Review study on older adults’ views on e-health

A HIBA project review on earlier literature on older adults’ views on e-health services shows that a heterogeneous body of research exists on older adults’ views on eHealth services. Common themes in the literature include eHealth service uses, enablers and barriers, and outcomes. eHealth service use can have positive outcomes but also negative consequences. The findings show that the methodological approach of the study is linked with the type of findings reported. There seems also to be a positivity bias particularly in quantitative studies.

Citation: Hirvonen, N.; Enwald, H.; Känsäkoski, H.; Eriksson-Backa, K.; Nguyen, H.; Huhta, A.-M. & Huvila, I. Older adults’ views on eHealth services: a systematic review of scientific journal articles. International Journal of Medical Informatics, 2020, 135.

WIS 2018

The biannual conference Well-being in the information society was organized in Turku on August 27-29, 2018, with the theme “Fighting inequalities”. The conference strives to be multidisciplinary and attracts delegates from several disciplines and well-being was in this conference analyzed from different viewpoints including wealth, the digital world, social policy and health. Several of the presentations were of interest also for the project HIBA.

The first keynote speaker was Director Sascha Marschang from the European Public Health Alliance, who talked about opportunities and gaps in digital health in Europe. Challenges include an ageing society and growing numbers of non-communicable diseases, as well as barriers to healthcare access. A digital divide is still a reality in Europe with e.g. elderly, lower educated and minority groups excluded, and there is a need for digital health literacy, that is a complex concept and involves several competencies, including basic, digital, media and health literacies. eHealth can provide opportunities and complement conventional healthcare, it can engage people, be fun, timely, accurate, and tailored but cannot replace face-to-face contact and Sascha Marschang claimed that health and eHealth must work in harmony. He also called for research into actual use of eHealth!

Roland Trill from Flensburg University of Applied Science, Germany, continued on the topic health literacy and had combined the eHEALS scale and the Digital Health Literacy Instrument (DHLI) to study current digital health literacy of diabetes in Germany. He called for further research on digital health literacy and claimed that health care professionals are target groups for improving this literacy. Anne-Marie Tuikka (University of Turku) showed that the claims by the keynote speaker seemed to be true. She had studied nationwide data gathered by the National Institute for Health and Welfare and focused on the digital disability divide, defined as the gap between disabled and non-disabled people. The results showed that internet use was related to age, education level, marital status, and employment, and that people needing disability services used internet less than others. Internet can have an empowering impact on disabled people, but the results indicate that there could be a digital disability divide in Finland.

 

The conference chair, professor Reima Suomi, opening the WIS 2018 conference (photo: Gunilla Widén)

Nilmini Wickramasinghe from Deakin University, Australia, presented a study on the use of games for controlling diabetes and obesity. A pilot study already showed that there is an interest in using games for this purpose. Vitalija Petrulaitiene (Tampere University of Technology), on the other hand, presented and overview of how employee well-being can be supported through digital services, especially applications related to fitness, nutrition, or ergonomics. Marina Weck from Häme University of Applied Science presented digital assistive technology that means to use ICT for the support of everyday tasks and activities among elderly. A pilot study found that ageing people’s needs and preferences for digital assistive technology were positive, although they were not yet familiar with the latest devices or applications, and hence, for example, healthcare service providers could increase the utilization of technology and facilitate the integration of digital assistive technology. Hanna-Leena Huttunen (University of Oulu) had found that patients suffering from migraines are interested in using wearable sensors and mobile applications to manage their symptoms, especially to identify early symptoms and help them in everyday life.

The conference dinner was held at Turku Castle

Susanne Hämäläinen (Karelia University of Applied Sciences) and Päivi Sihvo (Savonia University of Applied Sciences) claimed that digitalization has not progressed as quickly as desired in social and health care and that both employees and citizens lack know-how and education about new technological developments. Digitalization should help customers and increase their welfare and that is why eProfessionals that can act as moderators between IT staff and health professionals are one important solution for digitalization. Tiina Nokkala (University of Turku, School of Economics) said that health information systems are not patient-centred, in the best case patients can look at their own medical records, but not add anything to them. There is a need for shared decision-making, and being able to make own entries can enhance feelings of management and empowerment among patients, but in order for patients to make their own entries in their records (e.g. blood sugar or blood pressure measurement data), there is a need to use similar metadata as for entries by professionals. Jani Koskinen from Turku University School of Economics, on his part, suggested that as modern healthcare relies strongly on technology and information systems there is also a special need for eHealth ethics. eHealth ethics could be the intersection of the traditional codes of ethics used within the two fields of healthcare and information technology or systems.

Kristina chaired a session on digital health and later presented a short paper by Hai Nguyen and herself based on first results from the survey of use and experiences of the online diabetes risk test at the website of the Finnish Diabetes Association. The paper is found in the proceedings. The results indicate that an active information-seeking style is sígnificantly related to intentions to seek more information in the case of increased risk of diabetes type 2, and that this has to be taken into consideration when providing information on websites offering self-assessments.

 

Pacific Asia Conference on Information Systems (PACIS 2018)

PACIS 2018 was organized in 26th to 30th June in Yokohama, Japan. It invited submissions in current and emerging areas of Information Systems research, especially those related to the conference theme “Opportunities and Challenges for the Digitized Society: Are We Ready?”

The annual conference offered keynote speeches and several concurrent tracks in addition to workshops. Tracks focused e.g., on smart cities, e-government, human computer interaction, IS education and e-learning and IS in healthcare.

The first keynote was given by Ikujirō Nonaka, emeritusprofessor, best known for his study of knowledge management. Nonaka has also proposed the SECI model, to present the spiraling knowledge processes of interaction between explicit knowledge and tacit knowledge.

Keynote by Nonaka

PACIS had attracted over 500 registered participants from all around the world. The conference took place in very modern Minato Mirai district in Yokohama.

Sight of Minato Mirai, the central business district of Yokohama.

Lunch with a view. Bentō lunch box provided at the conference.

HIBA-project presented work in progress by Nguyen, Eriksson-Backa and Enwald with the title: Preliminary results of a survey on user opinions and experiences on an online diabetes risk test.

Heidi Enwald presenting the poster by HIBA project.

Finland was nicely represented also as the best paper award was given to Finnish-Australian collaboration:

Ethical Evaluation of a Value Sensitive Persuasive System: Case Milky Way
by Liisa Kuonanoja (University of Oulu), Shahla Meedya (University of Wollongong), Khin Than Win (University of Wollongong) and Harri Oinas-Kukkonen (University of Oulu)

The conference proceedings and also our paper can be found here:

https://drive.google.com/drive/folders/1aI6jwwAAF40h238qsR85n7Er1ZOdQFmf

 

Anticipating ageing

A new article Anticipating ageing: Older adults reading their medical records (full-text for subscribers) on older adults perceptions of reading their medical record and using e-health services, written in collaboration between HIBA project and researchers of Swedish DOME Consortium has been published in Information Processing & Management. A post-print version of the article can be found at http://www.istohuvila.se/node/560

Abstract

In spite of the general interest in health information behaviour, there is little earlier research on how older adults, who are still active in working life but approaching retirement, differ from other age groups. A survey with Swedish patients who had ordered and read their medical record was conducted to map the preferences and motivations of older adults (born 1946-1960) ordering a copy of their medical record, and using medical records based e-health and information services in the future. The results do not indicate an obvious linear relationship between age and motivation to use online health information but show several differences between the age groups. Older adults were less interested in communication with their medical doctor by e-mail. Yet, they had searched health information in the Internet during the last week more likely than young. They were more inclined to read medical record to get an overview of their health than young, but less confident that they understood most of the content or turn to their family and friends to seek help than the elderly. When compared to younger adults and elderly people, older adults are the least confident and least motivated to use online health information. It is suggested that older adulthood can be seen as a transitory stage of life when the need of health information increases and engagement with health changes. The results agree with prior research on the potential usefulness of (online) medical records as a way to inform citizens. However, specific provision strategies may be necessary to match the needs and motivations of different age groups.

Osallistu terveysriskitestejä koskevaan tutkimukseen!

HIBA-projekti selvittää kokemuksia e-terveyspalveluista. Nyt käynnissä olevassa tutkimuksessa selvitetään riskitestipalvelujen käyttöön liittyviä kysymyksiä.

Vastaamalla kyselyyn voit auttaa e-terveyspalveluiden kehittämistä. Kyselyn vastaukset käsitellään luottamuksellisesti, ja ne tulevat ainoastaan tutkimuskäyttöön. Vastaukset eivät sisällä henkilökohtaista tietoa ja niitä käsitellään siten, että yksittäiset henkilöt eivät ole tunnistettavissa.

Jos et ole käyttänyt ennen Diabetesliiton diabetes-riskitestiä, tee testi ennen kyselyyn vastaamista.

Vastaa tutkimuskyselyyn tästä.

ITY spring seminar 11.5.2016 – Health information and eServices

This year the spring seminar of the National Society of Information Studies (Informaatiotutkimuksen yhdistys, ITY) was conducted in collaboration with the HIBA-project and with Information Studies, University of Oulu on 11th May at Oulu University. About 30 people participated the event and remote connection was also provided. The title of the seminar was Health information and eServices introducing multidisciplinary aspects on the topic.

Chair of ITY Heidi Enwald presenting wellcomin words

Chair of ITY Heidi Enwald presenting wellcoming words to the seminar

Senior lecturer Kristina Eriksson-Backa (Åbo Akademi University, Information Studies) presented the HIBA project, its research questions, methods and current stage of the research. The practical contribution of the HIBA project aims at understanding human information behavior to provide evidence-based recommendations how consumer health information technologies and their information contents could be designed and tailored to meet consumers’, in particular older adults’ (born 1946-1960), needs and preferences.

 University lecturer Heidi Enwald (University of Oulu, Information Studies ) presented some findings of the recently ended multidisciplinary GASEL (Gamified services for elderly) project. The project was funded by National Technology and Innovation Agency TEKES from 1.1.201 to 30.4.2016. Increasing ageing population’s use of information technology related to health was studied with a population-based questionnaire survey. The questionnaire was posted to 1500 home dwelling people aged 65 or more living in Oulu area. The return rate was 61 percent. The findings indicated that 74,5 % of the respondents had Internet connection at home. The Internet was most frequently (65 %) used for multiple e-Services (e.g. bank, tax services, tickets etc.) and the second popular activity (55,5,%) was to find information for example about timetables, health related aspects etc.  The next popular activities were reading news (49,8%) and using different communication channels  (41,7%, e.g. e-mail, Skype etc.) Regarding to health information there were some gender differences, for example men were more likely to consider that health related stories and articles are too long.

Noora Hirvonen

Noora Hirvonen

University lecturer Noora Hirvonen from Oulu University Information Studies spoke about studies of everyday health information literacy (EHIL) in different groups. Everyday health information literacy refers to competencies to find, to evaluate and to understand health-related information in everyday life situations. An EHIL screening tool (designed by Niemelä et al. 2012) is based on the Medical Library Association’s definition of health information literacy (2003). The EHIL tool is based on self-assessment and aims at identifying people with limited everyday health literacy. The EHIL tool has been piloted with a survey (n=217) in an upper secondary school in Finland in 2012 and further applied in a population of Finnish young men in 2012 and 2013 (n= 1870), with Finnish individuals with high risk for metabolic syndrome in 2013 and 2014 (n= 571) and with Namibian students (n= 271) with an English version of the tool. The comparison of the results indicates that different factors of EHIL seem to be important in different populations. Terminology and reliability of health information sources were important for people with high risk of metabolic syndrome and for Namibian students whereas lack of motivation was important with young Finnish men.

Pasi Karppinen (University of Oulu, Department of Information Processing Science) presented the eHealth service Onnikka which was designed for people with overweight or obesity (BMI 27-35) in a randomized lifestyle intervention study (PrevMetSyn). The study subjects were working-age males and females from the Northern Ostrobothnia Hospital District. The study groups A and B had eight (group A) or two (group B) group counselling visits  and the study group C was a control group which used the Onnikka service with no counselling visits. The Onnikka service was designed according to the Persuasive Systems Design (PSD) model (see Oinas-Kukkonen & Harjumaa 2009) containing the elements of primary task support, dialogue support, credibility support and social support. 43 users of Onnikka were interviewed after one year about their user experiences. The results showed that for example self-monitoring, reminders and tunneling were perceived as a beneficial persuasive features among the users. The credibility of the service was perceived high (the institutions behind the service were well known and highly respected) but the need and use for social support was somewhat contradictory. The discussion forum was perceived useful, but it was not actively used by the participants.

Pasi Karppinen

Pasi Karppinen

Hai Nguyen presentation

Hai Nguyen presentation

After the lunch break Hai Nguyen (HIBA researcher at Åbo Akademi University, Information Studies) presented findings from a study of Health Information Technology implementation and success factors in Nordic countries. Health Information Technology (HIT) systems store and retrieve information to support patient care activities, support administrative and financial activities (e.g. patient accounting, payroll, materials management etc.) and provide information and analytical tools to executive decision support systems for purposes of managerial decision-making. Success factors of implementing HIT systems were identified with a literature review and tested with a survey of 91 health care IT managers in the Nordic countries (Denmark 14, Finland 32, Norway 25 and Sweden 20). Some similarities in the Nordic comparison indicate that a more general instrument to define success factors for HIT implementation could be designed.

Associate professor Samantha Adams from Tilburg University Law School (Netherlands) spoke about online rating and recommendations sites in health care. This phenomenon is not yet familiar in Finland, but in USA and some European countries sharing opinions and experiences about hospitals and health clinics is in use. The basic idea is to improve quality of care and patient-centeredness by increasing transparency. However, the usefulness of the sites, ethical issues and true impact on the quality of care are not simple issues and need to be discussed further.

Samantha Adams, Tilburg Law school

Samantha Adams, Tilburg Law school

The slides of the presentations will soon be available at the webpages of  the National Society of Information Studies (Informaatiotutkimuksen yhdistys, ITY)

References

Niemelä, R., Ek, S., Eriksson-Backa, K. & Huotari, M.-L. (2012). A screening tool for assessing everyday health information literacy. Libri: International Journal of Libraries and Information Services 62(2): 125–134.

Oinas-Kukkonen, H & Harjumaa, M (2009) Persuasive Systems Design: Key Issues, Process Model, and System Features. Communications of the Association for Information Systems. 24(1): 485-500.

 

Seminaari: Health Information and eServices 

Informaatiotutkimuksen yhdistyksen (ITY ry) kevätseminaari

KE 11.5.2016, klo 9.15-13.30 Oulun yliopisto, TellUs Innovation Arena, Stage-tila

Seminaari järjestetään yhteistyössä Åbo Akademin HIBA-hankkeen ja Oulun yliopiston Informaatiotutkimuksen oppiaineen kanssa. Tilaisuuteen on vapaa pääsy, myös muille kuin ITY:n jäsenille, ei etukäteisilmoittautumista. Tilaisuutta voi seurata myös etänä (ilmoita tästä kiinnostuksesi Heidi Enwaldille viimeistään ma 9.5., heidi.enwald@oulu.fi ). Seminaari on englanninkielinen. Seminaarin jälkeen samassa tilassa järjestetään yhdistyksen kevätkokous (suomeksi).

First part 9.15-11.00
Welcoming words, Heidi Enwald
Introduction to HIBA-project, Kristina Eriksson-Backa (20 min)
GASEL project: eServices for healthy ageing, Heidi Enwald (20 min)
Everyday health information literacy in different populations, Noora Hirvonen (20 min)
From all the presentations 10 min discussion
Pasi Karppinen: Health Behavior Change Support Systems – Case of Preventing Metabolic Syndrome (20 min + 10 min for discussion)

11.00-11.15 Break

Second part:11.15-12.30
Hai Nguyen: Exploring Health Information Technology implementation success factors – a comparative investigation in Nordic countries (20 min + 10 min for discussion)
Samantha Adams: Questioning the rise of online rating and recommendation sites in healthcare (30 minutes + 10 minutes for discussion)
Closing of the seminar, Heidi Enwald

Pieni tauko ja n. 12.40 alkaen ITY:n kevätkokous samassa tilassa (kesto noin 1 h). Kaikki yhdistyksen toiminnasta kiinnostuneet ovat tervetulleita kokoukseen!