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HELSEVEL-H-Gode og effektive helse-, omsorgs- og velferdstjenester

Digitaliseringens konsekvenser for samhandlingen og kvaliteten på tjenestene

Alternative title: The consequences of digitization for the coordination and quality of health and welfare services

Awarded: NOK 0.80 mill.

Digital services in healthcare and welfare services may, for example, be digital remote monitoring of patients discharged from hospitals after surgery, electronic communication between general practitioners and NAV, internet treatment of mental health disorders or internet solutions to help people lose weight. There are expectations that digital solutions will increase access to services and thus help more users or patients get help ? and at the same time be cost-saving. Digital solutions can also help users be involved and active, and gain control of their own health and everyday life. More and more digital solutions are therefore being developed and tested for many different user groups. In this knowledge summary, we address research on digital collaboration/interaction tools for either service practitioner and service recipients (such as healthcare professionals and patients) or between service providers (e.g. between staff in the municipality and in hospitals). In a literature search we found 357 articles about digital collaboration/interaction tools. Most of them were about interaction between service providers and patients/users. An example is studies of healthcare professionals' and patients' use of digital solutions for treatment and follow-up of patients' diseases and problems. Many studies revolved around internet treatment for mental disorders, i.e. a form of eLearning that the patient can perform at home, supported with various amount of contact with your healthcare professional. Positive effects of such therapeutic approach have been found. Some patients may receive as good treatment on the internet as in a traditional face-to-face treatment. However, we still lack knowledge on why internet-based treatment works, whether it works better for some users than for others, and whether it is the ones who need it most who are actually offered such treatment. When it comes to studies on digital services for physical illnesses, we identified research on digital tools that will help people change behavior or lifestyle, such as diet and physical activity. In some studies, the digital service resulted in the desired effect, while others did not show any effect. The digital solutions we have studied are quite different, and it is therefore difficult to draw any firm conclusions about what it is that makes some of them work well. In somatic health, we also found some studies on remote monitoring of home dwelling patients, where patients can do a lot themselves. For example, they can conduct measurements at home with digital tools that transfer the result directly to hospitals, and they can also communicate with healthcare professionals in video consultations, via text messages or emails. Remote follow-up has positive consequences when patients can travel less frequently to the hospital and take more control over their own situation. It has negative consequences if it is difficult or tiring for the patient to carry out many tasks himself, or if the solution is too general and not well enough adapted to the individual's needs. Studies on digital communication between service providers show that digital solutions can strengthen communication between employees, but this does not include the Electronic Patient Record (EPR). The EPR can in some cases prevent good information flows. Adopting digital solutions leads to changes in staff's work practice, and these can be both positive and negative. In some cases, the digital solutions may be too rigid and time-consuming to make sure you get your job done as well as before, while in other cases tasks are performed more thoroughly and efficiently due to digital tools. Although some studies show that digital solutions improve services, there is a lot we still do not have knowledge of. In further research, it will be important to investigate more on the effects of digital tools in the long term, whether there are any negative consequences of using digital tools, and how the tools should be designed to fit to individual user groups' needs and preferences ? which means that we need to bring with us the users when developing solutions.

I prosjektet undersøker vi digitaliseringens konsekvenser for samhandling og kvaliteten på helse- og omsorgstjenestene, innenfor arbeids- og velferdstjenestene og i barne- og familievernet. Metodisk anvender vi systematiske litteratursøk og gjør kunnskapsoppsummering og en publikasjonsanalyse. Prosjektet besvarer følgende forskningsspørsmål: 1) Hva slags tema forskes det på? 2) Hva er de mest sentrale forskningsresultatene og hva er konsekvensene for tjenestene? 3) Hvilke forskningsmiljøer forsker på temaene? 4) Er det avdekket viktige kunnskapshull som det ikke forskes på? Hva består disse i tilfelle av? 5) Hva er likheter og forskjeller mellom norsk forskning sett opp mot en nordisk/internasjonal kontekst, og hva er norsk forsknings spesielle styrker og utfordringer? 6) Hvordan er kvaliteten på forskningen? Illustrert blant annet gjennom hvor det publiseres Prosjektet gjennomføres i et samarbeid mellom SINTEF Digital, avdeling Helse og NTNU Universitetsbiblioteket og NTNU Institutt for informasjonsteknologi og informatikk. Resultatene fra prosjektet vil formidles i et kunnskapsnotat.

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HELSEVEL-H-Gode og effektive helse-, omsorgs- og velferdstjenester