Pirkko Nykänen

Pirkko Nykänen
Tampere University | UTA · School of Information Sciences

About

112
Publications
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Publications

Publications (112)
Article
Full-text available
Aim: To examine whether a valid measure for the adequacy of nursing resources can be based on nurse-assessed optimality of the workload on nursing intensity and staffing systems. Background: In health care, nurse leaders need valid information regarding the adequacy of nursing resources. Earlier research suggested that nursing resources predict pa...
Article
Objectives: This paper draws attention to: i) key considerations for evaluating artificial intelligence (AI) enabled clinical decision support; and ii) challenges and practical implications of AI design, development, selection, use, and ongoing surveillance. Method: A narrative review of existing research and evaluation approaches along with expert...
Article
Full-text available
Objectives: The paper draws attention to: i) key considerations involving the confidentiality, privacy, and security of shared data; and ii) the requirements needed to build collaborative arrangements encompassing all stakeholders with the goal of ensuring safe, secure, and quality use of shared data. Method: A narrative review of existing research...
Chapter
An e-health ecosystem is a socio-technical system composed of healthcare organizations, service provider professionals, customers, citizens, and patients, industrial companies providing their products and services, technology-mediated platforms for communication, and infrastructures that in collaboration provide value and services. There are not ye...
Article
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Objectives: To set the scientific context and then suggest principles for an evidence-based approach to secondary uses of clinical data, covering both evaluation of the secondary uses of data and evaluation of health systems and services based upon secondary uses of data. Method: Working Group review of selected literature and policy approaches. Re...
Article
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Objectives: To set the scientific context and then suggest principles for an evidence-based approach to secondary uses of clinical data, covering both evaluation of the secondary uses of data and evaluation of health systems and services based upon secondary uses of data. Method: Working Group review of selected literature and policy approaches....
Article
Being able to design information systems to an untouched domain, without the burden of existing information systems, especially legacy systems, is often seen as a dream of most information system professionals. Uncharted domains are anyway scarce, and often such greenfield projects turn into brownfield projects, also to projects where existing stru...
Article
Systematic health IT evaluation studies are needed to ensure system quality and safety and to provide the basis for evidence-based health informatics. Well-trained health informatics specialists are required to guarantee that health IT evaluation studies are conducted in accordance with robust standards. Also, policy makers and managers need to app...
Article
Background and objectives: With growing use of IT by healthcare professionals and patients, the opportunity for any unintended effects of technology to disrupt care health processes and outcomes is intensified. The objectives of this position paper by the IMIA Working Group (WG) on Technology Assessment and Quality Development are to highlight how...
Chapter
Health IT evaluation studies have often been found to be of limited quality. To address this problem, several guidelines and frameworks have been developed as tools to support improvement of the quality of evaluation studies. In this contribution, we review available guidelines and then present the Good Evaluation Practice Guideline in Health Infor...
Article
Background: Patient classification systems have been developed to manage workloads by estimating the need for nursing resources through the identification and quantification of individual patients' care needs. There is in use a diverse variety of patient classification systems. Most of them lack validity and reliability testing and evidence of the...
Book
This book constitutes the refereed proceedings of the 6th International Conference on Well-Being in the Information Society, WIS 2016, held in Tampere, Finland, in September 2016. The 21 revised full papers presented were carefully reviewed and selected from 42 submissions. With the core topic "Building Sustainable Health Ecosystems" WIS 2016 focus...
Article
Health IT evaluation studies have often been found to be of limited quality. To address this problem, several guidelines and frameworks have been developed as tools to support improvement of the quality of evaluation studies. In this contribution, we review available guidelines and then present the Good Evaluation Practice Guideline in Health Infor...
Article
Modern eHealth, ubiquitous health and personal wellness systems take place in an unsecure and ubiquitous information space where no predefined trust occurs. This paper presents novel information model and an architecture for trust based privacy management of personal health and wellness information in ubiquitous environment. The architecture enable...
Article
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Background: Efficient collaboration and information exchange among care givers is essential during patient´s hospital period for the high quality and safety of patient care. Nursing documentation plays important role in effective collaboration and information exchange. One prerequisite for efficient and productive multidisciplinary collaboration is...
Article
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Background: Ubiquitous health has been defined as a dynamic network of interconnected systems. A system is composed of one or more information systems, their stakeholders, and the environment. These systems offer health services to individuals and thus implement ubiquitous computing. Privacy is the key challenge for ubiquitous health because of au...
Conference Paper
Electronic health records implementation has been a challenge for many governments worldwide, who have tried to realise a quality and cost-effective implementation through closed and/or open source software. The paper discusses the background and rationale for implementing health records through an open source software development process model. Wh...
Article
Full-text available
Improving the quality of reporting of evaluation studies in health informatics is an important requirement towards the vision of evidence-based health informatics. The STARE-HI - Statement on Reporting of Evaluation Studies in health informatics, published in 2009, provides guidelines on the elements to be contained in an evaluation study report. T...
Article
Full-text available
Background: Ubiquitous health is defined as a dynamic network of interconnected systems that offers health services independent of time and location to a data subject (DS). The network takes place in open and unsecure information space. It is created and managed by the DS who sets rules that regulate the way personal health information is collecte...
Article
Full-text available
To present the importance of Evidence-based Health Informatics (EBHI) and the ethical imperative of this approach; to highlight the work of the IMIA Working Group on Technology Assessment and Quality Improvement and the EFMI Working Group on Assessment of Health Information Systems; and to introduce the further important evaluation and evidence asp...
Article
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To present European reflections on the concept of eHealth and emerging challenges related to further development of eHealth in Europe. A survey with 10 questions was distributed to representatives of the national member associations of the European Federation of Medical Informatics (EFMI). The results document a shift from a constricting ICT-orient...
Article
A feasibility analysis has been performed to study the applicability of privacy attributes with a developed wellness information model. Information privacy concerns specifically access to individually identifiable personal information and one's ability to control information about oneself. We carried out a user scenario walk-through of the privacy...
Chapter
Health care systems are in transition to citizen-centered care with focus on prevention, proactive and personalized services and healthy lifestyles. Innovative technologies enable citizens’ empowerment and allow them to manage their complete health and wellness. Citizen-centered tools collect life-long cross-institutional information and data from...
Article
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Pervasive healthcare and citizen-centered care paradigm are moving the healthcare outside the hospital environment. Healthcare delivery is becoming more personalized and decentralized, focusing on prevention and proactive services with a complete view of health and wellbeing. The concept of wellness has been used to describe this holistic view of h...
Article
Full-text available
The objective of this study was to evaluate the feasibility of the national nursing model in Finland. The feasibility evaluation was carried out with nurses using interviews and patient case scenarios in primary, specialized and private healthcare. The nursing process model showed to be feasible in nursing practice but the current national nursing...
Article
Full-text available
Ubiquitous computing technology, sensor networks, wireless communication and the latest developments of the Internet have enabled the rise of a new concept-pervasive health-which takes place in an open, unsecure, and highly dynamic environment (ie, in the information space). To be successful, pervasive health requires implementable principles for p...
Article
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To evaluate the feasibility of the national nursing model and usability of four widely used nursing documentation systems and to study their usefulness in multi-professional collaboration and information exchange. Qualitative usability study methods were used, including the use of scenario walkthroughs, contextual inquiries, thematic interviews and...
Article
Full-text available
A Good evaluation practice in Health Informatics (GEP-HI) Evaluation Practice guideline has been developed through a consensus making process. The guideline lists a set of 60 issues that are relevant for planning, implementation and execution of an evaluation study in the health informatics domain. These issues cover the phases of an evaluation stu...
Article
Development of a good practice guideline to plan and perform scientifically robust evaluation studies in health informatics. Issues to be addressed in evaluation studies were identified and guidance drafted based on the evaluation literature and on experiences by key players. Successive drafts of the guideline were discussed in several rounds by an...
Article
Full-text available
Health informatics is generally less committed to a scientific evidence-based approach than any other area of health science, which is an unsound position. Introducing the new Web 3.0 paradigms into health IT applications can unleash a further great potential, able to integrate and distribute data from multiple sources. The counter side is that it...
Article
Full-text available
The purpose of this study was to describe and evaluate patient care documentation by hospital physicians in EHRs and especially the use of national headings and classifications in these documentations. The initial material consisted of a random sample of 3,481 medical narratives documented in EHRs during the period 2004-2005 in one department of a...
Article
Full-text available
We previously devised and published a guideline for reporting health informatics evaluation studies named STARE-HI, which is formally endorsed by IMIA and EFMI. To develop a prioritization framework of ranked reporting items to assist authors when reporting health informatics evaluation studies in space restricted conference papers and to apply thi...
Article
The healthcare paradigm is progressing towards preventive care and proactive services with holistic and personalized view on health and wellbeing. The concept wellness has been used to describe this holistic approach to health and well-being. Different wellness tools have already been introduced and some wellness applications are available to be us...
Article
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Information technologies (IT) are widely used in healthcare, however, little is known about the usability of nursing information systems. This article reports an evaluation study that aimed at researching the usability of four electronic nursing record (ENR) systems and thereby providing guidelines for further IT development. For the purposes of th...
Article
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E-health systems are increasingly important and widespread, but their selection and implementation are still frequently based on belief, rather than scientific evidence, and adverse effects are not systematically addressed. Progress is being made in promoting generic evaluation methodologies as a source of scientific evidence, but effort is now nee...
Article
Trustfulness (i.e. health and wellness information is processed ethically, and privacy is guaranteed) is one of the cornerstones for future Personal Health Systems, ubiquitous healthcare and pervasive health. Trust in today's healthcare is organizational, static and predefined. Pervasive health takes place in an open and untrusted information space...
Article
Turning from organization-centric to process-controlled or even to personalized approaches, advanced healthcare settings have to meet special interoperability challenges. eHealth and pHealth solutions must assure interoperability between actors cooperating to achieve common business objectives. Hereby, the interoperability chain also includes indiv...
Article
To improve the quality of reports of health informatics evaluations we recently devised and published a guideline named STARE-HI, now formally endorsed by IMIA. To develop a prioritization framework of ranked items (a mini-STARE-HI) to assist authors when reporting health informatics evaluation studies in a restricted space conference paper. Method...
Article
Most EU Member States have a documented policy on eHealth. Documented follow-up and evaluation strategies for assessing whether national level systems have reached their set aims and outcomes are, however, rare. Methodologies for large scale information system assessment and evaluation are poorly established. This article describes the approach use...
Conference Paper
Healthcare information exchange (HIE) has been refined from point-to-point messaging to wide-area networks integrating multiple service providers. Presently, federated information systems connect more than 25 hospitals with 60 municipal health centres in three Finnish hospital districts. The usability and benefits of these regional eHealth networks...
Article
Full-text available
There is understandable concern about low uptake and sub-optimal use of health informatics systems, which is often caused by a lack of shared objectives and values by the different stakeholders. Moreover, all parties work to different ethical codes. For future success, all need to work to the same values and objectives, measured by agreed outcomes...
Article
Medication information should be available in a correct content and format and where and when needed in medical care. In this paper process and information models are presented in order to identify the items, their relations, contents, sources and use contexts of medication information. The motivation for this study has been to develop a harmonized...
Article
Full-text available
Good evaluation practice guidelines have been developed through a consensus making process by a core team and the health informatics community. A set of 60 issues has been identified that is relevant for planning, implementation and execution of an evaluation study in the health informatics domain. These issues cover all phases of an evaluation stu...
Article
Most EU member states have a documented policy on eHealth. Documented follow-up and evaluation policies to assess reaching of the set aims, as well as evaluating outcomes of implemented systems at a national level are, however, rare. Methodologies for large scale information system assessment and evaluation are poorly established. In the workshop,...
Conference Paper
Medication information is an important component of the care process. Medication information is not always available in a correct content and format when and where needed. In various health information systems and electronic patient records medication information has different content and format. In this paper process models of medication informati...
Article
Full-text available
E-health is an important support technology in healthcare with considerable aspirations, but one which bypasses the normal requirement to prove a system's effectiveness or safety. There is therefore an ethical duty to evaluate systems scientifically, and thereby also to raise the scientific standing of the health informatics discipline. To assist i...
Article
Information structures of current electronic patient record systems (EHRs) are based on the traditional paper-based documentation systems. The semantic interoperability of these systems is limited and security aspects are static. The usability and usefulness of these systems to citizen-based care model is very limited. In this research we identify...
Article
Objective: Development of guidelines for publication of evaluation studies of Health Informatics applications. Methods: An initial list of issues to be addressed in reports on evaluation studies was drafted based on experiences as editors and reviewers and as authors of systematic reviews , taking into account guidelines for reporting of medical...
Article
This paper reviews the research literature on electronic health record (EHR) systems. The aim is to find out (1) how electronic health records are defined, (2) how the structure of these records is described, (3) in what contexts EHRs are used, (4) who has access to EHRs, (5) which data components of the EHRs are used and studied, (6) what is the p...
Conference Paper
Finland is being transformed into a knowledge economy driven by information and communication technologies - 96 % of primary care health centres, 95 % of hospital districts and 89 % of private sector service providers use an electronic patient record (EPR). The governance and funding of the Finnish health care system is very decentralized and the l...
Article
This paper presents background of personal health systems research and analyses requirements for personal health systems from various perspectives. The analysis shows that social and contextual aspects of personal health systems need more attention in the future and that systems development should not be technology-driven but driven by user needs a...
Book
Full-text available
The China-Finland e-Health Partnership is a joint research project between Finnish and Chinese counterparts. The aim of the project is to improve information sharing in healthcare. The project was approved as part of the bilateral governmental China-Finland Science and Technology Programme. The research institutions in Finland are the University of...
Article
In 2002 a decision was reached to set up a nation-wide electronic health record system in Finland. The legal framework of actors with the necessary mandate was approved in the parliament in December 2006. A set of standards and norms have been selected that all health care actors need to follow. Functional specifications of the services were comple...
Article
This article describes a multidisciplinary framework and its use in the evaluation of a national medical e-Prescription system pilot in Finland. The framework was based on three theoretical concepts: activity system, actor network and development life cycle. These concepts have been developed within activity theory, developmental work research and...
Article
To identify success and failure factors in the design process of a regional health information system. A constructive evaluation study including interviews, observations, usability study and document analysis. Modelling was found to be a key element for the successful implementation of a health information system. The developed service chain model...
Article
Full-text available
The aim is to gain information on factors influencing success and failure for Health Informatics applications from a group of medical informaticians. Based on the presentations at a special topic conference on success and failure in Health ICT and analysis of the proceedings, we conducted a Delphi study on success and failure aspects. A total of 11...
Article
E-health refers to use of information and communication technologies to improve or enable health and healthcare. E-health broadens the scope of healthcare delivery; citizens are in the center of services and services are offered by information systems often via the Internet. In this chapter ehealth systems are classified on the basis of their use a...
Chapter
(Extracted from Ammenwerth. E., Brender, J., Nykänen, P., Prokosch, H., Rigby, M., & Talmon, J. [2004]). Visions and strategies to improve evaluation of health information systems Reflections and lessons based on the HIS-EVAL workshop in Innsbruck. International Journal of Medical Informatics, 73, 479-491.) Results from the European Science Foundat...
Article
Health care is entering the Information Society. It is evident that the use of modern information and communication technology offers tremendous opportunities to improve health care. However, there are also hazards associated with information technology in health care. Evaluation is a means to assess the quality, value, effects and impacts of infor...
Article
A decision support system can be approached from two major disciplinary perspectives, those of information systems science (ISS) and artificial intelligence (AI). We present in this chapter an extended ontology for a decision support system in health informatics. The extended ontology is founded on related research in ISS and AI, and on performed c...
Article
This paper reports results from a constructive evaluation study where design of a reagional social and health care information system was assessed from information technology perspective. We studied the models of social and health care processes, the needs and requirements of the clients and users and the planned information system. Our results env...
Article
A decision support system can be approached from two major disciplinary perspectives, those of information systems science (IS) and artificial intelligence (AI). We present in this study an extended ontology for a decision support system in health informatics, which is founded on experience from related research fields as well as being informed by...
Article
This paper presents the results from an inventory of validation approaches and methodologies which have been used in selected health telematics projects. The inventory was performed in the VATAM Validation of Telematic Applications in Medicine project, HC1115HC. The purpose of the inventory was to analyse the methodologies and their application ass...
Article
Evaluation and assessment of the impact of information and communication technology in medicine is gaining interest. Unfortunately, till now there were no agreed upon approaches. The objective of the VATAM project is to develop guidelines that will assist assessors to set-up and execute studies. This paper describes the background of the VATAM proj...
Article
VATAM (Validation of Telematics Applications in Medicine) is an EU supported project in the Health care sector of the Telematics Application Programme. Its objective is to assist other health telematics projects by providing a platform for discussion on validation, eventually resulting in 'guidelines for validation of telematics applications in med...
Article
The objective of KAVAS-2 is the development of a tool, named KAVIAR, with which domain experts can make their knowledge explicit. It contains components for (computer assisted) knowledge elicitation and for machine learning. A key issue in KAVAS is the assessment of the quality of the classification and domain models built. Various quality measures...
Article
OpenLabs has four major objectives: to improve the efficiency and effectiveness of clinical laboratory services by the integration of Knowledge Based Systems (KBSs) with Laboratory Information Systems (LISs) and equipment; to provide and implement standard solutions for Electronic Data Interchange (EDI) between laboratories and other medical system...
Article
Evaluation is critical to the development and successful integration of knowledge-based systems into their application environment. This is of particular importance in the medical domain--not only for reasons of safety and correctness, but also to reinforce the users' confidence in these systems. In this paper we describe an iterative, four-phased...
Article
The utilisation of laboratory services for patient diagnosis and management involves many steps with both clinical and laboratory components. The clinical components include the decision to order a test, interpretation of the test results and actions taken on the basis of the results. The laboratory components on the other hand include receipt of t...