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Publisher Copyright: © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Copyright: Copyright 2021 Elsevier B.V., All rights reserved. Despite much criticism, global digital platforms hold some promise for small-scale entrepreneurs (SSEs) in the global south. However, they are often excluded from direct participation in global initiatives, such as crowdfunding. Besides socio-cultural disparities, accessibility and adoption issues, technology usage and integration present a major challenge. To bridge those gaps we propose a workable model consisting of a local tech mediator operating on a digital platform connecting local SSE to global digital services. We have engaged a group of informal settlement SSE in Windhoek, Namibia to jointly conceptualise the roles, tasks and responsibilities of a local tech mediator, concurrently with technical skills training as well as the development of an international crowdfunding campaign. We assert that the jointly developed concepts of a local instantiation of the model as well as the co-design process have enabled us to create model, which would allow the utilisation of global digital platforms for SSEs inthe global south.

Background and Objectives: During past years, gamification has become a major trend in technology, and promising results of its effectiveness have been reported. However, prior research has predominantly focused on examining the effects of gamification among young adults, while other demographic groups such as older adults have received less attention. In this review, we synthesize existing scholarly work on the impact of gamification for older adults. Research Design and Methods: A systematic search was conducted using 4 academic databases from inception through January 2019. A rigorous selection process was followed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Twelve empirical peer-reviewed studies written in English, focusing on older adults aged ≥55, including a gameful intervention, and assessing subjective or objective outcomes were identified. Eleven of the 12 studies were conducted in the health domain. Randomized controlled study settings were reported in 8 studies. Positively oriented results were reported in 10 of 12 studies on visual attention rehabilitation, diabetes control, increasing positive emotions for patients with subthreshold depression, cognitive training and memory tests, engagement in training program, perceptions of self-efficacy, motivation and positive emotions of social gameplay conditions, increased physical activity and balancing ability, and increased learning performance and autonomy experiences. The results are, however, mostly weak indications of positive effects. Discussion and Implications: Overall, the studies on gameful interventions for older adults suggest that senior users may benefit from gamification and game-based interventions, especially in the health domain. However, due to methodological shortcomings and limited amount of research available, further work in the area is called for.

Publisher Copyright: © 2021 The Authors. The Electronic Journal of Information Systems in Developing Countries published by John Wiley & Sons Ltd. Unemployment is a serious issue in many areas of Global South. Over the last years, microwork platforms have started to emerge offering opportunities for earnings and promising improved livelihoods. Although the gig economy facilitated by these platforms has been criticized in the literature, we argue that in the context of informal economy, participation on these platforms does not always worsen the livelihood and thus should be examined. This paper investigates the requirements for using such platforms and assesses their applicability in an informal settlement in Namibia. The Sustainable Livelihoods Approach provides the conceptual framework for the research. We devised a simulation by using design science research methods, where the community members were able to complete digital micro-tasks for monetary compensation. The experiment evoked excitement among participants. This paper argues that the digital micro-tasks have promise for the individuals, and elaborates on human, financial, physical, and social capitals required to use these platforms. Finally, we propose a new way, trained peers called “tech mediators,” that can act as facilitators to make these platforms more available for the communities in Global South in the future.

Digital services have not been truly available for marginalised rural communities, especially in the Global South. Rural communities often lack technical infrastructures, awareness about available services and the necessary skills to use them to their full potential. In this paper, we present a collaborative web-site development project initiated by a rural San community in Namibia. The website intends to support a current community livelihood activity of setting up a campground next to their village. Embedded in a community-based research approach we have deployed co-design methods and techniques to establish a consensus-based business description, including target market, activities, pricing and promotion strategies. Co-design techniques enabled the community to examine and refine their conceptualisation of their business endeavour as well as anticipate target audiences and operational scenarios. A basic website has been created including the agreed upon content. Further efforts include a wider dissemination of the information as well as possible inclusion in global broker websites. We conclude with a reflection on the co-design process providing a researcher and a community perspective.

Electronic cigarettes (e-cigarettes) usage has surged substantially across the globe, particularly among adolescents and young adults. The ever-increasing prevalence of social media makes it highly convenient to access and engage with content on numerous substances, including e-cigarettes. A comprehensive dataset of 560,414 image posts with a mention of #vaping (shared from 1 June 2019 to 31 October 2019) was retrieved by using the Instagram application-programming interface. Deep neural networks were used to extract image features on which unsupervised machine-learning methods were leveraged to cluster and subsequently categorize the images. Descriptive analysis of associated metadata was further conducted to assess the influence of different entities and the use of hashtags within different categories. Seven distinct categories of vaping related images were identified. A majority of the images (40.4 %) depicted e-liquids, followed by e-cigarettes (15.4 %). Around one-tenth (9.9 %) of the dataset consisted of photos with person(s). Considering the number of likes and comments, images portraying person(s) gained the highest engagement. In almost every category, business accounts shared more posts on average compared to the individual accounts. The findings illustrate the high degree of e-cigarettes promotion on a social platform prevalent among youth. Regulatory authorities should enforce policies to restrict product promotion in youth-targeted social media, as well as require measures to prevent underage users' access to this content. Furthermore, a stronger presence of anti-tobacco portrayals on Instagram by public health agencies and anti-tobacco campaigners is needed.

In this paper we discuss the necessity to preserve the sense of presence in virtual reality (VR). A high sense of presence has proven advantages but is also very fragile to interruptions. We outline scenarios where interaction and communication between persons inside and outside virtual environments are necessary and assess challenges for maintaining the immersed user’s sense of presence in such cases. We also use existing literature to outline an experiment that allows us to try out different methods of collaboration between immersed users and external facilitators in order to discern their effect on presence.

In this paper, we present results of a contextual inquiry study in a Community-Based Tourism (CBT) village. We investigate the influence of an enabling digital service platform for tourism that rural Tanzanians utilise to attract and host guests. Our interviews and observations show that hosting tourists delivers positive short-term livelihood outcomes (income, visitors), but the long-term impact (social, infrastructure) to the communities requires deeper consideration. We recommend that sustainable digital service platforms for CBT should be developed and assessed including their features in addressing long-term impacts on livelihood. We propose the following topics for consideration in future development of digital CBT platforms: the role of surrounding communities, rewards to platform contributors, enabling of indirect economic activities, understanding conflict-of-interest between communities and platform, empowerment all of the users, and monitoring the local performance of the platform for its users.

In this exploratory paper we discuss the relation between empowerment and global sharing economy in a Global Southern context. We distinguish two primary meanings of 'empowerment' namely,the liberation from oppression and the ability to act. We inspect working for sharing economies from both angles. A critical factor for assessing whether sharing economies are empowering for global South workers is the change it brings. If the platform work offers opportunities for formerly unemployed, the change is considered as empowering. However, it is possible, that these platform jobs instead replace the traditional, more protected employments, in which case the change is considered dis-empowering. We exemplify our arguments with a contextual inquiry into community-based tourism in a small village Tanzania.

In the era of digital services and digital connectivity, a massive amount of knowledge has become available and accessible all the time and for all ages. This mandates significant structural changes in the ways in which knowledge are shared and contents are presented. The ways in which knowledge is shared and learners become engaged with that knowledge are crucial in lifelong learning. In lifelong learning the knowledge and the content must be delivered to learners at the right time, without distractions and noise. The traditional educational offering in classrooms is not anymore feasible and supportive as learning happens in a disengaged manner in lifelong learning. In new lifelong learning services, user experience (UX) plays a key role in delivering content appropriately and supporting transition of learning between different contexts with adaptive learning media. The objective of this study is to illustrate and elaborate on the roles of feelings and emotions in engaging students in lifelong learning applications. We have applied systematic literature review (SLR) to identify emotional factors associated with lifelong mobile learning (m-learning) environments. Based on the findings, we propose an application concept as a case study to demonstrate how emotional factors can manifest themselves in lifelong learning applications. Finally, based on the findings of the literature review and the case study evaluation, we propose a model illustrating the facets in lifelong learning applications.

The low adoption and use of e-Government have motivated interest in researching citizen-centric e-Government. This is important to developing countries where e-Government is seen as promoting social exclusion due to differences in income, access to ICTs and literacy rates across the populace. This study used a prototype m-Government application to investigate factors of citizen-centric e-Government. The study targeted one of the Ministries in Namibia and investigated challenges faced by citizens when accessing government service. While m-Government and e-Government could play a key role in addressing some of the challenges faced, it was noted that the government need to strategically implement e-Government given a number of contextual factors. For instance, while an urban-based citizen could afford a smartphone and operate one, the case is different with a citizen living in rural communities; rural populace, characterised by the aged cannot afford smartphones nor operate ones without assistance. This is mainly down to the fact that part of the rural populace cannot read and write in English or their native language. Hence, this study suggests understanding ICTs accessible to the populace, ICT skills, attitude towards technology, ICT infrastructure, costs, security and using a community-based partnership approach as key factors of e-Government in Namibia.

Patient experience (PX) is getting attention among researchers and healthcare service providers, but little is known about the experiences of child patients and how to explore those. This paper reports findings from a study in which two participatory research methods, photo elicitation and video diary, were applied to investigate the elements of children’s PX in the context of children’s hospital. The aim was to find out what elements constitute the PX of children aged 7–16 years. The research data were gathered in 2016–2017. Twenty-two child patients participated in the study: eight children aged between 7 and 10 in the photo elicitation part, and fourteen children aged from 10 to 16 in the video diary part. In the analysis, the data were first analyzed per research method but afterwards combined and analyzed together. Based on the analysis, four main themes of PX of children were identified: 1) hospital facilities and entertainment, 2) medical care, 3) social relationships with the hospital personnel and other people, and 4) feelings and coping with the illness. Feedback on the research methods from the participated children was mainly positive. Further work is needed to validate the findings and introduce new creative approaches to research PX of children of different ages.

Libraries are increasingly adopting user-centred design (UCD) approaches to the development of their services for the benefit of customers. Less attention is paid to evaluating the activity of designing. To address this managerial question, we present a study that examines UCD performance in the context of digital library services' development. The study builds on the existing knowledge on library and design evaluation and examines the literature from two theoretical perspectives: performance management and temporalities. As the main contribution of this paper, we introduce the conceptual 360-Degree Temporal Benefits Model, which captures the situation where many stakeholders are involved in a design activity of a digital library service. Application of the model on two cases demonstrates that the stakeholders can assess the benefits of UCD very differently. We argue that the new model helps in framing the change from the measurable design benefits towards more ambitious and ambiguous public values.

Terveydenhuollon ammattilaisten kokemuksia potilastietojärjestelmistään on maailmanlaajuisesti kartoitettu vähän, vaikka käyttäjäkokemukset ovat keskeinen osa järjestelmien kehitystä ja arviointia. Sairaanhoitajien kokemusten valtakunnallinen kartoitus tehtiin ensimmäistä kertaa Suomessa alkuvuodesta 2017. Kohteena olivat työikäiset sairaanhoitajat, terveydenhoitajat ja kätilöt Sairaanhoitajaliiton ja Tehyn jäsenrekisteristä. Vastaava tutkimus on tehty lääkäreille vuosina 2010, 2014 ja 2017. Menetelmänä oli lääkärikyselyn pohjalta muokattu sähköinen kyselylomake, jonka Sairaanhoitajaliitto ja Tehy lähettivät jäsenilleen. Yhteensä 3607 sairaanhoitajaa vastasi kyselyyn. Vastaukset ryhmiteltiin Sote-tieto hyötykäyttöön -strategian aihealueen ”Kyvykkäille käyttäjille fiksut järjestelmät” tavoitteiden mukaisiin osa-alueisiin. Kaikissa osa-alueissa todettiin eroja sekä potilastietojärjestelmien tuotemerkkien että vastaajien toimintaympäristöjen välillä. Yksi keskeisimpiä korjattavista ongelmista oli saman asian kirjaaminen moneen paikkaan. Sen voidaan katsoa altistavan virheille ja osoittavan huonosti onnistunutta tietojärjestelmäintegraatiota. Kehittämiskohteiksi nousivat myös tietojärjestelmien käyttökatkot, jotka on aiemmassa kirjallisuudessa todettu riskiksi potilasturvallisuudelle. Tutkimuksessa löytyi eroja tuotemerkkien välillä tietojärjestelmien käytettävyydessä ja potilaan hoidossa tarvittavan, ajantasaisen ja laadukkaan tiedon saamisessa paikallisesti, alueellisesti ja kansallisesti. Vastaajat kokivat tietojärjestelmien edellyttämien toimintatapojen muutosten käyttökoulutuksen riittämättömäksi. Tietojärjestelmien kehittämistyöhön aktiivisesti osallistuvat antoivat muita paremman kouluarvosanan tietojärjestelmälleen. Tätä selvitetään tarkemmin erillisessä artikkelissa. Osallistuminen tietojärjestelmien kehittämistyöhön ja koulutus vievät alkuun aikaa asiakas- ja potilastyöltä, mutta hyvän käytettävyyden ja käyttötaidon voidaan myöhemmin odottaa säästävän ammattilaisten aikaa tietojärjestelmien käytöltä suoraan asiakas- ja potilastyöhön. Tunnistetut erot potilastietojärjestelmien käytettävyydessä ja tuessa työlle sekä hoidon laadulle auttavat tunnistamaan hyviä käytäntöjä eri toimintaympäristöissä sairaanhoitajan ajankäytön tehostamiseksi ja potilasturvallisuuden ja yhteistyön lisäämiseksi. Sairaanhoitajia on kuultava paremmin tietojärjestelmiä kehitettäessä. Organisaatioiden on syytä suunnitella tietojärjestelmäkoulutukset niin, että ammattilaisten osaaminen pysyy ajan tasalla tietojärjestelmien ja niiden käyttötapojen kehittyessä. Myös sairaanhoitajaliiton sähköisten terveyspalveluiden strategia korostaa digiosaamista ja kehitystyöhön osallistumista., Globally, there are only a few studies on healthcare professionals' experiences of their patient information systems, although user experiences are a key component of system development and assessment. A nationwide survey of nurses' experiences was conducted for the first time in Finland in early 2017. The survey was targeted to working-age nurses, community nurses and midwives from the Membership Registers of the Nursing Association and the Tehy. A similar study has been conducted for physicians in 2010, 2014 and 2017. An electronic questionnaire, based on the physicians’ questionnaire, was sent by the Nursing Association and Tehy to their members. A total of 3607 nurses responded to the questionnaire. The results were grouped using the objectives of the Finnish eHealth and eSocial 2020 Strategy theme "Smart Systems for Capable Users". Responses differed by patient information system brands and by the respondents' operating environments. One of the most prominent problems was the need to record the same thing in many places, which can expose to errors and indicates poor information system integration. Poor stability of information systems was also identified as a common problem; identified as a risk to patient safety in previous literature. There were differences between brands in usability of information systems and availability of up-to-date and high quality information in patient care locally, regionally and nationally. Respondents felt that in-service training was inadequate with regard to changes in operating methods required by information systems. Active user participation in the development of information systems was associated with better school grades given by the respondent for the information system. This will be studied in more detail in a separate article. Participation in the development of information systems and training take initially time from direct customer and patient work, but good usability and usage skills can later be expected to save time due to fluent use of information systems. The system and context specific differences in the information system usability and support to work as well as quality of care identified in this study can be used to pinpoint good design practices in different contexts of use. This is needed to improve efficiency of the nurses’ work and to increase patient safety and co-operation. Nurses need to be better consulted when developing information systems. Organizations need to design information system training so that the skills of the professionals remain up to date as information systems and their usage patterns evolve. The Nursing Association's e-Health Strategy also emphasizes the user eHealth competence and participation in development work.

According to earlier studies, Finnish physicians suffer from stress caused by poor usability of their digital tools and feel excluded from healthcare IT development. Active participation in usability evaluation could help involve doctors into developmental work, but more effective and participatory methods are needed. The objective of this study was to research whether physicians with no training in usability evaluation are able to discover usability problems using heuristic walkthrough technique. In addition, we wanted to find out if the level of EHR user experience affects the nature of the usability problems found. Heuristic walkthrough using a modified set of Nielsen’s heuristics and clinical tasks was performed to evaluate usability of a widely used Electronic Health Record (EHR) in Finland. Medical students and physicians with no previous experience in usability evaluation and 1) with or 2) without prior experience in using the EHR in question were recruited as evaluators. A control group of usability experts was used. Physicians were able to identify usability problems, ranging from cosmetic flaws to problems concerning patient safety and significant hindrance for work. Analysis of the found usability problems revealed that experienced EHR users discovered usability problems in nearly all major functions within the given scenario and time span. Physicians as evaluators in heuristic walkthrough has the potential to produce relevant data about EHR usability. The arrangement benefits participating physicians by introducing them to usability. Further research needs to find out, whether the suggested method could support better communication and collaboration between end-users and software developers.

The use of social media across the educational landscape is on the rise. Subsequently, the body of research on this topic is vibrant and growing. In this article, we present findings from a review of 103 peer-reviewed scientific studies published over the last decade (2007-2017) that address the use of Twitter for educational purposes across formal and informal settings. The majority of the studies reported in the literature are descriptive case studies carried out with students in North American and European higher education settings. Analysis of these studies signals Twitter as a useful tool for communication due to high accessibility, novelty, and real-time format. Students, teachers, and other stakeholders use it as a pedagogical tool to gain information, interact and engage with each other, participate in their respective communities of interests, and share their insights about specific topics. Moreover, Twitter has the potential to enhance students' learning capabilities as well as improve their motivation and engagement due to its unique features and non-traditional teaching approach. Finally, our analysis advocates for carrying out further empirical studies focusing on digital trace data and inference, particularly in the developing countries.

Interest in studying experiences has grown rapidly; however, little attention has been paid to the applicability of qualitative methods for capturing the service experience in children’s health care. This study examined and compared three data collection methods to capture the multidimensional service experience of child patients and their families: video diaries with child patients, narrative interviews with parents of a child patient, and semistructured interviews with health-care professionals working with child patients. The methods were analyzed with respect to their benefits and limitations and their applicability for capturing the multidimensional service experience presented by service experience co-creation framework, including the temporal, factual, spatial, locus, control, and organizational dimensions. The key findings are as follows: (A) The video diary method has the potential to capture the temporally broad and spatially complex phenomenon of child patients’ service experience and enables researchers to capture service experience created beyond the hospital setting (e.g., through hobbies or in school). (B) Narratives with parents have the potential to capture the temporal, spatial, locus, and organizational dimensions through stories and are well-suited for mapping children’s experiences and the actors influencing them. (C) Semistructured interviews with health-care professionals have the potential to capture a generalized but temporally narrow view of the service experience of child patients, concentrating on experiences within hospital settings. This is beneficial for developing health-care service providers’ actions. Structured analysis and comparison of methods guides researchers to select appropriate methods to take a complementary approach in the understanding of experiences in the context of children’s health care.

To promote eHealth services effectively, it is important to understand what motivates people to use these services and how they can be further supported. Our aim was to explore user experiences with eHealth services from the viewpoint of patients with chronic illnesses. The survey data included responses from 397 patients actively using eHealth services in Finland. Most of them had positive experiences using the services. We found that these positive experiences and the perceived benefits of eHealth services encouraged patients to continue using the services. In order to bolster the use of eHealth services, patients and other potential users must be informed about the new services and how to access them. Healthcare personnel play a key role in introducing eHealth services to patients and instructing them on their use.

Introduction: Timely, complete and accurate patient data is needed in care decisions along the continuum of care. To access patient data from other organizations, there are three types of regional health information exchange systems (RHIS) in use In Finland. Some regions use multiple RHISs while others do not have a RHIS available. The recently introduced National Patient Data Repository (Kanta) is increasingly used for health information exchange (HIE). Objectives: The purpose of this study was to assess usage of paper, RHISs and Kanta by context in 2017; evolution of paper use over the years; and predictors of paper use in 2017 among Finnish physicians for HIE system development. Methods: Data from national electronic health record (EHR) usage and user experience surveys were taken from 2010 (prior to ePrescription system implementation), 2014 (prior to implementation of Kanta) and 2017 (Kanta was in full use in the public sector and in large private organizations). The web-based surveys were targeted to all physicians engaged in clinical work in Finland. Results: Kanta was the most frequently used means of HIE in 2017. Paper use had reduced significantly from 2010 to 2014. The trend continued in 2017. Still, up to half of the physicians reported using paper daily or weekly in 2017. There were great variations in paper use by healthcare sector, available RHIS type and EHR system used. In multivariable analysis (with all other variables constant), predictors of more frequent use of paper than electronic means for HIE were: private sector or hospital, access to Master Patient Index RHIS (type 1), multiple RHIS (type 4) or no RHIS (type 5), two particular EHR systems, older age, less experience, operative, psychiatric or diagnostic specialties, and male gender. Conclusions: Usability of HIE systems including EHRs as access points to HIE need to be improved to facilitate usage of electronic HIE. Usage ensures more timely and complete patient data for safe, coordinated care. Specialty-specific needs and requirementscall for more user participation in HIE design. Especially older professionals need training to better exploit HIS for HIE.

Electronic government (e-Government) is expected to play a critical role of enabling the attainment of best practices of governance. Despite various efforts to implement e-Government, its use by the populace remains low. There are claims that e-government promotes social exclusion of those in under-served rural communities on technical, language, costs and culture grounds. As such, this study assumes a co-designing and co-creation approach in an attempt to incorporate different contextual factors resulting from cultural surroundings, capacities and skills among rural population. The aim is to promote electronic participation by rural based citizens and attain social inclusivity. Users based in under-served rural communities shall be engaged in identifying characteristics of e-Government and issues with rural ICT. The study makes use of solar powered technology (mobile phone and internet access) provided by the “Fusion Grid” project. Selected e-Government services are used to experiment the process of co-designing and co-creation of e-Government.

The number of eHealth services supporting patients’ self-care and self-management is increasing. Patients are expected to participate more actively in their care, but nevertheless chronically ill patients use eHealth services less frequently than healthy citizens. The healthcare personnel’s motivation and guidance could increase willingness and capability of patients to use eHealth services. This article reports a study, which investigates what kind of support patients receive and how patients wish the healthcare personnel to support them in using eHealth services as well as what kind of eHealth services patients want to use in future. The study was conducted in Finland. A total of 397 patients representing three patient organizations for chronic illnesses (heart disease, diabetes or cancer) answered to the online questionnaire. Most of the respondents had used at least one eHealth service (92%) and the most common purpose was to seek information. eHealth services were mostly used on the patients’ own initiative. Only less than half of the patients (47%) had received information about eHealth services from the healthcare personnel. Even less participants had been encouraged (30%) or advised (21%) how to use these services by the healthcare personnel. The study shows that patients wish for a more active manner from the healthcare personnel in informing about the availability of eHealth services as well as providing guidance and encouragement in using the services. The wishes about future eHealth services were rather modest. Respondents wished for a more versatile digital booking of medical appointments and novel, easy-to-use communication channels with the personnel. The results suggest that it is not only sufficient to increase the number of eHealth services, but also the active patients need more information about eHealth services as well as guidance in their use.

Lasten ja nuorten sekä heidän perheidensä potilaskokemusta on tutkittu varsin vähän. Potilaskokemus on käsitteenä moniulotteinen ja monimerkityksellinen, minkä johdosta sen määritteleminen ja mittaaminen on haastavaa. Lapsus-tutkimushankkeessa selvitetään lapsipotilaiden ja heidän perheidensä näkökulmia sairaalakäynneistä, saaduista hoidoista ja palveluista sekä sairastamisen arjesta. Kolmivuotinen tutkimushanke on Tekesin rahoittama ja liittyy kiinteästi Uuden lastensairaalan toiminnalliseen kehittämiseen. Hankkeessa ovat mukana Aalto-yliopisto ja Tampereen Teknillinen yliopisto sekä Helsingin, Turun ja Oulun yliopistollisten sairaalojen lastenklinikat. Hankkeen tavoitteena on tukea lapsipotilasperheiden kokemusten huomioimista uusia sairaaloita rakennettaessa ja sairaalojen toimintaa kehitettäessä. Tutkimuksellisesta näkökulmasta keskeisimpiä tavoitteita ovat potilaskokemuksen ulottuvuuksien kuvaaminen lapsipotilaiden ja heidän perheidensä näkökulmasta, potilaskokemuksen ja arvonmuodostuksen seurantaan liittyvän metodiikan ja mittaristojen kehittäminen, sekä potilaskokemustiedon linkittäminen osaksi jatkuvaa parantamista. Hankkeen toteutus koostuu osatutkimuksista, joiden aiheita ovat A) Lapsipotilasperheen potilaskokemuksen ulottuvuudet ja potilaspolut, B) Potilaskokemuskyselyt vanhempien kokemusten mittaamiseksi, C) Videopäiväkirja nuorten potilaskokemusten tutkimusvälineenä, D) Valokuvamenetelmä lasten potilaskokemusten tutkimisessa, E) Ekosysteemi rakentamassa potilaskokemusta, F) Potilaspalautteen keruu ja hyödyntäminen lastensairaalassa. Lapsus-tutkimushankkeessa kehitetyt menetelmät ja tutkimuksesta saadut kokemukset auttavat ymmärtämään, minkälaiset asiat koetaan tärkeiksi ja arvokkaiksi, ja miten kokemustietoa voidaan kerätä ja hyödyntää lastensairaalan toiminnan kehittämisessä., Patient experience of children, adolescents and their families has been studied only a little. Patient experience is a multidimensional and ambiguous concept and thus, it is challenging to define and measure. Lapsus research project investigates the perspectives of pediatric patients and their families on hospital visits, received care and services, and the everyday life with the illness. The project is funded by Tekes and is closely related to the design of the New Children’s Hospital. Lapsus is a joint project of two universities, Aalto University and Tampere University of Technology, and three children’s hospitals, Hospital District of Helsinki and Uusimaa, Oulu University Hospital and Turku University Hospital. The aim of the research project is to promote that the experiences of the families with pediatric patients are taken into consideration when constructing new hospitals and improving healthcare services. From the scientific standpoint, the key objectives include describing the dimensions of patient experience from the perspectives of pediatric patients and their families, developing methodology and instrumentation for monitoring patient experience and value creation, and linking patient experience data to continuous improvement. The project consists of several sub-studies: A) The dimensions of the patient experience and patient journeys of families with pediatric patients, B) Questionnaires for measuring the patient experience of parents, C) Video diary as an instrument for studying the patient experience of adolescents, D) Photo elicitation method for studying children’s patient experience, E) Ecosystem’s role in patient experience, F) Collecting and utilizing patient feedback in children’s hospital. The research methods developed in the Lapsus project together with the practical experiences gained from the studies, help to understand which issues are meaningful and valuable for the patients and how patient experience data can be collected and utilized to improve the services of children’s hospital.

Loppukäyttäjien osallistuminen potilastietojärjestelmien kehittämiseen on keskeistä, jotta järjestelmiä voidaan kehittää heidän tarpeitaan vastaaviksi ja työtehtäviin sopiviksi. Sairaanhoitajien ja lääkärien osallistumista käyttämiensä tietojärjestelmien kehittämistyöhön selvitettiin valtakunnallisten kyselytutkimusten avulla. Sairaanhoitajien aineisto kerättiin keväällä 2017. Lääkärien kyselytutkimus toteutettiin samoin keväällä 2017 ja lisäksi vuosina 2014 ja 2010, tosin vuonna 2017 lääkäreiltä ei kysytty kehittämiseen osallistumisen tavoista. Kyselyyn vastanneista sairaanhoitajista 46 % ja lääkäreistä 49 % kertoi osallistuneensa tietojärjestelmien kehittämistyöhön. Sairaanhoitajista 21 % oli valmiita osallistumaan kehittämisryhmiin ja vain 20 % ei ollut lainkaan kiinnostuneita osallistumaan; vuoden 2014 kyselyssä lääkäreillä vastaavat osuudet olivat 18 % ja 16 %. Ohjelmistotoimittajien ei koettu olevan kiinnostuneita loppukäyttäjien näkemyksistä eikä kehittämisehdotuksia toteutettu toivotulla tavalla eikä ripeydellä. Verrattuna vuosiin 2010 ja 2014 lääkärien arviot eivät olleet muuttuneet positiivisemmiksi. Loppukäyttäjistä suuri osa olisi halukkaita osallistumaan kehittämistyöhön jollakin tavalla, mutta ohjelmistokehitys ei ole toistaiseksi löytänyt parhaita tapoja heidän osallistumisensa mahdollistamiseen. On ilmeistä, että loppukäyttäjät eivät koe pystyvänsä vaikuttamaan ohjelmistokehitykseen toivotulla tavalla. Osallistamisen on myös oltava mahdollista osana jokapäiväistä työtä. Terveydenhuollon organisaatioiden on tunnistettava kehittämistyöhön osallistumisen merkitys ja mahdollistettava esimerkiksi tietojärjestelmälääkärien ja -hoitajien urapolut. Tärkeää on, että tietojärjestelmiä kehittävien lääkäreiden ja sairaanhoitajien kliininen työ jatkuu tietojärjestelmien kehittämisen rinnalla, jotta näkemys työhön, missä järjestelmiä käytetään, säilyy., End user participation in healthcare IT system development is essential in order to develop systems that fit together with healthcare professionals’ work tasks and needs. National questionnaire studies were conducted to explore how nurses and physicians participate in system development and what kind of experiences they have on participation. The questionnaire to nurses was conducted in spring 2017. Similarly, the questionnaire to physicians was conducted in spring 2017 but also earlier in 2010 and in 2014. The number of respondents was 4018 for physicians and 3607 for nurses. Participation rates in the system development were following: 46% of the nurses and 49% of the physicians had participated in the system development. 21% of the nurses were willing to participate in the development groups and 20% were not willing to participate at all. The physicians’ rates were 18% and 16% in 2014, respectively. Depending on the used software, 43 - 93 % of the respondents felt that software vendors were not interested in the views and opinions of the end users, nor did the proposed improvements take place in the desired manner or quick enough. Compared to years 2010 and 2014, physicians’ opinions had not changed more positive. The study results indicate that a large number of the end users would be willing to participate in healthcare IT system development. However, suitable methods and appropriate practices on how to involve end users in development work seem to be lacking. The results indicate that end users feel not to be able to influence to the development in the way they wish. The participation should take place as a part of the daily work. Healthcare organisations need to recognise the importance of participating in development work and, for example, enable career paths for IT physicians and nurses. It is important that the clinical work of physicians and nurses who develop information systems, will continue alongside the development to keep the practical “touch” to work in which systems are being used.

Usability should be considered already by the procuring organizations when selecting future systems. In this paper, we present a framework for usability evaluation during electronic health record (EHR) system procurement. We describe the objectives of the evaluation, the procedure, selected usability attributes and the evaluation methods to measure them. We also present the emphasis usability had in the selection process. We do not elaborate on the details of the results, the application of methods or gathering of data. Instead we focus on the components of the framework to inform and give an example to other similar procurement projects.

Patient experience is an emerging concept that supports the improvement of healthcare services through identified patient expectations and experiences. In addition to structured feedback through official channels, experiences about healthcare appear increasingly in digital services and social media. We explore a new patient experience harvesting process based on linguistic patterns to identify relevant expressions in online discussions about children's health. Our results from the analysis of 98 229 unique sentences suggests that the 7-step process can be useful in discovering patients' evaluations of their care experiences. We propose ways to extend the process to other care contexts by adjusting the semantic reference models.

Digital services are increasingly being developed for the healthcare sector. In Finland, the five university hospitals in 2016 launched a virtual hospital platform, Healthvillage.fi that includes several portals. The aim of this study is to explore the needs of children and their families related to digital services in the context of a children's hospital in Finland. Two methods were used to examine the needs and expectations of children and their families: a web-based survey for parents and video diaries for children. We identified nine categories of needs and noticed they were related to better communication between families, healthcare professionals, and peers. These observations were used to further analyze possible novel digital services for child patients' families to support and to complement the recently launched Healthvillage.fi platform.

Compared to patient satisfaction, less research has focused on patient experience, which is a complex phenomenon by nature, thereby challenging to define and measure. Today, healthcare organizations are short of appropriate instruments surveying patient experiences. Satisfaction questionnaires are used to evaluate the quality of hospital care from the viewpoint of adult patients. However, questions remain whether the hospitals should use these results to support their development activities. This article describes the development process of a patient experience survey instrument targeted for the parents of pediatric patients, introduces the first versions of the questionnaire, and the plan for further development. The development process included several phases: interviews with 17 families, identification of aspects which influence patient experiences (5 themes), description of related potential metrics (22 metrics), formulation of the first version of the questionnaire (67 statements) and pilot testing, data gathering at a pediatric outpatient clinic (106 respondents), and based on exploratory factor analysis development of the second version of the questionnaire (22 statements). The further development includes validation with a second round data gathering and statistical analysis. The aim is to condense the number of statements into about 10 and implement the survey in an electronic format. In the Lapsus project similar patient experience questionnaires will be developed for all relevant phases of patients paths. The development work will utilize the reported process and the first version of the questionnaire. The plan is take the instruments in use in the New Children’s hospital in Helsinki and in other similar hospitals., Potilaskokemus on potilastyytyväisyyteen verrattuna moniulotteinen ja vähän tutkittu aihe. Terveydenhuollon organisaatioilta puuttuvat instrumentit kokemustiedon keräämiseksi potilaspolun eri vaiheissa. Nykyiset potilastyytyväisyyskyselyt keskittyvät sairaalahoidon laadun arviointiin aikuispotilaiden näkökulmasta, ja niiden tuottamien tulosten hyödynnettävyyttä sairaalan toiminnan kehittämisessä on kritisoitu vahvasti. Tässä artikkelissa kuvataan lapsipotilaiden vanhemmille suunnatun kokemuskyselyn kehittämisprosessi, kyselyn ensimmäiset versiot sekä jatkokehitystehtävät. Tutkimus on osa Lapsus-tutkimushanketta, jossa tavoitteena on kehittää potilas- ja kokemuslähtöisiä instrumentteja lapsipotilaiden ja heidän perheidensä kokemustiedon keruuseen ajallisesti pitkän potilaspolun eri vaiheissa. Vanhemmille suunnatun kyselyn kehittämisprosessi sisälsi seuraavat vaiheet: haastattelut 17 lapsiperheen kanssa, lapsiperheen potilaskokemuksiin vaikuttavien tekijöiden tunnistaminen (viisi teemaa) ja näihin liittyvien mittareiden määrittely (22 mittaria), kokemuskyselyn ensimmäisen version kehittäminen (67 kokemusväittämää) ja pilotointi, aineistonkeruu Lastensairaalan poliklinikalla (106 vastaajan aineisto), ja kokemuskyselyn toisen version (22 kokemusväittämää) kehittäminen eksploratiivisen faktorianalyysin avulla. Kyselyinstrumentin jatkokehitys sisältää kyselyn validoinnin uuden aineistonkeruun ja faktorianalyysin avulla. Tavoitteena on tiivistää vastaanottokäyntiin liittyvän kokemuskyselyn väittämien määrä noin kymmeneen ja toteuttaa kysely sähköisesti. Lapsus-hankkeessa tullaan kehittämään vastaavia kyselyjä myös potilaspolun muihin vaiheisiin. Näiden kehitystyö tulee noudattelemaan tässä artikkelissa kuvattua prosessia ja työn lähtökohtana on haastattelututkimuksen perusteella kehitetty kokemuskyselyn ensimmäinen versio. Tutkimushankkeen tuloksia on tarkoitus hyödyntää lähitulevaisuudessa paitsi Helsingin Uudessa lastensairaalassa, myös muissa vastaavissa lastensairaaloissa.

This paper describes the use of video diaries as a tool for understanding children’s patient experience and as a potential method for directly gathering patient experience information from children. It was hypothesized that this method would uncover otherwise hidden knowledge about children ages 10–16 years with chronic illnesses. The aim of this paper is to assess the potential applicability of this method as a standalone tool for the public healthcare sector to capture and better understand the patient experiences as a basis for continuous service development. Therefore, this paper does not describe the results on children’s patient experiences. The video diaries proved to offer rich data, but certain shortcomings were also identified. Motivating teens, especially boys, was found to be difficult. Needed changes are addressed, and suggestions for future work are presented.

Electronic Government (e-Government) adoption and use remains low in Africa. This has coincided with studies that focus on proposing factors of e-Government and mobile Government (m-Government). Little validation is being done in the form of implementing these e-Government solutions in order to better understand their feasibility in a real world context. This study adopted a citizen-centric e-Government framework and developed a mobile application solution that was used to solicit the views of participants. The aim was to evaluate the feasibility of e-Government propositions in the literature in a real world environment. Study findings suggest that m-Government can succeed if there is access to ICTs, ICT skills, community-based partnerships, an understanding of citizen information needs, ICT infrastructure and a positive attitude towards ICTs use. As such, implementers of m-Government could look into these factors if they are to succeed.

Avaa tiedosto julkaisun ilmestyttyä, jos se on pre- tai post-print!!! Knowledge work organizations are increasingly leveraging automation to enhance and transform their business processes. Many types of automation tools are being deployed in a large variety of information processing tasks, requiring effective management of human–automation co-operation. Yet, conceptual understanding of human–automation hybrid work remains thin and current literature lacks practical recommendations for managers. To address this gap, we synthesize findings from our three earlier case studies with organizations pursuing a wide array of automation tools and examine them through the lens of distributed cognition. We demonstrate how distributed cognition informs about the organizing for human-automation interaction when deploying automation. Our contribution lies in the presentation of six recommendations on three issues: human–automation task allocation, mitigation of the risk of deskilling, and management of collective knowledge across human and automation.