Helena Karsten

Åbo Akademi University, Turku, Province of Western Finland, Finland

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Publications (39)14.59 Total impact

  • Anne Forsell, Helena Karsten, Riikka Vuokko
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    ABSTRACT: Users gave us 104 different reasons for the failure of implementing an EPR in a surgical clinic. We classify the reasons with the issue order model, where the first issue level is for simple and technical issues, the second one for more complex and combined issues, and the third one for political or ideological issues. However, what appears as a first order issue to a manager might be seen as an insurmountable third order issue for a worker and vice versa. The issues are interrelated, and solving one issue might have a substantial influence on other issues. Also, the issues seemed to accumulate and concentrate on points. The analysis helps focus on key problems, with consideration to related issues.
    Studies in health technology and informatics 01/2010; 157:118-26.
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    ABSTRACT: Fluent patient information flow is a prerequisite for clinical decision making. Our purpose is to identify unmet information needs in the flow of Finnish intensive care narratives in order to focus the development of natural language processing methods for this domain. Our data set consists of 516 authentic electronic patient records. First, we assess statistically the amount of narratives. We find that the amount is substantial: elective admission type and high nursing intensity contribute this. Second, we perform a content analysis. We observe that notes relevant for a given topic are scattered over the narratives, headings are inconsistent, and the flow from earlier narratives is fragmented. Consequently, support for gaining topical overviews is needed. Meeting this clinical need holds the promise of making narratives better accessible throughout a patient's stay and thereby improving clinical decision making and outcomes of care.
    Bioinformatics and Biomedicine Workshop, 2009. BIBMW 2009. IEEE International Conference on; 12/2009
  • Helena Karsten, Hanna Suominen
    International Journal of Medical Informatics 12/2009; 78(12):786-7. · 2.06 Impact Factor
  • Riikka Vuokko, Helena Karsten
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    ABSTRACT: Nursing work is intertwined with a number of technologies. This paper explores the work practices in a pediatric intensive care unit, and discusses some possible directions for introducing new technologies. Work in intensive care is approached as a set of complex and networked practices that are characterized by dynamism and reflexivity of situated action. We observed how, in the intensive care unit, the emerging issues and complexity of organizational action are anticipated with situational adaptability and self ordering of action. Although the nurses are capable of adapting to rapidly changing situations, at the same time, the nursing practices are bounded by the situational rationalities, such as the information available on the patient. With new technologies, we see several opportunities for change in time place arrangements, in coordination and communication practices, and in information sharing practices. The roles and tasks of the various actants may reformulate, and thereby possibly their skills and professional identities as well. All of this will take place when work practices, new technologies, and care processes are negotiated and made irreversible through the actions of the participants. Full Text at Springer, may require registration or fee
    International Federation for Information Processing Digital Library; Information Technology in the Service Economy: Challenges and Possibilities for the 21st Century;. 06/2008;
  • Matthew R. Jones, Helena Karsten
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    ABSTRACT: The work of the contemporary British sociologist Anthony Giddens, and in particular his structuration theory, has been widely cited by Information Systems researchers. This paper presents a critical review of the work of Giddens and its application in the Information Systems field. Following a brief overview of Giddens's work as a whole, some key aspects of structuration theory are described, and their impli- cations for Information Systems research discussed. We then identify 331 Information Systems articles published between 1983 and 2004 that have drawn on Giddens's work and ana- lyze their use of structuration theory. Based on this analysis 1 Jane Webster was the accepting senior editor for this paper. Gerry DeSanctis, Alain Pinsonneault, and Leighann Neilson served as reviewers. The associate editor and a fourth reviewer chose to remain anonymous. a number of features of structurational research in the Infor- mation Systems field and its relationship to Giddens's ideas are discussed. These findings offer insight on Information Systems researchers' use of social theory in general and suggest that there may be significant opportunities for the Information Systems field in pursuing structurational research that engages sympathetically, yet critically, with Giddens's work.
    MIS Quarterly 01/2008; · 4.66 Impact Factor
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    ABSTRACT: Nursing narratives are an important part of patient documentation, but the possibilities to utilize them in the direct care process are limited due to the lack of proper tools. One solution to facilitate the utilization of narrative data could be to classify them according to their content. Our objective is to address two issues related to designing an automated classifier: domain experts' agreement on the content of classes Breathing, Blood Circulation and Pain, as well as the ability of a machine-learning-based classifier to learn the classification patterns of the nurses. The data we used were a set of Finnish intensive care nursing narratives, and we used the regularized least-squares (RLS) algorithm for the automatic classification. The agreement of the nurses was assessed by using Cohen's kappa, and the performance of the algorithm was measured using area under ROC curve (AUC). On average, the values of kappa were around 0.8. The agreement was highest in the class Blood Circulation, and lowest in the class Breathing. The RLS algorithm was able to learn the classification patterns of the three nurses on an acceptable level; the values of AUC were generally around 0.85. Our results indicate that the free text in nursing documentation can be automatically classified and this can offer a way to develop electronic patient records.
    International Journal of Medical Informatics 01/2008; 76 Suppl 3:S362-8. · 2.06 Impact Factor
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    Helena Karsten, Riikka Vuokko
    01/2008;
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    ABSTRACT: The present study discusses ethics in building and using applications based on natural language processing in electronic nursing documentation. Specifically, we first focus on the question of how patient confidentiality can be ensured in developing language technology for the nursing documentation domain. Then, we identify and theoretically analyze the ethical outcomes which arise when using natural language processing to support clinical judgement and decision-making. In total, we put forward and justify 10 claims related to ethics in applying language technology to nursing documents. A review of recent scientific articles related to ethics in electronic patient records or in the utilization of large databases was conducted. Then, the results were compared with ethical guidelines for nurses and the Finnish legislation covering health care and processing of personal data. Finally, the practical experiences of the authors in applying the methods of natural language processing to nursing documents were appended. Patient records supplemented with natural language processing capabilities may help nurses give better, more efficient and more individualized care for their patients. In addition, language technology may facilitate patients' possibility to receive truthful information about their health and improve the nature of narratives. Because of these benefits, research about the use of language technology in narratives should be encouraged. In contrast, privacy-sensitive health care documentation brings specific ethical concerns and difficulties to the natural language processing of nursing documents. Therefore, when developing natural language processing tools, patient confidentiality must be ensured. While using the tools, health care personnel should always be responsible for the clinical judgement and decision-making. One should also consider that the use of language technology in nursing narratives may threaten patients' rights by using documentation collected for other purposes. Applying language technology to nursing documents may, on the one hand, contribute to the quality of care, but, on the other hand, threaten patient confidentiality. As an overall conclusion, natural language processing of nursing documents holds the promise of great benefits if the potential risks are taken into consideration.
    International Journal of Medical Informatics 11/2007; 76 Suppl 2:S293-301. · 2.06 Impact Factor
  • Helena Karsten, Aija Laine
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    ABSTRACT: Integrated information systems for managing patient data transform the nature of hospital work to the extent that the work practices, the responsibilities, even the professional identities are likely to undergo major changes. Therefore, during the organizational implementation of the IS, attention should be paid to the future users and how they understand and see what is going on. Here the focus is on these interpretation processes, analyzed as technological frames. That is, people develop different assumptions, expectations and knowledge concerning new technology. During this sense-making process they build their idea of that technology, its technological frame. We analyzed the pre-implementation frames that could be discerned in 24 interviews of hospital personnel. Main influences on the frames in this case were the work role in the organization, knowledge about the new system, and attitudes toward the old systems. The social context appeared to have a significant influence in the users' interpretation processes and the frames seemed to be congruent within one group. So far, the incongruence between groups appeared to have caused no major problems for the implementation.
    International Journal of Medical Informatics 07/2007; 76 Suppl 1:S136-40. · 2.06 Impact Factor
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    GAMEON'2007, (Covers Game Methodology, Game AI, Art Design and Graphics, Mobile Gaming, Online Gaming and Security, Education, Serious Gaming), November 20-22, 2007, University of Bologna, Bologna, Italy; 01/2007
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    ABSTRACT: This paper discusses theoretical considerations of ethics in building and using a text mining application in nursing documentation. Nursing documentation is based on the process of gathering information from the patient, setting goals for care, documenting nursing interventions and evaluating delivered nursing care. Privacy-sensitive health care documentation brings specific ethical concerns and difficulties that one needs to be aware of and conform to when developing and using text mining tools in electronic patient records. We discuss how patient confidentiality can be ensured in this domain and how text mining might support nurses to give better and more efficient care for their patients. Our conclusion is that text mining of nursing documents holds the promise of great benefits when the potential risks are taken into consideration.
    Studies in health technology and informatics 02/2006; 122:359-64.
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    Roberta Lamb, Helena Karsten
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    ABSTRACT: Hybrid organizations have become increasingly central to university-industry technology transfer efforts in all regions that hope to harness technological innovation as a generator of entrepreneurial development. Finland, for example, has added a new "third mission" to the 2002 statutes on universities which creates incentives for direct contributions to the nation, and its economy in university-industry R&D. In Hawaii, a few firms have adopted an ICT-infused form of industry-based R&D that could serve as a model to other economic regions, like the Baltic Sea Region; and it could also help policy makers understand how local and global policies can build bridges that shape an environment that is conducive for hybrids. In this research-in-progress paper, our empirical analysis focuses on the ways in which hybrid R&D organizations have leveraged their information and communication technology expertise to "tech-up" other members of their collaboration network, and to increase their ability to derive the R&D resources from public and private research funding agencies that sustain their hybrid form. We use institutional theory concepts to examine the dynamics of academia-industry relationships in the Baltic Sea Region, particularly in Finland, and to combine these observations with findings from a qualitative study that focuses on high-tech firms in Hawaii.
    01/2006;
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    ABSTRACT: Current computer-based patient records provide many capabilities to assist nurses’ work in intensive care units, but the possibilities to utilize existing free-text documentation are limited without the appropriate tools. To ease this limitation, we present an adaptation of the Regularized Least-Squares (RLS) algorithm for ranking pieces of nursing notes with respect to their relevance to breathing, blood circulation, and pain. We assessed the ranking results by using Kendall’s τ b as a measure of association between the output of the RLS algorithm and the desired ranking. The values of τ b were 0.62, 0.69, and 0.44 for breathing, blood circulation, and pain, respectively. These values indicate that a machine learning approach can successfully be used to rank nursing notes, and encourage further research on the use of ranking techniques when developing intelligent tools for the utilization of nursing narratives.
    01/2006;
  • Jarmo Sarkkinen, Helena Karsten
    01/2005;
  • Helena Karsten
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    ABSTRACT: Interdependencies are constructed when peoplegradually build mutual relationships betweenthemselves. In this study the focus is oninterdependencies at work, in long-termprojects or groups. Viewing interdependencerelationships dynamically, as social practices,it is possible to appreciate the complex andsituated nature of this formation. The maingoal of the study is to develop a theoreticalaccount of the dynamics of the intertwinedprocesses of interdependence construction andcollaborative technology appropriation and use.The main dimensions of this account are: (1)how interdependence is constructed andestablished as a social process, (2) howinformation and communication are involved inthese processes, and (3) in what wayscollaborative information technology cancontribute to or hamper these processes. Thefirst dimension builds upon structurationtheory. Three earlier case studies arere-visited with the approach, with the outcomeof several issues to be explored. Thetheoretical approach opens up an extensiveresearch program of interdependenceconstruction in relation to collaborativeinformation technology appropriation and use.
    Computer Supported Cooperative Work 01/2003; · 0.61 Impact Factor
  • Helena Karsten
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    ABSTRACT: The goal of this research is to study the relation between organizational form (OF) and organizational memory (OM). It examines what kind of roles OM plays in different OFs--that is, how OM is used in organizational action--and whether changes in a firm's organizational form relate to changes in the role of OM. These relationships are examined in the context of how information technology (IT) is used to support organizational remembering. The study outlines different manifestations of OM in 1 company as it underwent major organizational transformations during a 3-year period. The manifestations are grouped into "bins," expanding the storage structure concept by Walsh and Ungson to include OM contents and processes of use. The bins are supplemented with an additional bin, the organizational information space, to address the collaborative aspect of OM. Another new construct, the organizational memory profile, is introduced to summarize the combination of OM manifestations in a particular organization at a particular time. The OM profiles are outlined for the case company and they show marked differences between OFs. This upholds the claim that different OFs present different kinds of arenas for OM. IT support for various bins is analyzed and a variety of IT support is recognized. This upholds the view that several OM support systems are needed and that IT can play a significant role in making past events more accessible.
    Journal of Organizational Computing and Electronic Commerce 06/1999; 9(2-3):129-150. · 0.43 Impact Factor
  • Helena Karsten
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    ABSTRACT: Collaborative information technologies have been claimed to enhance collaboration in organizations, under certain conditions. This claim was found problematic in several respects, also in the light of the results of 18 case studies of Lotus Notes use, taken from the literature. The cases may be split into three groups: (1) exploratory, conservative, or cautious use; (2) planned and expanding use; and (3) extensive and engaged use of Notes. In the first group, no changes in work arrangements due to Notes use could be found. In the second group, the planned Notes applications supported the established work arrangements, both collaborative and hierarchical. Only in the third group were there significant changes towards more collaboration. These changes were due to a conscious and continued effort to bring about new work arrangements and new kinds of Notes support.A number of issues emerged in the review that could help to understand the relationship of collaborative information technologies and changes in work and organization. The issues included the role of the specific capabilities of the technology; the difference between technology as a product and technology-in-use; the kind of care needed in bringing about desired changes; the emergent, drifting nature of the change process; the role of the technology as a constructive tool in improvising and enacting the changes; and the gradual translations of influences from work practices to organizational practices.
    DATA BASE. 01/1999; 30:44-65.
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    Helena Karsten, Matthew R. Jones
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    ABSTRACT: The role of collaborative information technology in organ- isational changes continues to be a source of controversy in the CSCW literature. We report organisational changes in a Ftih computer consukancy accompanying the introduc- tion and use of Lotus Notes over a period of three years. The case shows that collaborative information technologies, such as Lotus Notes, are capable of supporting a variety forms of organisation. The uptake and use of Notes appeared to be more strongly Muenced by aspects of the organisational contex< intemd social structure and the users' capabihties - in this case economic recessio~ chang- ing foci of cmttrol and the role changes in the company - than by any intilc logic of the technology.
    01/1998
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    Helena Karsten
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    ABSTRACT: One way to clarify the concept of organizational metn- ory is by defining organizational memory components in terms of their roles in different organizational forms. In this way the place and function of organizational memory in a business organization can be better understood A profes- sional organization, where both the organizational form and the role of shared organizational information underwent several major changes during the three-year case study, provides a concise real-life opportunity to study such role variations. A new construct, the 'organizational memory projile: is used to link the manifestations of organizational memory to organizational forms. The mani- festations studied are the individuals, the transformation mechanisms (such as routines), and the common informa- tion space. A key message of this study is that direrent maniyesta- tions of organizational memory take on d@erent roles depending upon the organizational form. The case study gives support to the following organizational memory pro- Jles, With entrepreneurs and markets, the role of individu- als is central, but some transformation mechanisms and common information space are also needed. In hierarchies, the focus is on transformation mechanisms, the enforced routines. Common information space is limited but still important for top management. In networks, the interde- pendence and collaboration are the key issues and the common information space is the main manifestation of organizational memory. The individuals interact and together form transformation mechanisms that carry the results of negotiations. The role of these negotiated routines is more central than expected.
    System Sciences, 1996., Proceedings of the Twenty-Ninth Hawaii International Conference on ,; 01/1996
  • Helena Karsten
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    ABSTRACT: The nature of the information systems needed in a networked firm is not well known: nor is the process leading to particular solutions. Describes a small computer-consulting company which works as a network of independent consultants, and analyses the slow and circuitous path from recognizing its IS/IT needs to its commitment to a particular solution as seven steps; using ideas of structuration theory as a focus. During the selection process, participants formed new interpretations of the firm, of technology, and of the appropriate process towards a feasible solution. New resources – both material and symbolic – were acquired to enable the search. Existing “norms” provided boundaries for the search process, but at times had to yield or be circumvented in order for the organization to reach a solution.
    Information Technology &amp People 01/1995; 8:7-34. · 0.66 Impact Factor

Publication Stats

219 Citations
14.59 Total Impact Points

Institutions

  • 2008–2010
    • Åbo Akademi University
      • Turku Centre for Computer Science
      Turku, Province of Western Finland, Finland
  • 2003–2007
    • University of Turku
      • • Turku Centre for Computing Science, TUCS
      • • Department of Information Technology
      Turku, Western Finland, Finland
  • 2006
    • Turku centre for biotechnology, finland
      Turku, Province of Western Finland, Finland
  • 1995–1999
    • University of Jyväskylä
      • Department of Computer Science and Information Systems
      Jyväskylä, Province of Western Finland, Finland