) were unique users aged 15-19 (females: 77.1%). One-fifth (47/218, 21.6%) had been encouraged by HCPs to read their records, and having been encouraged by HCPs was related to higher use frequency (p=0.018). All types of information were rated high on usefulness, while some functions were rated low, such as blocking specific clinical notes from HCPs and managing services for family members. The main reason for reading their health records online was out of curiosity. Conclusions Adolescents who read their records online perceive it to be useful. Encouragement by HCPs can lead to increased use of patient portals among adolescents. Findings should be considered in the future design of patient portals for adolescents., CC BY 4.0 DEED© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.Correspondence Address: J. Hagström; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; email: josefin.hagstrom@uu.seThis work was supported by NordForsk (grant number: 100477) and the Swedish Research Council for Health, Working Life and Welfare (FORTE) (grant number: 2020-01229).

The Nordic countries are, together with the United States, forerunners in online record access (ORA), which has now become widespread. The importance of accessible and structured health data has also been highlighted by policy makers internationally. To ensure the full realization of ORA’s potential in the short and long term, there is a pressing need to study ORA from a cross-disciplinary, clinical, humanistic, and social sciences perspective that looks beyond strictly technical aspects. In this viewpoint paper, we explore the policy changes in the European Health Data Space (EHDS) proposal to advance ORA across the European Union, informed by our research in a Nordic-led project that carries out the first of its kind, large-scale international investigation of patients’ ORA—NORDeHEALTH (Nordic eHealth for Patients: Benchmarking and Developing for the Future). We argue that the EHDS proposal will pave the way for patients to access and control third-party access to their electronic health records. In our analysis of the proposal, we have identified five key principles for ORA: (1) the right to access, (2) proxy access, (3) patient input of their own data, (4) error and omission rectification, and (5) access control. ORA implementation today is fragmented throughout Europe, and the EHDS proposal aims to ensure all European citizens have equal online access to their health data. However, we argue that in order to implement the EHDS, we need more research evidence on the key ORA principles we have identified in our analysis. Results from the NORDeHEALTH project provide some of that evidence, but we have also identified important knowledge gaps that still need further exploration., CC BY 4.0©Maria Hägglund, Anna Kharko, Annika Bärkås, Charlotte Blease, Åsa Cajander, Catherine DesRoches, Asbjørn Johansen Fagerlund, Josefin Hagström, Isto Huvila, Iiris Hörhammer, Bridget Kane, Gunnar O Klein, Eli Kristiansen, Jonas Moll, Irene Muli, Hanife Rexhepi, Sara Riggare, Peeter Ross, Isabella Scandurra, Saija Simola, Hedvig Soone, Bo Wang, Maedeh Ghorbanian Zolbin, Rose-Mharie Åhlfeldt, Sari Kujala, Monika Alise Johansen.Corresponding Author: Maria Hägglund, maria.hagglund@uu.seThis work was supported by the Citizen and Health Data Working Group in the European Federation for Medical Informatics (CHD WG, EFMI). This work was supported by NordForsk through the funding to Nordic eHealth for Patients: Benchmarking and Developing for the Future, NORDeHEALTH (project #100477), the Swedish Research Council for Health, Working Life and Welfare (FORTE) through the funding to Beyond Implementation of eHealth (project #2020-01229), the Strategic Research Council at the Academy of Finland (projects #352501 and #352503), and the Norwegian Centre for E-health Research. CB was supported by a Keane Scholar Award. The study funders played no role in the study design, data interpretation, writing of the results, or decision to submit the manuscript for publication., Nordic eHealth for Patients: Benchmarking and Developing for the Future, NORDeHEALTH

Informal caregivers, crucial contributors to healthcare, face myriad challenges in supporting individuals with health needs. While IT applications offer promising solutions, some caregivers hesitate to adopt them, favoring traditional communication approaches with healthcare and support providers. This study, conducted in Sweden, presents why caregivers are reluctant to use IT applications. Through a qualitative approach involving group interviews with caregiver association members, four key themes emerged, namely, need for in-person support with grief and stress, need for private support spaces, cognitive impairment, and financial constraints. Understanding these barriers is crucial for developing inclusive caregiving strategies that balance IT-based solutions with in-person assistance, promoting a sustainable caregiving support ecosystem.

Informal caregivers (ICs), including the patient's spouse, close relatives, or friends, play an important role in caregiving individuals with head and neck cancer (HNC). AI-based chatbots might offer information and assistance related to caregiving. This study presents the viewpoints of ICs and healthcare professionals (HCPs) on using AI-based chatbots in caring for individuals with HNC. A total of six focus groups were conducted with 15 ICs and 13 HCPs from three Swedish university hospitals. The study uncovers a widespread hesitancy toward the intention to use AI-based chatbots among ICs and HCPs. Factors contributing to this reluctance include their distrust in chatbot-provided information, negative past experiences of using chatbots, and lack of human connection in chatbot interactions. Embracing a holistic approach is crucial when designing chatbots, ensuring active user engagement and incorporating their perspectives into the design process.

This study explores the importance of constructive alignment in enhancing student engagement and learning outcomes in online courses, focusing on an online Human-Computer Interaction (HCI) course. We interviewed teaching assistants and reviewed the course feedback from students to identify challenges faced by teaching assistants and students, including unclear learning objectives, lack of engaging content, and insufficient assessment diversity. Drawing on feedback from both groups, we propose restructuring the course based on constructive alignment principles. Recommendations include incorporating recorded lectures, podcasts, seminars, and group discussions; restructuring assignments into smaller groups with clear guidelines and self-introduction videos; and diversifying assessment methods with design projects, final examinations, and quizzes. Additionally, we emphasize the importance of timely and clear feedback, explicit assignment instructions, and well-defined course guidelines. Implementing these recommendations aims to address existing challenges, enhance student engagement, and ensure clear alignment between teaching, learning, and assessment in the online HCI course.

The availability of Large Language Models (LLM), such as the widely accessible ChatGPT, has raised concerns regarding the reliability of assessment formats in university education. This presentation sheds light on the potential impact of ChatGPT on existing remote examination formats and offers recommendations to overcome associated challenges. Through interviews with three computer science educators and an analysis of insights from blog posts, social media platforms, and academic forums, we gathered diverse opinions and experiences related to ChatGPT's impact on university assessment formats. Our findings reveal challenges, particularly in cheating prevention, prompting the need for educators to adapt their teaching methods to this evolving landscape. While GPT performs well in answering open-ended questions, it struggles with calculations and problem-solving, with multiple-choice questions posing additional challenges. Incorporating interactive activities and oral examinations should be prioritized in this context. As ChatGPT gains traction, institutions must address concerns to maintain academic integrity.