Intelligent Physical Robots in Health Care: Systematic Literature Review.

BACKGROUND: Intelligent physical robots based on artificial intelligence have been argued to bring about dramatic changes in health care services. Previous research has examined the use of intelligent physical robots in the health care context from different perspectives; however, an overview of the antecedents and consequences of intelligent physical robot use in health care is lacking in the literature. OBJECTIVE: In this paper, we aimed to provide an overview of the antecedents and consequences of intelligent physical robot use in health care and to propose potential agendas for future research through a systematic literature review. METHODS: We conducted a systematic literature review on intelligent physical robots in the health care field following the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Literature searches were conducted in 5 databases (PubMed, Scopus, PsycINFO, Embase, and CINAHL) in May 2021, focusing on studies using intelligent physical robots for health care purposes. Subsequently, the quality of the included studies was assessed using the Mixed Methods Appraisal Tool. We performed an exploratory content analysis and synthesized the findings extracted from the included articles. RESULTS: A total of 94 research articles were included in the review. Intelligent physical robots, including mechanoid, humanoid, android, and animalistic robots, have been used in hospitals, nursing homes, mental health care centers, laboratories, and patients' homes by both end customers and health care professionals. The antecedents for intelligent physical robot use are categorized into individual-, organization-, and robot-related factors. Intelligent physical robot use in the health care context leads to both non-health-related consequences (emotional outcomes, attitude and evaluation outcomes, and behavioral outcomes) and consequences for (physical, mental, and social) health promotion for individual users. Accordingly, an integrative framework was proposed to obtain an overview of the antecedents and consequences of intelligent physical robot use in the health care context. CONCLUSIONS: This study contributes to the literature by summarizing current knowledge in the field of intelligent physical robot use in health care, by identifying the antecedents and the consequences of intelligent physical robot use, and by proposing potential future research agendas in the specific area based on the research findings in the literature and the identified knowledge gaps.

Elderly Forgotten? Digital Exclusion in the Information Age and the Rising Grey Digital Divide.

Background: Information and Communication Technology (ICT) is being spread at an unprecedented rate across the globe. Yet, new research suggests that digital divide is not only continuing but also deepening at the same time. After access to basic ICT equipment, it is now the lack of skills and quality of hardware and software that leads to a continuing digital divide. Digital divide which is specifically related to elderly is known as grey digital divide. Objectives: The focus of this paper is to review and analyze recent relevant research on grey digital divide which is fast emerging as a major challenge in the era of ageing. A side objective is to raise implications for theory and practice discourses to minimize grey digital divide. Method: Literature on digital divide and grey digital divide is reviewed to gather relevant knowledge on the grey digital divide. The articles were filtered according to the relevance for grey digital divide in the present age. Literature review spanned over a 5 years' timeline to discuss the current trends on the topic. Results: Results indicate a rising problem of ageing, mainly in developed countries. Grey digital divide constitutes a major challenge for elderly to participate and benefit from the digital revolution. Elderly face problems for basic tasks such as booking tickets or renewing bus cards to claiming old-age benefits because most of the systems are digitized. Another challenge is the social exclusion faced by elderly because they cannot connect with peers through digital networks due to lack of digital skills. This situation is also observed in developing countries, although in developing countries elderly get immediate help from family members due to the family system of joint living. Implications and future directions: A practical implication of this research can be a full-scale fieldwork in different countries of the world to further understand the grey digital divide. Joint collaboration between ICT and healthcare industry may result in revolutionizing of ergonomic ICT products and services which are elderly-friendly. It would be interesting to know how culture impacts grey digital divide across various countries.

Electronic prescription as a driver for digitalization in Finnish pharmacies.

BACKGROUND: Finnish community pharmacies have undergone digitalization during the past decade. The introduction of the electronic prescription has had a significant impact on pharmacy workflows, such as the dispensing process. This inevitably has significant sociotechnical implications. We examine the impact of digitalization on the dispensing process and the sociotechnical orientation of a pharmacy. METHODS: We utilize data collected in customer service situations in Finnish community pharmacies at two points in time: in the traditional workflow, when electronic prescriptions were not in use, and in the new direct dispensing workflow, which is the usual delivery model in the case of electronic prescriptions. We analyze this data in terms of changes in workflow efficiency. We also draw on existing literature to build a conceptual model for digitalization in the pharmacy sector from a sociotechnical standpoint. RESULTS: In the Finnish environment, the results, based on our study sample, show that with electronic prescriptions and the direct dispensing model, the delivery time for a single medication over the counter was reduced by 13%. The results also indicate that the process has become more predictable, as the variation in terms of the workflow lead time has decreased. CONCLUSIONS: The results indicate that the dispensing process has become more efficient in terms of time and throughput as well as more technically oriented and predictable. From a sociotechnical perspective, the results indicate that the technical subsystem has strengthened, and pharmacies have adapted to the new technology in the dispensing process.

Eliminating medicine waste in a Finnish university hospital - a qualitative study.

BACKGROUND: Medicine waste in hospitals leads to severe economic loss. This waste emerges for a number of reasons. Medicines are often ordered in too large quantities, which leads to stock expiring without being dispensed. Wastage can also be a consequence of poor management practices. Technical aids, such as automatic dispensers, have been suggested to reduce waste, but they too have shortcomings. Information systems can arguably contribute to waste reduction, but this area has not been widely researched.In this exploratory case study, we scrutinized the management of medicines waste in a hospital from an information systems perspective and examined how information systems are used to manage the medicine supply chain and medicine waste. Our research case was a Finnish university hospital, its central pharmacy, and, more widely, the medicine supply chain within the hospital. METHODS: This is a qualitative case study, based on data gathered through interviews and a survey and a review of other information sources, including annual reports and other relevant collateral. The study participants included pharmacy staff members and other hospital staff involved in medicine supply. The interviews were conducted in two rounds, first capturing the main themes and then exploring them further in the later study stages. RESULTS: The findings outline a picture of unfit technology and inconsistent and unreliable information. This is compensated for by manual practices and processes that cause an excessive administrative burden and ultimately increased wastage. An infrequent ordering process combined with the lack of recycling practices increase the wastage even more. CONCLUSION: Medicine supply and waste management remain a manual administrative task. Inconsistent information and unfit information systems make this task challenging, and the process relies on the medicine supply staff's experience and assumptions.

A process evaluation of a mobile cooperation intervention: A mixed methods study.

BACKGROUND: A mobile cooperation intervention was developed to facilitate the cooperation of nursing students with nurse teacher and to improve the students' clinical learning outcomes. The intervention consisted of training in a mobile application's functionality and its use during clinical practicum cooperation procedures. OBJECTIVES: To describe the development of a mobile application for student-teacher cooperation and to examine the acceptability of the mobile cooperation intervention for advancing intervention development. DESIGN: A user-centred design and a mobile application development lifecycle model were applied to develop a mobile application. A process evaluation that used mixed methods design was conducted within the intervention group after a randomized controlled trial of a complex mobile cooperation intervention. SETTING: The clinical practicum wards of seven hospitals in a hospital district in Finland. PARTICIPANTS: Second-year pre-registration nursing students (N = 52) from one nursing school. METHODS: Process evaluation questionnaires were completed upon completion of the five week intervention and essays were written by the students eleven weeks after the intervention ended. RESULTS: A system usability scale (SUS) assessed the overall usability of the mobile application as rather good (a mean SUS score of 69.86 out of 100). Positive feedback about the mobile application's usability and utility was reported and recommendations for further development were highlighted. The intervention demonstrated high acceptability. In general, the students actively used the mobile application for intervention procedures at home and in the clinical practicum ward. CONCLUSIONS: The findings support the high acceptability of mobile cooperation intervention and its potential while also providing evidence for the development team's future development of the mobile application. Additionally, this study provides an example of mobile application development and process evaluation in nursing education research.

Green Turning Brown - Domain Engineering for Social and Health Services in Finland.

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 structures severely constrain the development of new systems. In this article we discuss the concepts of greenfield and brownfield domain engineering and software development, and reflect their possible messages to the re-engineering of the Finnish health- and social care ecosystem currently under way. In our fieldwork we could identify a lot of need and wish for greenfield domain engineering in the Finnish health and social services delivery. As well we found a lot of brownfield elements inhibiting change. Our proposal for the future is a ecosystem approach, where new and established elements could live together in a self-governed balance.

Effectiveness of a mobile cooperation intervention during the clinical practicum of nursing students: a parallel group randomized controlled trial protocol.

AIM: The aim of this study was to describe a study protocol for a study evaluating the effectiveness of a mobile cooperation intervention to improve students' competence level, self-efficacy in clinical performance and satisfaction with the clinical learning environment. BACKGROUND: Nursing student-nurse teacher cooperation during the clinical practicum has a vital role in promoting the learning of students. Despite an increasing interest in using mobile technologies to improve the clinical practicum of students, there is limited robust evidence regarding their effectiveness. DESIGN: A multicentre, parallel group, randomized, controlled, pragmatic, superiority trial. METHODS: Second-year pre-registration nursing students who are beginning a clinical practicum will be recruited from one university of applied sciences. Eligible students will be randomly allocated to either a control group (engaging in standard cooperation) or an intervention group (engaging in mobile cooperation) for the 5-week the clinical practicum. The complex mobile cooperation intervention comprises of a mobile application-assisted, nursing student-nurse teacher cooperation and a training in the functions of the mobile application. The primary outcome is competence. The secondary outcomes include self-efficacy in clinical performance and satisfaction with the clinical learning environment. Moreover, a process evaluation will be undertaken. The ethical approval for this study was obtained in December 2014 and the study received funding in 2015. DISCUSSION: The results of this study will provide robust evidence on mobile cooperation during the clinical practicum, a research topic that has not been consistently studied to date.

Effects of electronic prescription on pharmacy productivity.

Electronic prescriptions affect pharmacy workflows. In this study, we measure the workflow efficiency in pharmacies in 2006 and 2012: both, in traditional workflow when electronic prescription was not in use, and in new direct delivery workflow, which is the mandated workflow model in the case of electronic prescriptions.

Promoting health in virtual worlds: lessons from second life.

BACKGROUND: Social media services can help empower people to take greater responsibility for their health. For example, virtual worlds are media-rich environments that have many technically advantageous characteristics that can be used for Health 2.0 purposes. Second Life has been used to build environments where people can obtain information and interact with other users for peer support and advice from health care professionals. OBJECTIVE: The intent of the study was to find out whether Second Life is a working and functional platform supporting the empowerment of people in health-related issues. METHODS: We conducted a review of the current health-related activity in Second Life, coupled with an extensive series of observations and interactions with the respective resources inside Second Life. RESULTS: A total of 24 operative health resources were found in Second Life, indicating that health-related activity is rather limited in Second Life, though at first glance it appears to contain very rich health-related content. The other main shortcomings of Second Life relate to a lack of activity, a low number of resource users, problems with Second Life's search features, and the difficulty of finding trustworthy information. CONCLUSIONS: For the average user, Second Life offers very little unique value compared to other online health resources.

Ambulatory orthopaedic surgery patient education and cost of care.

PURPOSE: To describe and compare ambulatory orthopaedic surgery patients' reported cost of care (out-of-pocket costs, use of time, and consultations with healthcare organizations) and nurses' cost of care (use of time and consultations with other professionals such as other nurses, physicians, and anesthesiologists) when patients receive 2 different types of patient education (Internet-based or face-to-face). METHOD: Pretest/posttest design. SAMPLE: Random assignment of all ambulatory orthopaedic surgery patients in a university hospital in Finland. INTERVENTION: The experimental group received Web-based patient education and the control group received face-to-face patient education. OUTCOMES OF INTEREST: Financial and time costs. FINDINGS: Pre-, intra-, and postoperative costs did not differ between the groups. However, Internet-based education was more time-consuming for the patient and face-to-face education was more time-consuming for the nurse. There were no differences between the groups in patients' use of consultations of healthcare professionals. Nurses' consultations were few and did not differ between the groups. The small number of patients' and nurses' consultations indicates that patients in both education methods had enough knowledge to deal with the surgery.

Towards a National Health Information System evaluation.

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 used to generate the Finnish National Health Information System (NHIS) evaluation plan. The core elements of the plan are illustrated, discussing also challenges and solutions in implementation. The article is based on NHIS evaluation planning project [15] and its presentation in the MIE workshop in Sarajevo in 2009 [16], where core issues and challenges of large-scale evaluations were discussed using the Finnish NHIS evaluation plan as a frame of reference.The Finnish plan offers other countries tools with which to assess their own plans and generate national methodologies for NHIS evaluation.

The creation and evaluation of an ambulatory orthopedic surgical patient education web site to support empowerment.

The use and evaluation of Web sites in ambulatory surgery patients' education are rare; hence, innovative approaches to educate these patients should be adopted and evaluated. The aim of this study was to describe the creation of and evaluate the utility and usability of an ambulatory orthopedic surgical patient education Web site. A descriptive study design was used. The evaluators were 72 ambulatory orthopedic surgery patients receiving education through a Web site. The data were collected after education preoperatively and 2 weeks postoperatively. Two instruments were used: "Patients' Evaluation of Education" and "Diary of the Use of the Website." Web site evaluators' scores for utility of the Web site ranged from 57.56 to 87.87 of 100. Utility of the Web site evaluations was significantly higher (P < .05) 2 weeks postoperatively than immediately after the operation. Web site evaluators' scores for usability of the Web site ranged from 85.69 to 88.32. The use of this program as educational material for orthopedic surgery patients was supported by the patients' opinions of the usability and utility of the Web site.

Planning for national health information system evaluation.

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, the Finnish evaluation plans for the National Health Information System (NHIS) are used as a case in the workshop to reflect on core issues and challenges in large-scale evaluation for supporting system development, implementation and positive impacts. The results of the discussions are documented to be used in further refinement of the Finnish evaluation methodology and for enhancing networking of respective parties in different countries. The results will also benefit participants including policy makers, developers and researchers of national eHealth systems in pursuit of national evaluation activities.