Beyond implementation of eHealth

The main objective of this research is to explore key factors that will affect implementation and adoption of collaborative eHealth, that is eHealth that is used by both patients and healthcare professionals, and to propose concrete interventions or tools to ensure widespread adoption of such eHealth.

One of the more discussed collaborative eHealth tools that have been implemented in recent years, both in Sweden and internationally, is the patient accessible electronic health record (PAEHR), or open notes as referred to in the United States. We will use the implementation of PAEHRs or open notes in the United States and in Sweden as our example case. We choose this because it is a widespread type of eHealth system, it is used by both healthcare professionals, patients, and family caregivers, it has been controversial and debated, and it affects power hierarchies, professional and patient roles. Healthcare organizations (in the United States) and regions (in Sweden) have taken different approaches to implement the innovation, and adoption and actual use still vary widely between contexts.

The project’s goals are:

1: To identify key contextual factors that influence implementation and adoption of collaborative eHealth in general and specifically PAEHR/open notes.

2: To explore ethical factors and factors related to professional roles and patient-clinician relationship that influence implementation and adoption of collaborative eHealth in general and specifically PAEHR/open notes.

3: To design and test interventions to facilitate implementation and adoption of PAEHR/open notes addressing contextual and ethical factors

4: To adapt existing implementation and adoption theories to the context of collaborative eHealth.

A participatory action research approach will be used in close collaboration with patients, healthcare professionals and other stakeholders.