Study on Automation of eServices in Primary Care

Automation where humans and computers cooperate on various levels is transforming society. Many jobs are anticipated to be partially or completely automated in the future. OECD, for example, calculate that 14% of current jobs could completely disappear in the next 15-20 years, and they estimate that around 32% are likely to change entirely as tasks are automated (OECD 2019). Another well cited calculation estimates that 47% of all jobs in the US will be threatened by technology development in the next 10 to 20 years (Frey and Osborne 2017). This transformation using automation is also seen in the healthcare sector and some areas of automation are clinical development, non-invasive surgeries, robots in the medical pill dispersion and administrative systems being automated 

Automation has also recently moved into the area of patient-centric services to address society’s challenges with an ageing population and healthcare provision. The goal of the transformation with automation here is to make healthcare more efficient, and to empower patients. Given the work environment problems in healthcare, with a large turnover of especially nurses (Hsu 2016) and recent evidence that suggest digitalisation is experienced as a part of the problem by many healthcare professionals (Kroth et al. 2019; Scandurra et al. 2014), it is vital to investigate the effects of automation and digitalisation on work engagement. 

As a part of the STRIA work we did a study on staff at 1177 that we published in a Swedish technical report found here

Abstract:

Denna rapport innehåller en kartläggning av 1177-personalens digitala arbetsmiljö vid arbete med den chattfunktion till patienter som användes under ett pilotprojekt hösten 2019. Rapporten är skriven med utgångspunkt från att läsaren har inblick i personalen på 1177s arbete, och har kunskap kring de IT-system som används. Kartläggningen genomfördes som ett samarbete mellan forskningsprojektet Systemutvecklingsmetoder för digital arbetsmiljö som leds av Uppsala Universitet och Region Uppsalas projekt Nära Vård Online under hösten och vintern 2019/2020.

Kontextuella intervjuer genomfördes på plats under cirka fem timmar. Dessutom genomfördes nio semistrukturerade intervjuer med sjuksköterskorna och åtta med läkare. Intervjufrågorna grupperades i fyra teman: intervjupersonens bakgrund; arbetsmiljö relaterat till pilotprojektet; arbetsmiljö relaterat till det äldre sättet att arbeta och några avslutande frågor. Alla intervjuer transkriberades och tematisk analys gjordes.

Inom temat upplevelse av krav visar intervjuerna att det som är mest stressande, och som nästan stressar alla, är köbildningen i chattsystemet. Det som stressar är otillräcklig information om vilka samtal som väntar, och att man inte kan veta när personen man chattar med svarar. Dessutom påpekar några att man inte heller kan se vilka patienter som behöver snabb hjälp och vilka som kan vänta.

Inom temat stöd kan man konstatera att alla upplever systemen som stabila, och har god inblick i vad man kan göra om systemen inte fungerar. Många tycker att systemen fungerar mycket bra. Några påpekar att samarbetet och stödet från kollegor som jobbar hemifrån inte fungerar lika bra som att arbeta på samma plats.

Inom området upplevelse av kontroll finns det förbättringsområden vad det gäller vilka frågor som patienten svarat på, och sjuksköterskor påpekade att systemet delvis är designat för läkare och inte för sjuksköterskors arbete. Många upplevde att de kunde vara med och påverka i förändringsarbetet, och att de i mycket stor utsträckning varit delaktig.

Rapporten innehåller också några rekommendationer kring design och implementering av liknande tjänster ur ett arbetsmiljöperspektiv. Slutligen finns lästips för den intresserade läsaren.

 

Workload and Working from Home in Corona Times

I’ve been working from home from the first week of March. By now that sums up to around six weeks. The first couple of weeks work was calmer, in my experience, with less meetings and things cancelled. Everything was a bit chaotic there the first weeks. Two conferences where I was going to talk as key note were cancelled which gave me several empty days on a short notice.  Also other things disappeared from the calendar and many things were cancelled. But the last weeks it has been more or less the same amount of “too much to do” as usual. But with a different flavour and content.

For me distance meetings takes much more energy than ordinary meetings where everyone is in the same room. Often I have had 5-7 hours of meetings in a day and it doesn’ really work well. Also, very often I am the meeting leader and meetings have a different character than usual. Perhaps that takes some energy from me too? One example is that people are muted and the meetings become a bit more organised. They also need to be more carefully planned. For the future I need to cut down on the number of meetings per day to be able to have energy enough for the other parts of my work: planning things, writing funding applications and papers and reading. The following weeks I will try to cut down to four meetings a day, and not book more than that.

The workload when it comes to teaching has also increased due to Corona. Instead of being prepared to discuss the content/material of my lectures, I also need to prepare the interactions with students to the very detail. In my classes very few students speak up in the zoom meeting classroom, so instead I use polls, and other interactive tools to keep them activated. These needs to be put in place before the lecture starts. Also, the lectures in themselves have been stressful with all kinds of technical issues, even though I am lucky enough to have had good help from Diane Golay who teaches the course with me.

Also the work load when it comes to the family has been different and heavier during these Corona times. The oldest son’s school is closed so he is always studying from home, and me and my husband work from home too. And at least one of the other three kids have stayed at home too every working day. So far there has been only two days with three people at home, and the rest we have had 4-6 people at home every day.  This truly affects the grocery shopping, cleaning and cooking. When I sit in my meetings the kids play with different things, and the house is a mess. Unfortunately cleaning and cooking are not my favourite hobbies. I have never been so happy about our robot vacuum cleaner as these days. It does hard work cleaning the house every day! Another example of increased work load is lunch: Instead of walking to the the local restaurant at work we plan and prepare lunch for on average five people every work day. And lunch needs to be one hour due to meetings being booked which often is too short and there is no time to fill the dishwasher etc.

 

 

Soon ten years since I defended my PhD: “Date set, opponent accepted! Now the only thing that is missing is the text”

10 years have soon passed since I defended my PhD. Facebook has given me some memories such as “Date set, opponent accepted! Now the only thing that is missing is the text”.  I remember that I had tree months to write the introduction to the text and organise everything around the PhD. The PhD was based on eight papers related to how to work with software engineering (user centred design- UCD) in large organisations, and a large action research project with eight different public authorities. You find the thesis here: http://uu.diva-portal.org/smash/record.jsf?pid=diva2%3A310201&dswid=-5735

The thesis has three research questions:

  1. What happens when UCSD is introduced in a public authority?

I was also interested in the values and perspectives of people involved in the organisation as well as how UCSD can be introduced through new methods that affect the values and perspectives of the stakeholders including the system developers in the organisation. Therefore, this thesis also aims at understanding the following questions:

  1. How do perspectives of stakeholders in systems development projects affect the work with UCSD, usability and users’ health in the organisations studied?

The final question addresses the issues of how we can address the introduction of UCSD and change perspectives:

  1. What new methods can be used to introduce UCSD and to influence perspectives?

barnen

I finished my PhD during a tough period in life, and I had much support from my family, my supervisor Jan Gulliksen and my friends. One of my very best friends Helena Bernáld did the photos for the thesis, and my parents helped me with grocery shopping, cleaning and laundry. In parallel to writing my PhD I was a single mom of three kids aged 2, 6 and 7, see photo. In addition to this I had just bought a house that I renovated and I somehow I pulled off painting my new house. I don’t remember why I though it was so important. Why did I do that!!?? It sounds very crazy in hindsight.

I remember nailing the PhD thesis to a wall in the university building (see photo) and feeling so happy that I pulled things off! A big thanks to everyone that helped me during this period!!

Professor Bodil Jönsson was the opponent at my defence. I remember that the discussion was very nice and that she thought that I had used too many theories and added to much material to the thesis. And she had a point. Somehow the situation in life made the PhD defence seem like something that was possible to control. And I was really not very nervous about it, and writing the thesis was therapy related to life in general. That part is also difficult to understand! I guess people are strange, and I am equally strange myself. 

Keep safe in Corona times!

 

Digital Work Environment and The Health Care Sector: Presentation at Vitalis 2020

Magdalena Stadin from Jönköping University, David Borgestig from Region Uppsala and I will be presenting at Vitalis 2020!

The abstract for the talk (transpated from Swedish)

Today, health care in Sweden is largely digitalised. The data that the business needs to function such as clinical data on patients such as administrative data on personnel, resources and costs are now primarily in digital form. This means that most healthcare and administrative processes are performed using one or more computer systems. This has had major consequences for the health care workers’ work environment.
This presentation begins by explaining what the digital work environment consists of, and some of the work environment problems that have arisen in connection with digitalisation. The digital work environment includes all the different digital systems required to carry out one’s work. The digital work environment can have a major impact on the physical, mental, and social work environment. For example, clicking and typing with a keyboard can cause physical problems, such as musculoskeletal disorders. Poorly designed systems can increase the cognitive load and lead to brain fatigue and overload, which can contribute to fatigue. The transition to digital communication can also change social patterns and power relations in depth.

The presenters have many years of experience in research on digitalisation of healthcare from a work environment perspective and will give examples from the studies they participated in as an introduction to the presentation.

In the presentation we will also elaborate on two different case studies we have done on digitization and the working environment. The first study is about a pilot project in primary care around triaging patients with the help of a chat function. What are the advantages and disadvantages of the staff with the new service? How is the staff’s working environment affected by the change? What can be learned for future implementations in primary care. The second study is an interview study with leaders in health care and their experiences of aspects in the digital work environment that are perceived to contribute to stress and frustration, and how these aspects are handled in a concrete manner. A further theme highlighted by the second study is what improvement measures would be required for the digital work environment to be improved, from the leaders’ perspective.

Finally, we will make recommendations for working with digital work environment in health care.

Image by Gerd Altmann from Pixabay

Image by Gerd Altmann from Pixabay

Starting up Interview Study with the Aim of Defining “Digital Excellence”

The University Chancellor’s Office (Universitetskanslersämbetet ), together with the Swedish Growth Agency (Tillväxtverket), has been commissioned to analyze and propose how the supply of digital excellence can be developed in the short and long term. The assignment includes the development of improved statistics and forecasts of the total need for competence in business and the public sector with the aim of improving the conditions for universities and universities to meet the need for excellence in the short and long term.
However, there is no accepted definition of what digital excellence is. Our project hence aims to develop a definition of the concept of digital excellence. The definition should form the basis for UKÄ and the Swedish Growth Agency’s project.

As a part of this work Jan Gulliksen, Arnold Pears, Mattias Wiggberg and I are doing an interview study with 10-20 key players to understand their perspective of Digital Excellence. This week I have started doing these semi structured interviews, and it has been great fun. Doing an interview is always a learning experience, and people are often very wise and knowledgeable.

 

Participating in Conference about Social Work

I will participate in the conference organised by the Social Work Centre (CEASAR).  The conference will be run in Uppsala on the 12th and 13th of March. The purpose of this conference is to provide a forum for presentations of research in social work in a Swedish context.  The majority of the time will be devoted to seminar discussions papers. Simon Lindgren till give a key note which sounds really interesting on the topic of Digital Cultures and Digital Methods in the Social Sciences at the opening of the Conference. I will participate as a panel member discussing digitalisation in social work under the guidance of Professor Stefan Sjöström together with two other researchers:

  • Åsa Cajander, professor of human-computer interaction, Uppsala universityo
  • Lupita Svensson, associate professor in social work, Lund Universityo
  • Karin Osvaldsson Cromdal, associate professor in social work, Linköpingsuniversitet

Key Note at Uppsala Public Management Seminar 2020

On the 18th of March I will give a key note about work environment and digitalisation at the Uppsala Public Management Seminar 2020. When invited they want me to talk a bit about New Public Management and digitalisation, so that will be one theme. The key note will be in Swedish

 

Hur påverkas arbetslivet och arbetsmiljön av digitalisering?

Digitaliseringen är fantastisk och skapar nya möjligheter i samhället. Vi digitaliserar också alltmer och nya tekniker driver förändringen. Det vi ofta glömmer bort är att digitaliseringen i arbetslivet också påverkar vår arbetsmiljö. Under den här föreläsningen kommer Åsa Cajander att berätta om forskningsfronten inom området digitalisering och arbetsmiljö med illustrerande exempel. Föreläsningen kommer att beröra fragmentering av tid, förändringar i arbetsuppgifter och problemet med att vara ständigt uppkopplad och nåbar. Föreläsningen kommer också att innehålla rekommendationer och råd kring hur man digitaliserar med arbetsmiljön i fokus.

 

 

See you there

 

 

Working with a Definition of Excellent Digital Competence

I will be a part of a team that will work on a definition of Excellent Digital Competence (Digital spetskompetens) in the spring 2020. The project is funded by The Swedish Agency for Economic and Regional Growth (Tillväxtverket) and The Swedish Higher Education Authority (UKÄ). The work will be led by Professor Jan Gulliksen and the other members of the team are Arnold Pears and Mattias Wiggberg. The team is composed of people with complementary skills to create the best possible working group, and my area of speciality in comparison to the others is the gender perspective.

Excellent Digital Excellence is likely to include a basic broad knowledge of the basics of digitalisation as well as in-depth expertise in one or more sub-areas, such as programming technology, AI, data security or user experiences, just to name a few. Digital excellence also certainly includes some form of documented practical experience of actively participating in several successful development projects.

The OECD notes that the lack of digital specialists and digital excellence is a bottleneck for innovation and growth in Sweden. The need is expected to increase in the coming years as digitalisation develops and new technologies such as AI will have an impact.

In order to work with this on a political level there is a need for a definition of Excellent Digital Competence, and we will work with this using several different methods:

  • Literature studies to map the state of knowledge, analyses of identified documents
  • Short interviews to capture the different needs of the target groups, both from industry and academia
  • Continuous reconciliation meetings with clients to clarify the work and give it direction and to iteratively refine and improve the quality of the result
  • Workshop / Focus groups to discuss and anchor proposed definitions, as well as to anchor the work and to get input into problem picture
  • Design thinking methodology for developing creative innovative solutions

I think it will be great fun to work in this project! I think that the topic is of high importance, and it will be great fun to reconnect with Arnold Pears, Jan Gulliksen and Mattias Wiggberg.

Attending the University’s Executive Program in 2020

I love attending leadership and management courses! They are often so inspirational and gives me a chance to reflect on who I am, and who I want to be. I see them as a chance to deepen my understanding of management and professional competence as a research leader and deputy head of department of Vi2. I also very much enjoy meeting and learning from other participants in the courses.

This year I was accepted to my 11th leadership course that includes seven occasions of two day meetings (14 days in total) in addition to individual coaching sessions. According to the information provided the executive program at Uppsala University aims to give you increased knowledge about the responsibilities and powers that the managerial assignment entails and about the laws and regulations that are applicable at the university. The training will also provide the conditions for developing your own leadership and leadership as well as offer support in the role based on your individual needs.

The first two days of the course will take place in Noors castle, see the picture of the blog post.

IEEE Frontiers in Education in Uppsala 2020

IEEE Frontiers in Edcuation (FIE) is a major international conference focusing on educational innovations and research in engineering and computing education. FIE will be running in Uppsala, Sweden Wednesday, October 21, 2020 to Saturday, October 24, 2020. Of course I will be attending this conference when it runs in Uppsala! The conference  really covers many interesting aspects of education, and I have published many papers with the UpCERG group at this conference. FIE is the place to be to be inspired by research on for example gender, professional competencies or employability in engineering and computing education.

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