Tarja Heponiemi

• Research professor
• Finnish Institute for Health and Welfare

Digitalisaatiolla voi olla merkittäviä vaikutuksia vammaisten henkilöiden palveluihin, joissa on havaittu tarpeenmukaisuuden ja oikea-aikaisuuden puutteita. Tilannekuvan kartoittamiseksi tämä tutkimus selvitti digitalisaation tavoitteiden toteutumista vammaistyössä ammattilaisten kokemana. Lisäksi tutkittiin digitalisaatiota ohjaavien työympäristöt...

Background Digital health technologies (DHTs) aim to optimise resource allocation and improve public health outcomes as care supplements. However, many patients do not access them independently. Nurses, as central contacts for primary care patients, can integrate digital health assessments, patient portals, remote monitoring, and teleconsultations...

Background In digital health services, including services for older people, video consultations can enhance access to care while enabling interaction through audio and visual means. Registered nurses are pivotal in digital care delivery and there is a need for more understanding regarding the use of video consultations in nursing. This study aims t...

Background For individuals managing long-term illnesses and often requiring complex care across health and social care sectors, the transition to digital platforms holds considerable potential to facilitate management of one’s health. This study examined factors among people with long-term illnesses associated with their perception that digital ser...

Background The digitalisation of healthcare has changed physicians’ clinical and administrative work. For example, decision support systems (DSSs) are expected to support physicians’ daily work. The present study examined physicians’ experiences of DSSs’ support for their work analysed by age, gender, employment sector and leadership position. Met...

Aims To describe the frequency of digital client work among Finnish registered nurses, including video consultations, secured messaging and digital promotion of care without direct contact with the client. In addition, the study examines the association between various factors related to nurses' characteristics and work environment with digital cli...

The COVID-19 pandemic has increased worldwide mental health conditions, substantially affecting the demand and provision of mental health services. To continue services and safeguard the health and well-being of mental health service users, service providers have responded to the pandemic with the adoption of remote services. The objective of our s...

Drawing on a socio-technical approach, we examined Finnish social welfare professionals’ (n = 990) perceptions of the effects of digitalization on their work and how these are associated with factors related to work and client information system usage using mixed graphical modelling. Overall, perceptions were predominantly positive. Digitally repla...

The rapid advancement of technology in healthcare is creating new competency requirements for professionals, such as skills for data management and the adoption of new technologies, understanding the effect of digitalisation on clinical processes, and evaluating clinical safety and ethics within the context of digitalisation. These requirements cal...

Yhteiskunnallisten palvelujen siirtyessä yhä enemmän sähköisesti tarjottaviksi, on tärkeää kartoittaa vammaisten henkilöiden kohtaamia haasteita sähköisten palvelujen käytössä. Vammaispalvelujen ammattilaiset ovat keskeisessä roolissa havaitsemaan asiakkaiden sähköisten palvelujen käyttöön liittyviä haasteita ja tarjoamaan tarvittaessa tukea palvel...

The increased use of eHealth and information systems impacts health care work broadly, including cultural and social aspects of work such as the roles of health care professionals. This qualitative descriptive study examined the perceptions of health care professionals in terms of how eHealth and information systems have changed their roles. The da...

Objectives: To examine with a population-based longitudinal survey design whether poor health, longstanding activity limitation, impaired cognitive functioning, mental distress, or loneliness predict poor access to healthcare and whether digital competence mediates these associations. Methods: The data were from the longitudinal FinHealth -survey g...

Aim To examine the association between the integrated care competencies and cross‐cultural competence of registered nurses prior to the integration of social and healthcare services in Finland. Design A descriptive correlational cross‐sectional questionnaire survey was conducted. Methods A simple random sample of 10,000 registered nurses was draw...

Background Increased digital health and social care services are generally considered to improve people’s access to services. However, not everyone can equally access and use these resources. Health and social care professionals should assess clients’ suitability for digital solutions, but to succeed, they need information about what to evaluate an...

Objective This study aims to describe the factors related to the individual, the system and their interaction, which can affect eHealth literacy from the perspective of people living with one or multiple chronic diseases. As digital solutions are increasingly used in healthcare, perspectives of patients with chronic diseases must be considered. Me...

Background Physicians’ work is often stressful. The digitalization of healthcare aims to streamline work, but not all physicians have experienced its realization. We examined associations of perceived changes in work due to digitalization and the amount of digital work with job strain among physicians. The moderating role of the length of work expe...

Background Excessive workload and waiting times in primary care, along with problems in information flow, can hamper the achievement of the public health benefits of preventive care. Digitalisation aims to promote prevention by expediting access to care and advancing self-care and seamless care, which might also streamline work. This study examined...

Background The need to optimize health care services by utilizing digital technologies has been recognized worldwide to respond to the population's growing care needs. However, not everyone can benefit from digital solutions. Health care professionals have a crucial role in evaluating whether their patients could utilize digital health. This requir...

Background The integration of information systems in health care and social welfare organizations has brought significant changes in patient and client care. This integration is expected to offer numerous benefits, but simultaneously the implementation of health information systems and client information systems can also introduce added stress due...

Osa kansalaisista kokee haasteita käyttää yhteiskunnassamme yhä yleistyviä digitaalisia palveluita terveytensä ja hyvinvointinsa edistämiseksi. Heidät on tunnistettava, jotta toimia digisyrjäytymisen ennaltaehkäisemiseksi voidaan toteuttaa. Lisäksi käyttäjäryhmien piirteiden tunnistamisen avulla voidaan tukea palveluiden kehittämistä. Tässä työpape...

BACKGROUND Increased digital health and social care services are generally considered to improve people’s access to services. However, not everyone can equally access and use these resources. Health and social care professionals should assess clients’ suitability for digital solutions, but to succeed, they need information about what to evaluate an...

Background Today, digitalisation is strongly present in health and social care, and it increasingly affects the organisation of work, work requirements, tasks and tools. Due to the constant change in work, up-to-date knowledge is needed about these micro-level effects of digitalisation and how professionals experience the effects in their work. Fur...

Objective The aim of this study was to describe the benefits of digital health and social services perceived by older adults and to examine factors associated with perceiving these benefits. Several factors related to (a) sociodemographic characteristics, (b) area of residence, (c) physical, cognitive, psychological, and social functioning, and (d)...

Aims To identify different nursing informatics competence (NIC) profiles in nurses, examine the factors associated with profile memberships and examine the associations of the derived profiles with the nurses' perception of the usefulness of a health information system (HIS). Design A cross‐sectional study. Methods A sample of 3610 registered nur...

Objective Utilising digital health services in the treatment of patients who frequently attend outpatient care could be beneficial for patients’ health and the sustainability of health systems but carries the risk of digital exclusion. This study aimed to explore the patterns of acceptance and use of digital health services among frequent attenders...

Background: The rapidly increasing role of the internet in obtaining basic services poses challenges, especially for older adults' capabilities of getting the services they need. Research on the predictors of older adults' internet use and digital competence is especially relevant given that people are living longer than before, and the age profil...

Koronaviruksen leviäminen Suomeen vuonna 2020 joudutti jo käynnissä olevaa terveyspalveluiden digitalisointia. Digitalisaation leviäminen on nostanut riskiä eriarvoisuuden lisääntymiseen eri potilasryhmissä. Tämän haastattelututkimuksen tarkoituksena oli kuvata paljon palveluita tarvitsevien asiakkaiden kokemuksia terveydenhuollon etäpalveluiden ma...

Background Digitalization has increased rapidly in health and social care and plays an increasingly important role in the daily work of health and social care professionals. The effects of digitalization are often viewed from the societal and economic perspectives, and less from the perspective of the changing health and social care work. This stud...

Purpose The purpose of this study is to describe primary health-care managers’ perceptions of management competencies at different management levels in digital health services using the management competency assessment program as a framework. Design/methodology/approach A secondary analysis study involving 21 semi-structured individual interviews...

Introduction: In the STEPS 3.0 project, the health information exchange (HIE) features of hospital districts were surveyed, both as physicians’ experiences (2021) and as availability reported by hospital administration (2020). We look into the combined data to see which organizational features are related to physicians’ satisfaction in HIE. Mater...

BACKGROUND The rapidly increasing role of the internet in obtaining basic services poses challenges, especially for older adults’ capabilities of getting the services they need. Research on the predictors of older adults’ internet use and digital competence is especially relevant given that people are living longer than before, and the age profile...

Background In health care, the benefits of digitalization need to outweigh the risks, but there is limited knowledge about the factors affecting this balance in the work environment of physicians. To achieve the benefits of digitalization, a more comprehensive understanding of this complex phenomenon related to the digitalization of physicians’ wor...

The COVID-19 pandemic has led to an increase in the digitalisation of services that poses the risk of digital exclusion, especially among older adults. We examined the predictors of Internet use for services and its increase or decrease among a longitudinal population-based sample of 1426 older adults from Finland aged between 70 and 100 years, gat...

This study aimed to examine the associations of sociodemographic factors and factors related to physical, mental, cognitive, and social functioning with the non-use of digital services among older adults during the second wave of the COVID-19 pandemic. Nationally representative data from Finland were collected between October 2020 and January 2021....

In an older version of this paper, the category names (user and non-user) in Table 1, “Characteristics of the respondents according to non-use of digital services” on page 602, were incorrect. This has been corrected.

Background Physicians commonly suffer from workplace aggression and its negative consequences. Previous studies have shown that stressors such as job demands increase the risk of inappropriate treatment at workplace. Poorly functioning, and constantly changing information systems form a major work stressor for physicians. The current study examined...

Background: In the abnormal circumstances caused by the COVID-19 pandemic, patient portals have supported patient empowerment and engagement by providing patients with access to their health care documents and medical information. However, the potential benefits of patient portals cannot be utilized unless the patients accept and use the services....

Background: In the abnormal circumstances caused by the COVID-19 pandemic, patient portals have supported patient empowerment and engagement by providing patients with access to their healthcare documents and medical information. However, the potential benefits of patient portals cannot be utilized unless the patients accept and use the services....

BACKGROUND In the abnormal circumstances caused by the COVID-19 pandemic, patient portals have supported patient empowerment and engagement by providing patients with access to their health care documents and medical information. However, the potential benefits of patient portals cannot be utilized unless the patients accept and use the services. D...

Background The COVID-19 pandemic has given an unprecedented boost to already increased digital health services, which can place many vulnerable groups at risk of digital exclusion. To improve the likelihood of achieving digital health equity, it is necessary to identify and address the elements that may prevent vulnerable groups from benefiting fro...

Objective Online health and social care services are getting widespread which increases the risk that less advantaged groups may not be able to access these services resulting in digital exclusion. We examined the combined effects of age and digital competence on the use of online health and social care services. Methods We used a large representa...

Background Although the COVID-19 pandemic has significantly boosted the implementation of digital services worldwide, it has become increasingly important to understand how these solutions are integrated into professionals’ routine work. Professionals who are using the services are key influencers in the success of implementations. To ensure succes...

Online symptom checkers (SCs) are eHealth solutions that offer healthcare organizations the possibility to empower their patients to independently assess their symptoms. The successful implementation of eHealth solutions, such as SCs, requires a supportive organizational culture and leadership. However, there is limited knowledge about the factors...

The use of information systems and electronic documentation has become a central part of a nurse’s work, and it is expected to increase the quality of documentation and patient safety. However, errors related to documentation have been identified as a significant risk for the quality and safety of care. This study examined whether information syste...

Background: Identifying the most significant risk factors for physician burnout can help to define the priority areas for burnout prevention. However, not much is known about the relative importance of these risk factors. Aims: This study was aimed to examine the relative importance of multiple work-related psychosocial factors in predicting bur...

Background Nursing informatics competences (ie. knowledge and skills in electronic and structured documentation) have become a necessary prerequisite for nurses to carry out their professional roles. Therefore, there is a global need to integrate nursing informatics into nursing curricula. In Finland, the requirements to increase nursing informatic...

Abstract Background The use of information systems takes up a significant amount of nurses’ daily working time. Increased use of the systems requires nurses to have adequate competence in nursing informatics and is known to be a potential source of stress. However, little is known about the role of nursing informatics competence and stress related...

Koronaviruspandemian aiheuttama kriisitilanne on muokannut työkulttuuria terveydenhuollossa, jossa on turvauduttu yhä voimakkaammin digitaalisiin ratkaisuihin koronaviruksen leviämisen ehkäisemiseksi. Koronaviruspandemian vaikutuksia digitaaliseen työkulttuuriin ja sen johtamiseen on tutkittu vähän ja tietoa tarvitaan muun muassa terveydenhuollon o...

Suomessa on ylläpidetty ennennäkemättömiä sosiaalisen etäisyyden toimenpiteitä COVID-19-epidemian leviämisen estämiseksi. Etäisyyden pitäminen voi heikentää mielenterveyttä ja lisätä yksinäisyyttä erityisesti mielenterveyskuntoutujilla. Tutkimuksemme tarkoituksena oli selvittää, miten viestintäpalvelut sekä etäyhteydellä toteutetut sosiaali- ja ter...

Factors influencing the reporting of patient safety incidents that result from health information technology (HIT) failure are poorly understood. We examined whether organizational justice is associated with the non-reporting of HIT system-related safety incidents among registered nurses. Cross-sectional survey data were collected from nurses (N =...

In recent years, digital health care and social welfare services have been spreading rapidly and partly replacing face-to-face services, particularly in developed countries. This may lead to a pronounced digital inequality. This population-based study of Finnish adults (N = 4495) examined the associations of offline resources with perceived benefit...

BACKGROUND Although the COVID-19 pandemic has significantly boosted the implementation of digital services worldwide, it has become increasingly important to understand how these solutions are integrated into professionals’ routine work. Professionals who are using the services are key influencers in the success of implementations. To ensure succes...

BACKGROUND Healthcare personnel’s engagement in patient portal implementation is necessary in embedding the use of the portal in everyday practices of a healthcare organization. While portal implementation may raise personnel’s positive expectations of the benefits in patient care, it is often also stressful for them due to increased workloads and...

Background Health care personnel’s (HCP) engagement in patient portal implementation is necessary in embedding the use of the portal in everyday practices of a health care organization. While portal implementation may raise personnel’s positive expectations of the benefits in patient care, it is often also stressful for them due to increased worklo...

BACKGROUND Mobile devices such as tablets and smartphones are increasingly used in health care in many developed countries. Nurses form the largest group in health care that uses electronic health records (EHRs) and their mobile versions. Mobile devices are suggested to promote nurses’ workflow, constant updating of patient information and improve...

Background Mobile devices such as tablets and smartphones are increasingly being used in health care in many developed countries. Nurses form the largest group in health care that uses electronic health records (EHRs) and their mobile versions. Mobile devices are suggested to promote nurses’ workflow, constant updating of patient information, and i...

Psychiatric outpatient care has been actively digitalized even before the COVID-19 outbreak. However, COVID-19 has increased the adoption of digital and remote health services. The aim of this cross-sectional study was to examine whether COVID-19 has impacted on the form of psychiatric outpatient services and describe psychiatric healthcare leaders...

BACKGROUND The significance of online health and social care services has been highlighted in recent years. There is a risk that the digitalization of public services will reinforce the digital and social exclusion of vulnerable groups such as individuals with mental health problems OBJECTIVE We examined the association between mental health probl...

Background The significance of web-based health and social care services has been highlighted in recent years. There is a risk that the digitalization of public services will reinforce the digital and social exclusion of vulnerable groups, such as individuals with mental health problems. Objective This study aims to examine the associations betwee...

Introduction The use of eHealth is rapidly increasing; however, many healthcare professionals have insufficient eHealth competency. Consequently, interventions addressing eHealth competency might be useful in fostering the effective use of eHealth. Objective Our systematic review aimed to identify and evaluate the behavior change techniques applie...

Background Cultural diversity in healthcare settings requires that care professionals are able to provide culturally competent care. This means that educational institutions have a crucial role to play in equipping students with the skills to deal with diversity in cross-cultural and multicultural contexts. Ensuring that cultural competence is part...

BACKGROUND High expectations have been set for the implementations of health information systems (HIS) in health care. However, nurses have been dissatisfied after HIS implementations. Especially poorly functioning electronic health records (EHRs) have been found to induce stress and cognitive work load. Moreover, need to learn new systems may requ...

Background High expectations have been set for the implementations of health information systems (HIS) in health care. However, nurses have been dissatisfied after implementations of HIS. In particular, poorly functioning electronic health records (EHRs) have been found to induce stress and cognitive workload. Moreover, the need to learn new system...

Background: The popularity of web-based patient-professional communication over patient portals is constantly increasing. Good patient-professional communication is a prerequisite for high-quality care and patient centeredness. Understanding health care professionals’ experiences of web-based patient-professional communication is important as they...

Background: Electronic health records (EHRs) are expected to provide many clinical and organizational benefits. Simultaneously, the end users may face unintended consequences, such as stress and increased cognitive workload, due to poor EHR usability. However, whether the effects of usability depend on end user characteristics, such as career stage...

Background Due to the rapid digitalization of health care, leadership is becoming more complex. Leadership in digital health services is a term that has been used in the literature with various meanings. Conceptualization of leadership in digital health services is needed to deliver higher quality digital health services, update existing leadership...

BACKGROUND Due to the rapid digitalization of health care, leadership is becoming more complex. Leadership in digital health services is a term that has been used in the literature with various meanings. Conceptualization of leadership in digital health services is needed to deliver higher quality digital health services, update existing leadership...

Asiakas- ja potilastietojärjestelmät ovat sairaanhoitajien työssä keskeisiä työvälineitä. Artikkelissa selvitettiin, missä määrin eri asiakas- ja potilastietojärjestelmät tukevat sairaanhoitajien työtä eri toimintaympäristöissä. Tavoitteena oli tuottaa tietoa kansallisen tiedonhallinnan strategian täyttymisestä ja sairaanhoitajien käyttäjäkokemuksi...

Background Ability to use information systems is a crucial part of nurses' competence, but evidence on whether this competence is associated with stress among nurses is lacking. As part of the 'Towards socially inclusive digital society: Transforming service culture' (DigiIN, funded by the Strategic Research Council, project 327145), we examined th...

Background Health information systems (HIS) have been widely adopted in nursing to increase the efficiency and safety of patient care. Previous studies have shown that low HIS quality is a barrier to obtaining such benefits from HIS use. The association between HIS quality and HIS benefits has not, however, been studied taking into account the char...

Background Digital services have become an essential part of nurse's work and nursing informatics competence a prerequisite for nurses to carry out their professional roles. Urgent investments are needed in informatics competence development and integrating informatics into nursing curricula. However, this has shown to be a challenge in many countr...

BACKGROUND Electronic health records (EHR) are expected to provide many clinical and organizational benefits. Simultaneously, the end-users may face unintended consequences such as stress and increased cognitive workload due to poor EHR usability. However, whether the effects of usability depend on end-user characteristics, such as career stage or...

Electronic health records (EHRs) have an impact on physicians’ well-being and stress levels. We studied physicians’ experiences with EHRs and their experienced time pressure and self-rated stress by an electronic questionnaire sent to Finnish physicians aged under 65 in 2017. Our sample was 2980 physicians working in the public sector, health care...

BACKGROUND The popularity of online patient-professional communication over patient portals is constantly increasing. Good patient-professional communication is a prerequisite for high-quality care and patient-centeredness. Understanding healthcare professionals’ experiences of online patient-professional communication is important since they play...

Online symptom checkers and assessment services are used by patients seeking guidance on health problems. In this study, the goal was to identify health professionals' experiences of the benefits and challenges of new symptom checkers providing triage advice. Data was collected through an online survey of 61 health professionals who were target use...

Despite major investment, health information technology (HIT) implementation often tends to fail. One of the reasons for HIT implementation failure is poor leadership in healthcare organisations, and thus, more research is needed on leaders’ roles in HIT implementation. The aim of the review was to identify the role of healthcare leaders in HIT imp...

Aim To examine: 1) whether nativity status was associated with workplace discrimination, 2) whether this association was mediated through psychosocial work characteristics (job strain, job demands and job control) among registered female nurses. Design Cross‐sectional survey with a self‐report questionnaire was conducted. Methods A random sample...

Objective: Workplace violence against nurses is a widespread phenomenon that has been associated with many unfavorable individual and organizational outcomes. The aim of this study was to analyze the relationship between violence and work functioning in a sample of Italian nurses. Design: Cross-sectional, with retrospective analysis of exposure....

BACKGROUND The number of online services in health care services is increasing rapidly in developed countries. Clients and patients are expected to have a more skilled and active role in taking care of their health and prevention of ill-health. This induces risks that especially those who need the services the most would drop out of digital service...

Background: The number of online services in health care is increasing rapidly in developed countries. Users are expected to take a more skilled and active role in taking care of their health and prevention of ill health. This induces risks that users (especially those who need the services the most) will drop out of digital services, resulting in...

1. TIIVISTELMÄ Sosiaali- ja terveydenhuollon asiakkaille tarjottavat sähköiset asiointi- ja omahoitopalvelut ovat lisääntyneet nopeasti. Nämä palvelut edellyttävät asiakkailta entistä aktiivisempaa roolia oman terveytensä ja hyvinvointinsa hoidossa, mikä muuttaa myös ammattilaisten toimenkuvaa ja tehtäviä. Nopea muutos edellyttää sopeutumista sekä...

Background: Usability associates with patient safety and quality of care. This article reports results from nation-wide usability-focused survey studies for physicians and nurses in Finland. Earlier research has shown dissatisfaction and serious deficiencies, which hamper the efficient use of health information systems (HIS); however, evaluation s...

Health and social care professionals today are seeing an increasing number of patients and clients from different cultural and linguistic backgrounds. Cultural competence, such as understanding how perceptions of health, behaviour and actions are affected by various social and cultural factors, is therefore increasingly important for the provision...

Background: A physician shortage is a worldwide problem and foreign-born physicians fill in the shortage of physicians in many developed countries. One problem that is associated with the physician shortage is increased physician turnover. Also, regarding foreign-born physicians, migration can be costly. The present study aimed to examine the turn...

Background: Nowadays, healthcare professionals worldwide deliver care for increasing numbers of culturally and linguistically diverse patients. The importance of cultural competence is evident in terms of the quality of healthcare, and more knowledge is needed about different educational models and approaches that aim to increase cultural competen...

The training and competence of healthcare professionals are key factors in adopting new eHealth services. The scope of eHealth is broadening from information systems to eHealth services such as patient portals supporting self-management, which create a need for new competencies. In this study, we evaluated clinical leaders' eHealth competencies and...

Background: Electronic health records (EHRs) are an elementary part of the work of registered nurses (RNs) in healthcare. RNs are the largest group of healthcare workers, and their experiences with EHRs and their informatics competence play a crucial role in a fluent workflow. The present study examined EHR usability factors and nurses' informatic...

Cross‐cultural competence is an essential component of the nursing profession, but little is known about the specific psychosocial work characteristics that potentially promote or hinder such competence. In the present study, psychosocial work characteristics were based on Karasek's Job Demand—Control Model. The researchers examined whether Karasek...

This study aimed to find out which countries around the world require psychosocial hazards and workplace violence to be assessed by employers through a mandatory occupational risk assessment process and to compare the type of legislation between countries. We systematically searched the International Labour Office (ILO) "LEGOSH" database for docume...

Background To test the validity of the Finnish version of the Bernhard et al.’s Cross-Cultural Competence instrument of Healthcare Professionals (CCCHP). Methods The study sample comprised registered nurses (N = 810) from the Finnish “Competent workforce for the future” -project (COPE). Exploratory factor analyses and structural equation modelling...