eHealth development in Sweden : A  study  of  prominent  aspects  and  benefits  from  a  multi-userperspective

University essay from KTH/Industriell Management; KTH/Industriell Management

Author: Ludvig Jakobsson; Jonathan Sobin; [2014]

Keywords: ;

Abstract:

The  European  health  care  is  facing  challenges  with  an  increasing  ageing  population, with a higher frequency of chronic diseases, which have resulted in rising health care costs. Meanwhile, the trend shows how patients and citizens are becoming more active in their personal health care, with the number of existing doctors and nurses subsiding furthermore entailing problems. The area of eHealth, which involves information and communication technologies with health care, is hence seen as a partial long-term solution and is considered being a rapidly growing market both in Sweden, but also in Europe. eHealth services further consider to promote increased access, mobility and interoperability in the health care, but the lack of wholehearted commitment, financial support and complex EHR-systems in Sweden's municipalities and county councils might partially impeding down the development. The purpose of this report is therefore targeting to explore, identify and analyze prominent aspects for the continued development of the Swedish health care and eHealth services. The study also examines what subsequent benefits an implementation of an eHealth service entails, which also has been related to the identified prominent aspects.

This master thesis is based on  a thorough literature review extracted from a theoretical framework   including   an   interoperability-,  security-,   mobility-   and   business-modeling perspective, which are used as a foundation for the building of a set of hypotheses, which are subsequently verified with the aid of gathered empirics. The empirics are obtained from 10 semi-structured qualitative interviews, as well as two case studies, which together resulted in key-findings and conclusions.

Firstly: in relation to the interoperability perspective, it became clear how there should exist both   a   technical   and   social   interoperability   that   communicate   with   each   other. The  EHR-systems  of  today  are  often  considered  difficult  to  learn,  non-intuitive  and lacking interfaces that are user-friendly designed for the end-user. Increased interoperability was also seen as enabling and simplifying the access to the patient’s medical history, which the EHR-system TakeCare evidently demonstrated. Furthermore, it was acknowledged how there is no correlation between the increased time spent by health care professionals with administrative tasks and documentation with an increased interoperability. It also emerged that patients and the dominant part of the population had either no or very limited knowledge regarding the underlying security and overall management of personal health information in health care. Patients instead often blindly trust the Swedish health care system being secure, and prioritizing other things during medical appointments. The knowledge of security issues in the health care is predicted to increase among patients if they in the future would obtain full access to their own medical records. There is also a general opinion among health care professionals and related instances how new security risks will arise alongside the eHealth wave,  with  a  particular  concern  for  the  increasing  involvement  of  mobile  devices. Relationships between an increased interoperability also seem to favor increased mobility in health care, but security aspects often prevent the mobility development. Finally, it was unanimously espoused how non-financial values must not be ignored, where the on-going debate argues whether what real impact these non-financial values have, where inter alia strict budgets and large gaps between the decision-makers and end-users appeared as issues. Similar arguments were encountered regarding the actual impact of the opinions of patients in relation to business modeling, where a tripartite-problem and the patients’ limited access to their medical records was partly seen as a primary issue.

Secondly:  the  case  studies  demonstrated  how  a  transition  to  the  EHR-system  TakeCare generally did result in cost- and resource savings in terms of local servers, IT-maintenance and inventory management. The TakeCare implementation also led to an increased visibility among health care centers by enabling and simplifying the access to patient medical history. Increased communication, awareness, and more effective internal processes due to integrated modules and direct connections to ePrescriptions could also be accessed from the TakeCare transition. Finally, it emerged that relations existed between simplified access to the patient’s medical   history   and   how   it   subsequently   resulted   in   an   increased   interoperability. A correlation was also seen as the health care become generally more mobile due to increased interoperability.

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