Category Archives: eHealth

UCD Blog 1: IT Projects are Seldom Successful, and IT for Work is Problematic 

The last few weeks I have done lectures related to IT and UCD in different organisations.  I will do a blog series about these lectures, and I will also write some words about the different aspects that have been discussed in these seminars. I start out by saying a few words abou the situation with IT projects and the quality of IT systems.

Many investigations conclude that a majority of IT projects fail and do not deliver on time, on budget and with a satisfactory result. According to the Standish group’s definition of success only around 30 % of all IT projects are successful. This means that around 70% of all IT projects deliver too late, with low quality or with unsatisfactory results. These numbers are really horrible!

If one look at the computer systems for work, the problems are obvious and enormous. This is for example reflected in the organisation Unionen’s reports on digital work environment for white collar workers in Sweden.  These reports are based on surveys to employees that are members of the union named Unionen. They are named in the following way (translated from Swedish), and I let the titles speak for themselves:

2008: Why does not it get any better ?
2010: A system error ?
2011: Always Connected – Never Relaxed.
2012: One step ahead and two steps back.
2014:- No Lighting in sight.

The IT systems in health care do not work any better, as can be discvovered when reading any newspaper. The headlines in the photo to this blog post show some of the recent ones that I could find, and here you see some of the problems in the headlines:

X-ray Care has Large Problems Due to New IT system

Mapping shows: Non-stable IT support in ambulance care

Windows update reason for enormous breakdown at the hospitals in Uppsala

Stockholm cleans up among health care systems – investing 200 millions

Lessons Learned from Discussing Implementation of Psychosocial Support and Psychological Treatment via Internet – U-care

Last week I attended a very well organized day related to implementation of psychosocial support and psychological treatment via the internet organized by the U-care programme. There were lots of experienced researchers from all over the world present at the U-care venue, and presentations of relevant areas were mixed with workshops around implementation of IT in health care. Unfortunately, I had to run off a couple of hours in the middle of the day, but next time this kind of venue is organized I will try to attend the whole day. 

I especially enjoyed Anders Brantnells presentation of “Implementation of Complex Interventions – What does research say”. In this presentation, he went through relevant theories related to barriers and enablers when implementing, and we then got to discuss them in relation to implementation of IT in primary care. 

Some lessons learned from these discussions about implementation were: 

  • There are indeed numerous models related to implementation of IT. The ones discussed at the U-care event were very related to health care as such, and perhaps it is necessary to have specific models for different areas of application?
  • What kind of knowledge is possible to gain from implemenation research as it is done in many health care projects? What is not possible to learn? According to Wikipedia implemenation research is “Often, research projects focus on small scale pilot studies or laboratory-based experiments, and assume that findings can be generalised to roll out into a practice-based domain with few changes.”

Working with Reviewing Applications to the Upcoming eHealth Summer School in Dublin + Stockholm

We got more than 60 applications to the eHealth summer school, and I spent two working days going through the different applications. We will accept 36 of the applicants. Reviewing all these applications was of course hard work, but also quite a learning experience. We used a list of criteria when reviewing, and this made it easier and quicker. My collegues in the organising committe are now working in finalizing the results.

There were indeed very interesting research project in the applications. Here are some of my observations from this review process:

  • One can conclude that HCI is a very broad area when it comes to health care applications. There is a large variety of areas coverend, and with different perspectives in the reserach approach.
  • Many applications were quite loosely connected to health care, and were more of the caracter of pilot studies.
  • Some deceases such as diabetes and depression were quite popular.
  • There were indeed a high percentage of women researchers (!)! Much higher than in computer science.

– I am so much looking forward to this summer school!



DOME conference on Medical Records Online in Skövde

We had a great Dome conference in Skövde about our research on medical records online. There were 12 reserachers present during this conference from a large number of universities. The first day there were some presentations of new and upcoming studies of the effects of patients reading their medical records online.

Erebouni Arakelian who has a PhD in medicine joined a Dome meeting for the first time and presented the plan for a study on the patient group that she is working with, and that she has done studies on before. She will do 30 interviews during the coming years, and has already gotten ethical approval for her study.

Bridget Kane who does reserch in HCI and in Computer Supported Collaborative Work also joined the meeting for the first time and she did a presentation of her previous studies and what she has done in her work. She has covered a very interesting, and large area related to eHealth.

It was interesting to hear about the plans for the upcoming studies, and to discuss what areas we should look more into based on previous findings. Here are some of the upcoming  studies:

  • Interview study with cancer patients by Ereboni Arakelian as a follow up to the national survey sent out in the fall of 2016 and the interviews made around 2013.
  • Interview and survey study with health care professionals at the Oncology department about the effects on the work environment. Jonas Moll it in charge of this study and bloggs about this study here if you want to know more. (this study is a part of the Disa project)
  • Interviews with patients in primary care about their use of medical records online (as a part of Maria Hägglund and Isabella Scandurra’s project Pacess)

There were some new members of the consortium present at the conference, and some old members have moved on to other research areas. I am however really glad to see that we have created an open and well functioning community where newcomers are very welcome.

Apply NOW: The 2017 EIT Health/ACM SIGCHI Summer School on User-Centered Design of e-Health and m-Health Systems

Our summer school on user-centered design of e-Health and m-Health systems is now open for applications.

The school will bring together e-health researchers and innovators from Human-Computer Interaction, Technology, Health Sciences and Psychology. Students receive: grounding in qualitative and quantitative methods that can be used to design and validate e-health systems; practical experience in the refinement of application designs; an introduction to the technology transfer process, which should accompany the translation of research findings into medical practice; and instruction on how this process can operate in e-health.

You find more information here.  

It will involve a week in Dublin (TCD) and a week in Stockholm (KTH). 

We have a fantastic speaker line up already, and bursaries are available for students to help with travel costs.

Deadline is short so apply now!

See you in Dublin and at KTH!

Collaboration with the Department of EMR in Region Uppsala

We have had a very good collaboration with the department of EMR in the Region Uppsala since a few years. We call this collaboration the Dive (Digital work enVIronment and Ehealth) project, and we are a group of 3-4 reserachers who participate.  This collaboration has been in the form of an action research project where researchers from our department worked togehter with people from the EMR department in designing a new IT system for surgical planning. We have also collaborated in doing some evaluations of usability aspects that has been used in the deployment of the system. We will also do follow up evaluations of usability. Now we have moved on to looking into decision support systems, and my collegues do vision seminars and will work on a design.

The department of EMR also collaborate with us around the IT in Society class  that has resulted in a report, a presentation and also visibiliy at Vitalis 2017.

The Disa project is also supported by the department of EMR, and we collaborate around this project too. This project includes around 10 reserachers who will look into the effects of digitaliczation in health care and the project will result in concepts and a eWorkenvironment framework possible to use when implementing IT in health care. The department of EMR has an excellent and very active representative on the advisory board of the project who has helped us a lot in understanding the organisation.

In these kinds of collaborations it is crucial to find a win-win situation, where both the reserachers and the organisations feels that they get energy and effect from the collaboration. In our case the collaboration in the  Dive project has given us much insight in eHealth development and in the complexities of working with IT in health care, which is crucial to be able to work in that area. And I know that the department of EMR are very pleased with the input regarding design that we have given hem. The Disa project has just started, and hopwfully that will result in a win-win too.

We are extremely happy about this colllaboration, and strongly recommend other reserach groups to try the same approach to collaboration!

Uppsala University Psychosocial Care Programme: U-CARE

Since not so long I am connected to “the Uppsala University Psychosocial Care Programme: U-CARE” as a member of an advisory group for the programme (programberedning). 

U-CARE is one of the Swedish government’s strategic research programmes and started in 2010. U-CARE studies how people with physical illnesses and their families are affected psychosocially, and what help they need to deal with various psychological problems. U-care are developing self-help programs for these disorders. They are also working to develop and continuously improve an Internet platform (U-CARE portal) through which it is possible to offer and study the effect of psychosocial support and psychological treatment.

You can find a very informing YouTube film about U-care here:

A few weeks ago Helena Grönqvist visited our department to present their work with U-care and the how the programme has developed. You can find the seminar at the seminar series on “Current Challenges in Biomed-IT”



In this seminar Helena Grönqvist talks about that they forgot to include the users in a structured way when developing the U-care platform and that they ran into problems due to this mistake. She also talked of the problems they encountered using Scrum and Agile.

(Not including the users is really a very common mistake, and I have written a few papers on user are included in Scrum projects (You find some of them here at Reserach Gate). Such a common mistake!)

They have now changed their way of developing the U-care portal so they now have a cyclical process where the users are included and a part of the development.

Some of the challenges that U-care face in the future, according to Helena Grönqvist, are:

  • New technology changes what users want. Do they need to have the portal avaliable on different platforms?
  • Legislation and for example the professors’ privelege is a problem since they want U-care knowledge to be open access.
  • Implementation problems: It takes 17 years until their innovation is implemented in health care. How can we make things move faster?

I am really looking forward to continuing this work and I will keep you updated on the work. 🙂

Meet Our Students at Vitalis 2017. They will present “Envisioning Technology in Healthcare in 2025”

The students of the IT and Society Class of 2017 will present their work at Vitalis 2017 in Gothenburg. I wrote about the start of this years’ course in this blog post. This years’ student project was lead by Mikaela Eriksson (who has a bright future ahead of her as a leader). She worked hard in the project, and togehter with a team of around 30 students they have reserached the future of technology in healthcare in 2025. They also produced a YouTube film. This project was a collaboration with the county council in Uppsala and the topic of the project was set by them.

If you are interested in our work with this course, we have written several papers about it, and constantly improve it.

Below is the abstract to the student presentation.

See you at Vitalis! 

As a part of an interdisciplinary course, students from Uppsala University, Gannon University (US) and Rose-Hulman Institute of Technology (US), have collaborated with the Uppsala university Hospital to work on a vision for how healthcare can look like in 2025. With a technical background, our work has a different view on the field of healthcare. Not being limited by the present boundaries of healthcare regulations, we will present technologies from various areas and how they can be applied in future healthcare. With the patient in mind, we will answer questions such as:


  • What are the possibilities provided by technologies such as drones and artificial intelligence?
  • Can technology from the retail and banking sector be used in healthcare?
  • How can the gaming industry influence the patient experience?

In order to explore healthcare services and understand the patient’s needs we made field visits, which included observing current ways of working and interviewing involved stakeholders. In order to summarise and conclude this research, we conducted vision seminars. As a method for participatory design, we invited healthcare professionals and patients to discuss the current situation and future visions together.

In our research we have observed a very scattered patient experience, involving long waiting times and misleading and/or limited information exchange between patient and healthcare professionals. Our research has shown that today’s healthcare could be improved by increasing patient involvement. Inefficient systems take time away from staff and current technology limits communication.
Based on our research regarding technology in healthcare, we will present different scenarios to describe our vision for how healthcare can look like in 2025. Using examples from chronic diseases (diabetes), temporary severe diseases (cancer), and accidents (head trauma), the goal was to cover multiple aspects of healthcare – before, during and after a hospital visit. Having real life situations allows us to illustrate how various kinds of technologies can improve the patient experience in different scenarios. The idea is to give examples of how future everyday life technology such as self-monitoring devices or virtual and augmented reality could be used to generate a more patient-centered and technology enhanced care.

Seminar on Digital Work Environment with Examples from Health Care and DOME

Last week Gerolf Nauwerck and I did a presentation about Digital Work Environment at the Swedish Ergonomic Society’s yearly meeting. This blog post will shortly describe this presentation. It was the first time that Gerolf and I presented together, but despite limited time for preparing it went really well much thanks to Gerolf and an enthusiastic audience.

Gerolf started off the presentation by discussing the term Digital Work Environment that is used by for example Digitaliseringskommissionen, Prevent and Vision. For example Digitaliseringskommisionen defines it as:

 “The work environment in the digital economy”.

There is no scientific definition of the word, and in research other terms are used such as work engagement and healthy work.

Twenty years ago there were numerous different professions that worked with different tools, but working life has changed and today most work is done using a computer or an iPad, or other ICT technology, see image below:


When looking at the digital work environment there are numerous alarm reports from health care such as Isabella Scandurras “Disturbing or Facilitating“. Most health care professionals use around 25 different computer systems in their work, and these are often not connected or made to work well together even though they spend much of their time working through these systems. Physicians spend around 50% of their time working with the computer, and around 50% doing other things such as meeting patients. There are numerous media articles about the problems with ICT in health care, see the picture of the blog post. The problems are alarming, and health care professionals are as a consequence not always positive to changes related to IT.

One example of digitalisation in health care is medical records online for patients. Most physicians and nurses are very worried of the effects of this system. Mostly they are worried about the effects on the patient, but they are also worried about the effects on their work environment through the following changes:

  • Changes in well established work routines
  • Time pressure
  • Less time for preparation
  • Increased risk of misjudgements

Health care is not the only area where the digital work environment is problematic. Unionen (one of the largest Swedish unions) distribute a yearly or biannual survey to their members to investigate the digital work environment. The sub-titles of their reports called “The digital work environment of white-collar workers” tell us about the results from the survey:

2008: Why doesn’t it get better?

2010: A system error?

2011: Always online – never relaxed

2012: One step forward and two steps back

2014: No lightning ahead

In the seminar we continued with discussing what is known about software development and success factors, and we presented the results from the CHAOS report and research reports that show that one of the most important things when developing good IT for work is user involvement. But I guess that you already knew that 🙂