Rune Werner Fensli

• Sandberg, Edvard Liljedahl; Halvorsen, Sigrun; Berge, Trygve; Grimsmo, Jostein; Atar, Dan & Fensli, Rune Werner [Show all 8 contributors for this article] (2023). Fully digital self-screening for atrial fibrillation with patch electrocardiogram. Europace. ISSN 1099-5129. 25(5). doi: 10.1093/europace/euad075. Full text in Research Archive Show summary

  Aims Atrial fibrillation (AF) is the most common arrhythmia worldwide. The AF is associated with severe mortality, morbidity, and healthcare costs, and guidelines recommend screening people at risk. However, screening methods and organization still need to be clarified. The current study aimed to assess the feasibility of a fully digital self-screening procedure and to assess the prevalence of undetected AF using a continuous patch electrocardiogram (ECG) monitoring system. Methods and results Individuals ≥65 years old with at least one additional risk factor for stroke from the general population of Norway were invited to a fully digital continuous self-screening for AF using a patch ECG device (ECG247 Smart Heart Sensor). Participants self-reported clinical characteristics and usability online, and all participants received digital feedback of their results. A total of 2118 individuals with a mean CHA2DS2-VASc risk score of 2.6 (0.9) were enrolled in the study [74% women; mean age 70.1 years (4.2)]. Of these, 1849 (87.3%) participants completed the ECG self-screening test, while 215 (10.2%) did not try to start the test and 54 (2.5%) failed to start the test. The system usability score was 84.5. The mean ECG monitoring time was 153 h (87). Atrial fibrillation was detected in 41 (2.2%) individuals. Conclusion This fully digitalized self-screening procedure for AF demonstrated excellent feasibility. The number needed to screen was 45 to detect one unrecognized case of AF in subjects at risk for stroke. Randomized studies with long-term follow-up are needed to assess whether self-screening for AF can reduce the incidence of AF-related complications

• Jortveit, Jarle & Fensli, Rune Werner (2022). Remote ECG Monitoring by ECG247 Smart Heart Sensor. International Journal of Telemedicine and Applications. ISSN 1687-6415. 2022. doi: 10.1155/2022/6812889. Full text in Research Archive Show summary

  Background. Heart rhythm disorders are common and may be associated with serious complications. The quality of the ECG signal is crucial to detect and classify arrhythmias. Most available devices for assessment arrhythmias do not allow for remote monitoring. The Norwegian ECG247 Smart Heart Sensor is a new remote patch monitor developed to simplify the assessment of arrhythmias. This study was aimed at evaluating the quality of the ECG signal from the ECG247 Smart Heart Sensor compared to standard 12-lead ECG. Methods. ECG recordings with ECG247 Smart Heart Sensor and a standard 12-lead ECG recorder were performed in 97 volunteers at Sorlandet Hospital, Arendal, Norway, in 2019. All ECGs were analysed by two independent cardiologists. Results. A total of 97 participants (53% men, age 48 (±14) years) were included in the study. The ability for both systems to use recorded ECG data for arrhythmia detection was good (100%). The quality of the P-wave (mean score 1.1 vs. 1.5) and the QRS complex (mean score 1.0 vs. 1.0) from the ECG247 Smart Heart Sensor and that from the 12-lead ECG were comparable (scale: 1: extremely good, 9: not accepted). Noise artefacts were a minor issue in all recordings. Conclusions. The ECG quality from the ECG247 Smart Heart Sensor was comparable to the ECG quality from the standard 12-lead ECG. The ECG247 Smart Heart Sensor may enable easy and remote diagnostics of heart rhythm disorders. This trial is registered with NCT04700865.

• Sandberg, Edvard Liljedahl; Grenne, Bjørnar; Berge, Trygve; Grimsmo, Jostein; Atar, Dan & Halvorsen, Sigrun [Show all 8 contributors for this article] (2021). Diagnostic Accuracy and Usability of the ECG247 Smart Heart Sensor Compared to Conventional Holter Technology. Journal of Healthcare Engineering. ISSN 2040-2295. 2021. doi: 10.1155/2021/5230947. Full text in Research Archive Show summary

  Background. Heart rhythm disorders, especially atrial fibrillation (AF), are increasing global health challenges. Conventional diagnostic tools for assessment of rhythm disorders suffer from limited availability, limited test duration time, and usability challenges. There is also a need for out-of-hospital investigation of arrhythmias. Therefore, the Norwegian ECG247 Smart Heart Sensor has been developed to simplify the assessment of heart rhythm disorders. The current study aimed to evaluate the diagnostic accuracy and usability of the ECG247 Smart Heart Sensor compared to conventional Holter monitors. Methods. Parallel tests with ECG247 Smart Heart Sensor and a Holter monitor were performed in 151 consecutive patients referred for out-of-hospital long-term ECG recording at Sorlandet Hospital Arendal, Norway. All ECG data were automatically analysed by both systems and evaluated by hospital physicians. Participants were asked to complete a questionnaire scoring usability parameters after the test. Results. A total of 150 patients (62% men, age 54 (±17) years) completed the study. The ECG quality from both monitors was considered satisfactory for rhythm analysis in all patients. AF was identified in 9 (6%) patients during the period with parallel tests. The diagnostic accuracy for automatic AF detection was 95% (95% CI 91–98) for the ECG247 Smart Heart Sensor and 81% (95% CI 74–87) for the Holter system. The proportion of false-positive AF was 4% in tests analysed by the ECG247 algorithm and 16% in tests analysed by the Holter algorithm. Other arrhythmias were absent/rare. The system usability score was significantly better for ECG247 Smart Heart Sensor compared to traditional Holter technology (score 87.4 vs. 67.5, ). Conclusions. The ECG247 Smart Heart Sensor showed at least comparable diagnostic accuracy for AF and improved usability compared to conventional Holter technology. ECG247 allows for prolonged monitoring and may improve detection of AF. Trial reg: https://clinicaltrials.gov/ct2/show/NCT04700865.

• Smaradottir, Berglind F. & Fensli, Rune Werner (2020). An Evaluation of Telemedicine Systems in Patient-centred Care Teams. Studies in Health Technology and Informatics. ISSN 0926-9630. 271, p. 65–66. doi: 10.3233/SHTI200075. Full text in Research Archive
• Smaradottir, Berglind; Berntsen, Gro Karine Rosvold & Fensli, Rune Werner (2020). How to Enhance Digital Support for Cross-Organisational Health Care Teams? A User-Based Explorative Study. Journal of Healthcare Engineering. ISSN 2040-2295. 2020. doi: 10.1155/2020/8824882. Full text in Research Archive Show summary

  Health care service provision of individualised treatment to an ageing population prone to chronic conditions and multimorbidities is threatened. There is a need for digitally supported care, that is, (1) person-centred, (2) integrated, and (3) proactive. The research project <i>3P, Patients and Professionals in Productive Teams</i>, aimed to validate and verify the prerequisites for health care systems run with patient-centred service models. This paper presents an explorative study of the digital support of a cross-organisational health care team in Norway, providing services to elderly frail people with multimorbidities in hospital discharge transition. Qualitative research methods were employed, with interviews and observations to map and evaluate the information flow and the digital support of collaborative work across organisations. The evaluation showed a lacking interoperability between the digital systems and a limited support for cross-organisational teamwork, causing raised manual efforts to maintain the information flow. Tools for coordination and planning across organisations were lacking. To enhance the situation, principles for a cloud-based health portal are proposed with a shared workspace, teamwork functionality for cross-organisational health care teams, and automatic back-end synchronisation of stored information. The main implications of this paper lie in the proposed principles which are transferable to a multitude of clinical contexts, where ad-hoc based access to shared medical information is of importance for decision-making and life-saving treatment.

• Smaradottir, Berglind & Fensli, Rune Werner (2020). A Case Study of Technology Use and Information Flow at a Danish E-clinic, Proceedings from the 2019 International Conference on Computational Science and Computational Intelligence (CSCI'19). IEEE (Institute of Electrical and Electronics Engineers). ISSN 9781728155845. p. 961–965. doi: 10.1109/CSCI49370.2019.00182. Full text in Research Archive Show summary

  There is an urgent call from health organizations, health professionals and health authorities to re-design care delivery for patients with chronic conditions and multimorbidities. The research project 3P- Patients and Professionals in Productive Teams aims to study health care services that are run with different patient-centered teamwork models. In this context, a case study was made of an E-clinic in Denmark, with a focus on the technology use and information flow in a patientcentered clinical care context. Qualitative methods were applied with observations and interviews with key informants. The results showed that information flow worked well in a patient-centered care perspective, even though the technology was a standalone system for the E-clinic and with limited interoperability with other health care providers.

• Smaradottir, Berglind & Fensli, Rune Werner (2019). User Experiences and Satisfaction with an Electronic Health Record System. Advances in Intelligent Systems and Computing. ISSN 2194-5357. 972, p. 73–80. doi: 10.1007/978-3-030-19135-1_8. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2019). Patient Experiences and Digital Involvement in Patient-centred Care Models. Studies in Health Technology and Informatics. ISSN 0926-9630. 265, p. 181–185. doi: 10.3233/SHTI190160. Full text in Research Archive Show summary

  The provision of individualised treatment and care from health care services to patients with chronic conditions and multi-morbidities is under pressure because of an increasing elderly population. There is a need for services that are: 1) person-centred, 2) integrated and 3) proactive, and supported by digital technology. The research project 3P- Patients and Professionals in Productive Teams aims to study different patient-centred teamwork models in Norway and Denmark. This paper presents a study on patients’ experiences and digital involvement in patient-centred care teams. Qualitative research methods were applied with interviews and demonstrations of technology use made at patient’s homes. The results showed that the patients were satisfied with the patient-centred service models and had an increased feeling of safety. A constraint was information sharing between the patient-centred health care team and the patients. Most of them did not have access to read own medical information and mainly verbal information was shared between the patients and the health providers.

• Smaradottir, Berglind; Sjaavaag, Ståle; Ås, Inger-Alice Naley; Bakke, Bjørn; Alfsen, Linda & Tangene, Wenche [Show all 7 contributors for this article] (2019). Why is it so Hard to Integrate Telemedicine as a Part of Municipal Health Care Services? Experiences from a Norwegian Municipality. In Granja, Conceição & Solvoll, Terje (Ed.), Proceedings of the 17th Scandinavian Conference on Health Informatics 2019. Linköping University Electronic Press. ISSN 9789179299576. p. 87–92. Full text in Research Archive
• Gerdes, Martin; Smaradottir, Berglind; Martinez, Santiago; Jortveit, Jarle & Fensli, Rune Werner (2019). A Decision-support Algorithm for Self-management of Anticoagulation Therapy Used in a Smartphone Application, Proceedings from 2019 IEEE Symposium on Computers and Communications (ISCC2019). IEEE (Institute of Electrical and Electronics Engineers). ISSN 9781728129990. p. 1077–1080. doi: 10.1109/ISCC47284.2019.8969693. Full text in Research Archive
• Berntsen, Gro Karine Rosvold; Strisland, Frode; Malm-Nicolaisen, Kristian; Smaradottir, Berglind; Fensli, Rune Werner & Røhne, Mette (2019). The Evidence Base for an Ideal Care Pathway for Frail Multimorbid Elderly: Combined Scoping and Systematic Intervention Review. Journal of Medical Internet Research (JMIR). ISSN 1439-4456. 21(4). doi: 10.2196/12517. Full text in Research Archive Show summary

  <i>Background</i>: There is a call for bold and innovative action to transform the current care systems to meet the needs of an increasing population of frail multimorbid elderly. International health organizations propose complex transformations toward digitally supported (1) Person-centered, (2) Integrated, and (3) Proactive care (Digi-PIP care). However, uncertainty regarding both the design and effects of such care transformations remain. Previous reviews have found favorable but unstable impacts of each key element, but the maturity and synergies of the combination of elements are unexplored.<p> <p><i>Objective</i>: This study aimed to describe how the literature on whole system complex transformations directed at frail multimorbid elderly reflects (1) operationalization of intervention, (2) maturity, (3) evaluation methodology, and (4) effect on outcomes.<p> <p><i>Methods</i>: We performed a systematic health service and electronic health literature review of care transformations targeting frail multimorbid elderly. Papers including (1) Person-centered, integrated, and proactive (PIP) care; (2) at least 1 digital support element; and (3) an effect evaluation of patient health and/ or cost outcomes were eligible. We used a previously published ideal for the quality of care to structure descriptions of each intervention. In a secondary deductive-inductive analysis, we collated the descriptions to create an outline of the generic elements of a Digi-PIP care model. The authors then reviewed each intervention regarding the presence of critical elements, study design quality, and intervention effects.<p> <p><i>Results</i>: Out of 927 potentially eligible papers, 10 papers fulfilled the inclusion criteria. All interventions idealized Person-centered care, but only one intervention made what mattered to the person visible in the care plan. Care coordinators responsible for a whole-person care plan, shared electronically in some instances, was the primary integrated care strategy. Digitally supported risk stratification and management were the main proactive strategies. No intervention included workflow optimization, monitoring of care delivery, or patient-reported outcomes. All interventions had gaps in the chain of care that threatened desired outcomes. After evaluation of study quality, 4 studies remained. They included outcome analyses on patient satisfaction, quality of life, function, disease process quality, health care utilization, mortality, and staff burnout. Only 2 of 24 analyses showed significant effects.<p> <p><i>Conclusions</i>: Despite a strong common-sense belief that the Digi-PIP ingredients are key to sustainable care in the face of the silver tsunami, research has failed to produce evidence for this. We found that interventions reflect a reductionist paradigm, which forces care workers into standardized narrowly focused interventions for complex problems. There is a paucity of studies that meet complex needs with digitally supported flexible and adaptive teamwork. We predict that consistent results from care transformations for frail multimorbid elderly hinges on an individual care pathway, which reflects a synergetic PIP approach enabled by digital support.

• Smaradottir, Berglind & Fensli, Rune Werner (2019). Evaluation of the Technology Use in an Inter-disciplinary Patient-centered Health Care Team. Studies in Health Technology and Informatics. ISSN 0926-9630. 257, p. 388–392. doi: 10.3233/978-1-61499-951-5-388. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2018). Point of Care Solutions: Implementation of Sustainable Service Models. Studies in Health Technology and Informatics. ISSN 0926-9630. 250, p. 155–155. doi: 10.3233/978-1-61499-872-3-155. Full text in Research Archive Show summary

  Recent health reforms and strategies have urged Norwegian municipalities to re-organize their services to prepare for new ways of combining traditional home-based services with technology-assisted point of care interventions. This paper presents the outcomes from a qualitative study on modelling the municipal health care services for the future. The aim was to study the organisation and operation of point of care solutions and identify critical factors for how to model the services of the future.

• Karlsen, Tor-Ivar; Tveide, Marit Bolstad & Fensli, Rune Werner (2018). Factors affecting seniors' attitudes on the use of information technology. Linköping Electronic Conference Proceedings. ISSN 1650-3686. 2018(145), p. 78–81. Full text in Research Archive
• Smaradottir, Berglind; Martinez, Santiago; Borycki, Elizabeth; Loudon, Gareth; Kushniruk, André William & Jortveit, Jarle [Show all 7 contributors for this article] (2018). User evaluation of a smartphone application for anticoagulation therapy. Studies in Health Technology and Informatics. ISSN 0926-9630. 247, p. 466–470. doi: 10.3233/978-1-61499-852-5-466. Full text in Research Archive Show summary

  Anticoagulation therapy with Warfarin is used for specific cardiovascular diseases to control the ability of blood clotting. Traditional ways of selfmanagement therapy are based on paper forms and procedures. This paper presents an evaluation of the smartphone application Warfarin Guide, a computer-assisted decision-support system used to help patients in their management of anticoagulation therapy related to International Normalized Ratio (INR) values. The evaluation consisted of a usability test with 4 participants and a field test with 14 participants who used the application at home during four months. A mixed methods research approach included quantitative and qualitative analysis of the test results. The results showed that participants evaluated the Warfarin Guide as ‘useful’ for self-management of anticoagulation therapy, reporting key issues for further improvement.

• Smaradottir, Berglind; Moe, Carl Erik & Fensli, Rune Werner (2018). Infrastructure and Procedure for Simulation of Cardiac Remote Monitoring: Experiences from the Telemedicine Agder Project. In Arabnia, Hamid R.; Deligiannidis, Leonidas; Tinetti, F.G. & Tran, Qouc-Nam (Ed.), Proceedings of the 2018 International Conference on Health Informatics and Medical Systems (HIMS'18). CSREA Press. ISSN 9781601324795. p. 53–57. Full text in Research Archive Show summary

  Telemedicine are remote electronic clinical consultations using technology for delivery of health care services. Telemedicine can be offered as a service to citizens living at home with an aim of reducing the number of hospital visits or visits to the General Practitioner and improving longterm cost-effectiveness. In Norway, a recent health reform has caused municipalities to re-organize their design of health services, with an increased use of telemedicine. In this context, the “Telemedicine Agder” project focuses on the organization, implementation and operation of large scale telemedicine services. In the project, a simulation of a telemedicine service for monitoring of heart failure was made in a clinical laboratory together with a patient, nurses and physicians. In addition, there were technical professionals and a research team present. This paper presents the laboratory infrastructure for the simulation and experiences are shared from the research project.

• Holen-Rabbersvik, Elisabeth; Thygesen, Elin; Eikebrokk, Tom Roar; Fensli, Rune Werner & Slettebø, Åshild (2018). Barriers to exchanging healthcare information in inter-municipal healthcare services: a qualitative case study. BMC Medical Informatics and Decision Making. 18(92), p. 1–14. doi: 10.1186/s12911-018-0701-z. Full text in Research Archive
• Holen-Rabbersvik, Elisabeth; Eikebrokk, Tom Roar; Fensli, Rune Werner; Thygesen, Elin & Slettebø, Åshild (2018). Critical issues for employees in inter- municipal health care services: a multiple case study. BMC Health Services Research. 18(805), p. 1–13. doi: 10.1186/s12913-018-3586-8. Full text in Research Archive
• Smaradottir, Berglind; Fensli, Rune Werner & Moe, Carl Erik (2018). Recommendations of a Laboratory Infrastructure for Simulation of Telemedicine Services, 2018 IEEE Symposium on Computers and Communications (ISCC). IEEE (Institute of Electrical and Electronics Engineers). ISSN 9781538669501. doi: 10.1109/ISCC.2018.8538493. Full text in Research Archive Show summary

  In Norway, a health reform targeting coordination and continuity of care has urged municipalities to re-organize their services as there is an increasing use of remote monitoring and sensor technologies in citizens’ homes. In this context, the research project “Telemedicine Agder” is an opportunity to study the implementation, organization and operation of large scale telemedicine services, and identify the service models of the future. As part of the project, simulation of a telemedicine service for remote monitoring of diabetes II was tested in a clinical laboratory with key informants from municipalities, hospital and research partners. This paper presents the technical and physical infrastructure of the clinical laboratory environment for simulation of a telemedicine service workflow with recommendations based on experiences from the project, relevant and applicable to other eHealth-related contexts.

• Smaradottir, Berglind & Fensli, Rune Werner (2018). Evaluation of a Telemedicine Service Run with a Patient-centred Care Model. Studies in Health Technology and Informatics. ISSN 0926-9630. 251, p. 297–300. doi: 10.3233/978-1-61499-880-8-297. Full text in Research Archive Show summary

  The number of patients with chronic conditions and multi-morbidities is increasing, addressing a need for patient-centred care. The research project Patients and Professionals in Productive Teams aims to study patient-centred teamwork for this patient group. This paper presents an evaluation of a telemedicine service for chronic obstructive pulmonary disease patients run with a patient-centred care model. Observations and interviews were made to study the technology use and information flow. The results showed that the technology worked well in a patient-centred care perspective, even though the system was a standalone system for telemedicine services. The information in the system was only available for professionals providing the telemedicine services and was not shared with other health care providers.

• Smaradottir, Berglind & Fensli, Rune Werner (2018). The Technology Use and Information Flow at a Municipal Telemedicine Service. Studies in Health Technology and Informatics. ISSN 0926-9630. 251, p. 293–296. doi: 10.3233/978-1-61499-880-8-293. Full text in Research Archive Show summary

  Health care services face challenges with providing individualised treatment to an ageing population prone to chronic conditions and multi-morbidities. The research project Patients and Professionals in Productive Teams aims to study patient-centred teamwork service models. This paper presents an evaluation of a telemedicine service for chronic obstructive pulmonary disease patients integrated with municipal health care services. Qualitative methods were used to study the technology use and information flow. The results showed that the telemedicine technology was a standalone system, not integrated with the electronic health record of the municipality. A benefit of the system was a function to provide the patient with written instructions on agreements and advices. As a constraint for the patient-centred team approach, the information in the telemedicine system was available only for the telemedicine nurses and not to other health care professionals.

• Smaradottir, Berglind; Eikeland, Randi; Reiso, Harald & Fensli, Rune Werner (2018). User-centered design of a national medical registry for tick-borne diseases. Advances in Intelligent Systems and Computing. ISSN 2194-5357. 779, p. 99–108. doi: 10.1007/978-3-319-94373-2_11. Full text in Research Archive Show summary

  Tick-borne diseases are increasing in a global perspective, with Lyme disease and tick-borne encephalitis as the most frequent. The Norwegian National Ad-visory Unit on Tick-borne Diseases is preparing the development of a national medical registry for clinical follow-up of patients with tick-borne diseases based on the best practice guidelines and for research purposes. This paper presents the methodological approach of a user-centered design process applied in the in-itial phase of the registry development. A user workshop identified user needs, requirements and proposed a service workflow for the registry operation. As the next step, a simulation of the proposed service workflow was performed in a clinical laboratory together with end-user groups. The main contribution of this paper lies on the methodological descriptions of the user-centered design pro-cess, and how to facilitate the active contribution of end-users in a technical de-velopment process within a health care context.

• Smaradottir, Berglind; Martinez, Santiago; Thygesen, Elin; Holen-Rabbersvik, Elisabeth; Vatnøy, Torunn Kitty & Fensli, Rune Werner (2017). Innovative Simulation of Health Care Services in the Usability Laboratory: Experiences from the Model for Telecare Alarm Services-project. In Martinez, Santiago; Budrionis, Andrius; Bygholm, Ann; Fossum, Mariann; Hartvigsen, Gunnar; Hägglund, Maria; Moe, Carl Erik; Thygesen, Elin; Vimarlund, Vivian & Yigzaw, Kassaye Yitbarek (Ed.), Proceedings from The 15th Scandinavian Conference on Health Informatics 2017 Kristiansand, Norway, August 29–30, 2017. Linköping University Electronic Press. ISSN 9789176853641. p. 60–65. Full text in Research Archive Show summary

  In Norway, a recent health reform urged municipalities to prepare for telecare alarm services to handle alarms associated to welfare technology and telecare technology in citizens’ homes. That requires a re-organisation of health and social services in many municipalities and several are preparing to establish new telecare alarm services operated in inter-municipal response centres. In this context, the research project “Model for Telecare Alarm Services” aims to study how existing telecare alarm services in Norwegian municipalities are organised and operated, and identify critical factors when designing new models for future services. This paper presents how an innovative simulation of health care services was used in the research project, when key informants from several municipalities, research partners and industry tested different models of telecare alarm services in a usability laboratory. The lessons learned by the research group showed that laboratory simulation was an efficient way of testing different scenarios of new telecare service models, together with key informants from heterogenous end-user groups.

• Gerdes, Martin; Gallefoss, Frode & Fensli, Rune Werner (2017). The EU project “United4Health”: Results and experiences from automatic health status assessment in a Norwegian telemedicine trial system. Journal of Telemedicine and Telecare. ISSN 1357-633X. 25(1), p. 46–53. doi: 10.1177/1357633X17735558. Full text in Research Archive Show summary

  Introduction Patients with chronic obstructive pulmonary disease require help in daily life situations to increase their individual perception of security, especially under worsened medical conditions. Unnecessary hospital (re-)admissions and home visits by doctors or nurses shall be avoided. This study evaluates the results from a two-year telemedicine field trial for automatic health status assessment based on remote monitoring and analysis of a long time series of vital signs data from patients at home over periods of weeks or months. Methods After discharge from hospital treatment for acute exacerbations, 94 patients were recruited for follow-up by the trial system. The system supported daily measurements of pulse and transdermal peripheral capillary oxygen saturation at patients' homes, a symptom-specific questionnaire, and provided nurses trained to use telemedicine ("telenurses") with an automatically generated health status overview of all monitored patients. A colour code (green/yellow/red) indicated whether the patient was stable or had a notable deterioration, while red alerts highlighted those in most urgent need of follow-up. The telenurses could manually overwrite the status level based on the patients' conditions observed through video consultation. Results Health status evaluation in 4970 telemonitor datasets were assessed retrospectively. The automatic health status determination (subgroup of 33 patients) showed green status at 46% of the days during a one-month monitoring period, 28% yellow status, and 19% red status (no data reported at 7% of the days). The telenurses manually downrated approximately 10% of the red or yellow alerts. Discussion The evaluation of the defined real-time health status assessment algorithms, which involve static rules with personally adapted elements, shows limitations to adapt long-term home monitoring with adequate interpretation of day-to-day changes in the patient's condition. Thus, due to the given sensitivity and specificity of such algorithms, it seems challenging to avoid false high alerts.

• Gerdes, Martin; Martinez, Santiago; Smaradottir, Berglind; Fensli, Rune Werner & Jortveit, Jarle (2017). Warfarin Guide: Co-design of a Mobile Computer-Assisted Anticoagulant Therapy. Studies in Health Technology and Informatics. ISSN 0926-9630. 245, p. 1222–1222. doi: 10.3233/978-1-61499-830-3-1222. Full text in Research Archive Show summary

  Patients with some types of cardiovascular disease are prescribed anticoagulation therapy with Warfarin in order to control the ability of blood clotting. This work presents a co-designed mobile application, called Warfarin Guide, for a computer-assisted anticoagulant therapy. The application addresses the challenges that unexperienced patients may find when having to remember to regularly check their INR values and make temporary adjustments for INR value fluctuations that are not easy to interpret without direct medical advice.

• Smaradottir, Berglind & Fensli, Rune Werner (2017). A Case Study of the Technology Use and Information Flow at a Hospital-driven Telemedicine Service. Studies in Health Technology and Informatics. ISSN 0926-9630. 244, p. 58–62. doi: 10.3233/978-1-61499-824-2-58. Full text in Research Archive Show summary

  Health care services face the challenge of providing individualised treatment to a growing ageing population prone to chronic conditions and multi-morbidities. The research project Patients and Professionals in Productive Teams aims to study health care services that are run with a patient-centred teamwork approach. In this context, a case study was made of a hospital-driven telemedicine service for chronic obstructive pulmonary disease patients after hospital discharge, with a focus on information flow and technology use. The methods used were observation and interviews with key informants. The results showed that the technology was perceived as well-functioning for telemedicine support, but the technology used was a standalone system and not integrated with the electronic health record of the hospital. In addition, there was lack of support to provide the patients at home with written instructions on advices of medical treatment and care. The electronic information used for this telemedicine services, allowed shared access of information for teamwork between professional only within the hospital.

• Smaradottir, Berglind; Fensli, Rune Werner; Ås, Inger-Alice Naley & Gallefoss, Frode (2017). Telemedicine Follow Up of Chronic Obstructive Pulmonary Disease Integrated into a Patient-Centered Health Care Team-Setting Impacts on Patient Empowerment and Safety, Proceedings of the 2017 International Conference on Computational Science and Computational Intelligence. IEEE (Institute of Electrical and Electronics Engineers). ISSN 9781538626528. p. 1779–1781. doi: 10.1109/CSCI.2017.311. Full text in Research Archive
• Smaradottir, Berglind; Fensli, Rune Werner; Boysen, Elin Sundby & Martinez, Santiago (2017). Infrastructure for Health Care Simulation: Recommendations from the Model for Telecare Alarm Services Project. In Arabnia, Hamid R.; Deligiannidis, Leonidas & O'Hara, Micheal B. (Ed.), Proceedings of 2017 International Conference on Health Informatics and Medical Systems (HIMS2017). Part of the World Congress in Computer Science, Computer Engineering, & Applied Computing (CSCE'17), July 17-20, 2017 in Las Vegas. CSREA Press. ISSN 9781601324597. p. 64–69. Full text in Research Archive Show summary

  In Norway, a recent health reform targeting coordination and continuity of care has urged municipalities to manage telecare alarms related to an increasing number of welfare- and sensor technologies in citizens’ homes. In this context, the research project “Model for Telecare Alarm Services” has the aim to study the organization and operation of existing telecare alarm services and identify new service models of the future. In the project, simulation of health care services was used when key informants from municipalities, end-users, research partners and industry tested different models for future telecare alarm services. This paper presents the technical and physical infrastructure of a clinical laboratory environment for simulation of health care services, with recommendations based on experiences from the project.

• Martinez, Santiago; Bjerkås, Silje; Ludvigsen, Ann-Elisabeth & Fensli, Rune Werner (2016). Agder living lab: From ideas to large-scale deployment and long-term user adoption of inclusive health solutions. Advances in Intelligent Systems and Computing. ISSN 2194-5357. 500, p. 391–399. doi: 10.1007/978-3-319-41962-6_35. Full text in Research Archive
• Smaradottir, Berglind; Gerdes, Martin; Martinez, Santiago & Fensli, Rune Werner (2016). The EU-project United4Health: User-centred design of an information system for a Norwegian telemedicine service. Journal of Telemedicine and Telecare. ISSN 1357-633X. 22(7), p. 422–429. doi: 10.1177/1357633X15615048. Full text in Research Archive
• Smaradottir, Berglind; Martinez, Santiago; Holen-Rabbersvik, Elisabeth; Vatnøy, Torunn Kitty & Fensli, Rune Werner (2016). Usability Evaluation of a Collaborative Health Information System. Lessons from a User-centred Design Process. In Gilbert, James (Eds.), BIOSTEC 2016: 9th International Joint Conference on Biomedical Engineering Systems and Technologies, February 21-23, 2016, in Rome, Italy. SciTePress. ISSN 9789897581700. p. 306–313. doi: 10.5220/0005703603060313. Full text in Research Archive
• Smaradottir, Berglind; Holen-Rabbersvik, Elisabeth; Thygesen, Elin; Fensli, Rune Werner & Martinez, Santiago (2015). User-Centred Design of the User Interface of a Collaborative Information System for Inter-Municipal Dementia Team. In NN, NN (Eds.), Proceedings of the International Conference on Health Informatics (HEALTHINF-2015). SciTePress. ISSN 9789897580680. p. 446–453. doi: 10.5220/0005222704460453. Full text in Research Archive Show summary

  In the Norwegian Health sector there are currently undergoing changes at local, regional and national level triggered by recent health reforms. Municipalities are facing for first time the duty of implementing new primary health services. Inter-municipal coordination (IMC) health care teams have been created to operate across borders to share costs, extend geographical range of operation and optimise resources. This study focuses on the development and evaluation of the user interface (UI) functional prototype of a collaborative information system for IMC dementia team in Norway. Employing a user-centred design approach, the interface prototype was built based on the information gathered on two workshops where the end-users described their current clinical workflow of dementia assessment and how the UI would best fit into their daily work. The outcome of the workshops creatively informed the design of a working prototype that was qualitatively usability tested. Results showed that the UI effectively and efficiently supported the work of the IMC dementia team, with a sufficient level of satisfaction among the end-users. The resulting prototype established the foundation for the system implemented in the FP7 EU project United4Health.

• Smaradottir, Berglind; Martinez, Santiago; Holen-Rabbersvik, Elisabeth & Fensli, Rune Werner (2015). eHealth-extended Care Coordination: Development of a Collaborative System for Inter-municipal Dementia Teams- A research project with a user-centered design approach. In Arabnia, Hamid R.; Deligiannidis, Leonidas & Tran, Qouc-Nam (Ed.), 2015 International Conference on Computational Science and Computational Intelligence. IEEE (Institute of Electrical and Electronics Engineers). ISSN 9781467397957. p. 749–753. doi: 10.1109/CSCI.2015.79. Full text in Research Archive Show summary

  In Norway, a health reform was recently adopted to improve continuity of care. Services that were carried out in hospitals were transferred to municipalities. Small and medium size municipalities have established inter-municipal cooperation to provide specialized services across borders. The research project eHealth-extended Care Coordination studied the inter-municipal cooperation for assessment of dementia, identifying a need for improved communication and coordination. This paper presents the development process of a collaborative information system for dementia assessment using a user-centered design approach. Mixed methods, such as observations, semi-structured interviews and questionnaire, were used for data collection. The results showed that end-user involvement usefully informed the development. The information system effectively supported collaborative work and shared access to information for the inter-municipal team.

• Smaradottir, Berglind; Gerdes, Martin; Fensli, Rune Werner & Martinez, Santiago (2015). User Interface Development of a COPD Remote Monitoring Application A User-centred Design Process. In Miller, Leslie & Culén, Alma Leora (Ed.), ACHI 2015, The Eighth International Conference on Advances in Computer-Human Interactions. ThinkMind. ISSN 9781612083827. p. 57–62. Full text in Research Archive Show summary

  The Norwegian Health sector is undergoing changes at all levels due to recent health reforms. Services traditionally offered by specialized health care are being transferred to primary health care managed by municipalities. In this context, telemedicine technology is introduced to facilitate new services that support communication across local borders, optimizing resources and increasing cost effectiveness. This study focuses on the user-centred design, iterative development and evaluation of the user interface of a mobile application to be used in a new telemedicine service for remote monitoring of chronic obstructive pulmonary disease symptoms. The research is a result of the cooperation between a municipality and a hospital as part of the European Commission project United4Health. Through a user-centred design approach, the tablet device application was developed based on information gathered in a workshop and group interviews where the end-users, patients and health professionals, described their preferred way of interacting with the telemedicine technology. User evaluations reported positive results on the ease of use and user satisfaction with the interaction with the application. Iterative application’s user interface refinements were made through several end-users’ evaluations, resulting in a fully developed system suitable for remote monitoring.

• Gerdes, Martin; Smaradottir, Berglind; Reichert, Frank & Fensli, Rune Werner (2015). Telemedicine and Cooperative Remote Healthcare Services: COPD Field Trial. Studies in Health Technology and Informatics. ISSN 0926-9630. 210, p. 455–457. doi: 10.3233/978-1-61499-512-8-455. Full text in Research Archive Show summary

  The introduction of sustainable telemedicine solutions throughout Europe requires the development of secure, flexible and expandable systems and the evaluation of their operation in real-world settings such as field trials. This paper describes a system for a remote monitoring and care support field trial with Chronic Obstructive Pulmonary Disease (COPD) patients. By following a user-centred-development and Privacy by Design approach, the needs of all involved user groups could be addressed, while fulfilling, at the same time, national requirements with emphasis in security and privacy protection. The solution covers specific applications and services for COPD patients and their remote care takers, but allows the generalization of its applicability to other patient groups.

• Gerdes, Martin & Fensli, Rune Werner (2015). End-to-end Security and Privacy Protection for Co-operative Access to Health and Care Data in a Telehealth Trial System for Remote Supervision of COPD-Patients, SHI 2015 - Proceedings of the 13th Scandinavian Conference on Health Informatics, June 15-17, Tromsø, Norway. Linköping University Electronic Press. ISSN 9789176859858. p. 25–32. Full text in Research Archive
• Smaradottir, Berglind; Håland, Jarle Audun; Martinez, Santiago; Somdal, Åsmund Rodvig & Fensli, Rune Werner (2015). Recommendations on a Test Infrastructure for Evaluation of Touchscreen Assistive Technology for Visually Impaired Users, SHI 2015 - Proceedings of the 13th Scandinavian Conference on Health Informatics, June 15-17, Tromsø, Norway. Linköping University Electronic Press. ISSN 9789176859858. p. 41–46. doi: 10.1109/iscc.2017.8024537. Full text in Research Archive Show summary

  Mobile technologies’ touchscreen allows the use of choreography of gestures to interact with the user interface. Relevant aspects in mobile technology design become crucial when targeting users with disabilities. For instance, when assistive technology is designed to support speech interaction between visually impaired users and a system, accessibility and ease-of-use of such technology should be included in the usability and technical evaluation of their effectiveness. This paper presents the analysis of the technical and physical infrastructure of a controlled laboratory environment for user evaluations made in the research project “Visually impaired users touching the screen - A user evaluation of assistive technology” where VoiceOver, a screen reader in Apple Inc. products was tested. The paper reports on challenges related to the use of the test infrastructure, such as how to obtain valuable data when interactive high-speed gestures are performed and how to optimise the recording and syn-chronisation between audio and video data. The lessons learned by the research group showed that there are effective alternatives for each challenge, and these should be customised for each particular test, type of participants and device.

• Gerdes, Martin; Smaradottir, Berglind; Reichert, Frank & Fensli, Rune Werner (2015). Telemedicine and Cooperative Remote Healthcare Services: COPD Field Trial. In Cornet, Ronald; Stoicu-Tivadar, Lăcrămioara; Hörbst, Alexander; Calderón, Carlos Luis Parra; Andersen, Stig Kjær & Hercigonja-Szekeres, Mira (Ed.), Digital Healthcare Empowering Europeans, Proceedings of MIE2015. IOS Press. ISSN 9781614995111. p. 455–457. doi: 10.3233/978-1-61499-512-8-455. Full text in Research Archive Show summary

  The introduction of sustainable telemedicine solutions throughout Europe requires the development of secure, flexible and expandable systems and the evaluation of their operation in real-world settings such as field trials. This paper describes a system for a remote monitoring and care support field trial with Chronic Obstructive Pulmonary Disease (COPD) patients. By following a user-centred-development and Privacy by Design approach, the needs of all involved user groups could be addressed, while fulfilling, at the same time, national requirements with emphasis in security and privacy protection. The solution covers specific applications and services for COPD patients and their remote care takers, but allows the generalization of its applicability to other patient groups.

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• Smaradottir, Berglind & Fensli, Rune Werner (2020). 3P-resultater fra arbeidspakke 6: Forskning på digitale løsninger. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2020). The Research Project 3P: Results from the Evaluation of Digital Solutions for Patient-centred Care Teams (WP6). Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2019). Patient Experiences and Digital Involvement in Patient-centred Care Models. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2019). A Case Study of Technology Use and Information Flow at a Danish E-clinic. Full text in Research Archive
• Smaradottir, Berglind; Sjaavaag, Ståle; Ås, Inger-Alice Naley; Bakke, Bjørn; Alfsen, Linda & Tangene, Wenche [Show all 7 contributors for this article] (2019). Why is it so Hard to Integrate Telemedicine as a Part of Municipal Health Care Services? Experiences from a Norwegian Municipality. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2019). The 3P-project: Evaluation of Telemedicine Solutions in Patient-centered Care Teams. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2019). Evaluation of Technology Use in an Inter-disciplinary Patient-centered Health Care Team. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2019). User Experiences and Satisfaction with an Electronic Health Record System. Full text in Research Archive
• Gerdes, Martin; Smaradottir, Berglind; Martinez, Santiago; Jortveit, Jarle & Fensli, Rune Werner (2019). A Decision-support Algorithm for Self-management of Anticoagulation Therapy Used in a Smartphone Application. Full text in Research Archive
• Holen-Rabbersvik, Elisabeth; Prinz, Andreas; Gerdes, Martin; Martinez, Santiago; Thygesen, Elin & Fensli, Rune Werner [Show all 7 contributors for this article] (2018). Teaching High School Students eHealth through Role-play and Laboratory Simulation. Medicinsk Informatika. ISSN 1330-1799. 14, p. 35–36. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2018). Point of Care Solutions: Implementation of Sustainable Service Models. Full text in Research Archive
• Smaradottir, Berglind; Martinez, Santiago; Thygesen, Elin; Vatnøy, Torunn Kitty; Holen-Rabbersvik, Elisabeth & Fensli, Rune Werner (2018). Innovative Simulation of Telecare Alarm Services in Usability Laboratory Environment, Scientific Workshop. Full text in Research Archive
• Bahus, Marianne & Fensli, Rune Werner (2018). Helseteknologi, juss og etikk. Full text in Research Archive
• Smaradottir, Berglind; Martinez, Santiago; Borycki, E.; Loudon, Gareth; Kushniruk, A.W. & Jortveit, Jarle [Show all 7 contributors for this article] (2018). User Evaluation of a Smartphone Application for Anticoagulation Therapy. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2018). Integrasjon av en telemedisinsk sentral med kommunale helsetjenester, Erfaringer fra 3P-prosjektet. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2018). Teknologistøtte og informasjonsflyt på innovasjonsarenaene-oppsummering fra feltbesøk i WP6. Full text in Research Archive
• Holen-Rabbersvik, Elisabeth; Prinz, Andreas; Gerdes, Martin; Martinez, Santiago; Thygesen, Elin & Fensli, Rune Werner [Show all 7 contributors for this article] (2018). Teaching High School Students eHealth through Roleplay and Laboratory Simulation. Full text in Research Archive Show summary

  The transformation and digitalisation of health and care services foresees a need for recruitment of young individuals having a combination of health- and computer science knowledge to contribute in the workforces of the future. At the University of Agder in Norway there has been an eHealth Centre since year 2010 [1], where both already implemented and proposed eHealth services can be simulated and tested. In the project High School Students as Co-researchers in eHealth, experienced researchers allowed high school students to be enrolled in a project course to actively play and test an eHealth scenario. This paper aims at sharing the experiences on how the pilot of a class consisting of 10 high school students at the age of 17-19 years, were taught eHealth through role-play and simulation in the eHealth Centre. The research question stated was: How to introduce high school students to eHealth research and services in a life-long learning perspective?

• Smaradottir, Berglind & Fensli, Rune Werner (2018). The Technology Use and Information Flow at a Municipal Telemedicine Service. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2018). Evaluation of a Telemedicine Service Run with a Patient-centred Care Model. Full text in Research Archive
• Smaradottir, Berglind; Fensli, Rune Werner & Moe, Carl Erik (2018). Recommendations of a Laboratory Infrastructure for Simulation of Telemedicine Services. Full text in Research Archive
• Smaradottir, Berglind; Eikeland, Randi; Reiso, Harald & Fensli, Rune Werner (2018). User-Centered Design of a National Medical Registry for Tick-Borne Diseases. Full text in Research Archive
• Smaradottir, Berglind; Fensli, Rune Werner; Ås, Inger-Alice Naley & Gallefoss, Frode (2017). Telemedicine follow up of Chronic Obstructive Pulmonary Disease Integrated into a Patient-centered Health Care Team Setting. Full text in Research Archive
• Karlsen, Tor-Ivar; Tveide, Marit Bolstad & Fensli, Rune Werner (2017). Factors affecting seniors' attitudes on the use of information technology. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2017). Integrating Care Through Patient-Centred Health Team Working Across Organisational Borders. Studies in Health Technology and Informatics. ISSN 0926-9630. 244, p. 85–85. doi: 10.3233/978-1-61499-824-2-85. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2017). Integrating Care Through Patient-Centred Health Team Working Across Organisational Borders. Full text in Research Archive
• Smaradottir, Berglind; Martinez, Santiago; Thygesen, Elin; Holen-Rabbersvik, Elisabeth; Vatnøy, Torunn Kitty & Fensli, Rune Werner (2017). Innovative Simulation of Health Care Services in the Usability Laboratory: Experiences from the Model for Telecare Alarm Services-project. Full text in Research Archive
• Gerdes, Martin; Martinez, Santiago; Smaradottir, Berglind; Fensli, Rune Werner & Jortveit, Jarle (2017). Warfarin Guide: Co-design of a Mobile Computer-Assisted Anticoagulant Therapy. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2017). A Case Study of the Technology Use and Information Flow at a Hospital-driven Telemedicine Service. Full text in Research Archive
• Smaradottir, Berglind; Martinez, Santiago & Fensli, Rune Werner (2017). User-centred Design of E-health Technology for Patients and Professionals in Productive Teams-Multidisciplinary Work across Organisational Borders. Journal of Innovation in Health Informatics. ISSN 2058-4555. 24(1), p. 134–134. Full text in Research Archive
• Smaradottir, Berglind; Martinez, Santiago & Fensli, Rune Werner (2017). User-centred Design of E-health Technology for Patients and Professionals in Productive Teams-Multidisciplinary Work across Organisational Borders. Full text in Research Archive
• Smaradottir, Berglind; Fensli, Rune Werner; Boysen, Elin Sundby & Martinez, Santiago (2017). Infrastructure for Health Care Simulation: Recommendations from the Model for Telecare Alarm Services Project. Full text in Research Archive
• Leifson, Ragni MacQueen & Fensli, Rune Werner (2016). Telemedisinsk oppfølging av KOLS-pasienter. Full text in Research Archive
• Fensli, Rune Werner; Boysen, Elin Sundby & Svagård, Ingrid Storruste (2016). Evaluation of Organizational Models for Response Centres for Telecare Services of the Future. Full text in Research Archive
• Fensli, Rune Werner (2016). eHealth in Disaster e-health Telehealth and User-centered Design Standardization and challenges. Full text in Research Archive
• Fensli, Rune Werner (2016). Senter for eHelse og arbeidet med European Innovation Partnership (EIP-AHA). Full text in Research Archive
• Fensli, Rune Werner (2016). Agders satsing på European Innovation Partnership, EIP-AHA. Full text in Research Archive
• Fensli, Rune Werner (2016). Innføringskurs i forskningsmetodikk innen eHelse. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2016). User-centred Design of Health Information Technology. International Journal of Integrated Care (IJIC). 16(5). doi: 10.5334/ijic.2587. Full text in Research Archive
• Smaradottir, Berglind & Fensli, Rune Werner (2016). User-centred Design of Health Information Technology. Full text in Research Archive
• Smaradottir, Berglind; Martinez, Santiago; Holen-Rabbersvik, Elisabeth; Vatnøy, Torunn Kitty & Fensli, Rune Werner (2016). Usability Evaluation of a Collaborative Health Information System- Lessons from a User-centred Design Process. Full text in Research Archive
• Smaradottir, Berglind; Gerdes, Martin; Martinez, Santiago & Fensli, Rune Werner (2015). The EU-project United4Health: User-Centred Design and Evaluation of a Collaborative Information System for a Norwegian Telehealth Service. Full text in Research Archive
• Fensli, Rune Werner (2015). eHelse trender og forskningsprosjekter på Agder. Full text in Research Archive
• Fensli, Rune Werner (2015). Home2Health Living Lab Konseptuell ide. Full text in Research Archive
• Fensli, Rune Werner (2015). Fremtidens pasienter med Point-of-Care tjenester. Full text in Research Archive
• Fensli, Rune Werner (2015). eHelse fremtidstrender og markedsmuligheter. Full text in Research Archive
• Gerdes, Martin; Smaradottir, Berglind; Reichert, Frank & Fensli, Rune Werner (2015). Telemedicine and Cooperative Remote Healthcare Services: COPD Field Trial. Full text in Research Archive
• Fensli, Rune Werner (2015). MTU og Cloud solutions er utfordrende løsninger, men har MTF noen rolle i disse skytjenestene når pasienten er hjemmeboende? Full text in Research Archive
• Fensli, Rune Werner (2015). Hvordan kan hjemmeboende pasienter e-samhandle med helse- og omsorgstjenestene og varsle om hjelp når det trengs. Full text in Research Archive
• Fensli, Rune Werner (2015). eHelse Innovasjon. Full text in Research Archive
• Fensli, Rune Werner (2015). eHelse for hjemmeboende pasienter Med teknologi-støtte fra Behandlingshjelpemidler. Full text in Research Archive
• Fensli, Rune Werner (2015). På hvilken måte kan pasienter/brukere ha nytte og glede av ny teknologi, og hvordan vil dette endre helsetjenestene i fremtiden? Full text in Research Archive
• Fensli, Rune Werner (2015). Behandlingshjelpemidler for bruk i telemedisin. Full text in Research Archive
• Fensli, Rune Werner (2015). UiA sitt arbeid knyttet til forskning og utdanning innen Telecare/Telehealth. Full text in Research Archive
• Gerdes, Martin; Reichert, Frank; Nytun, Jan Pettersen & Fensli, Rune Werner (2015). Future Telehealth and Telecare Reference Design based on IoT Technologies: From Remote Monitoring to Smart Collaborative Services with Decision Support. Full text in Research Archive
• Fensli, Rune Werner & Gallefoss, Frode (2015). Erfaringer fra prosjektet United4Health. Full text in Research Archive
• Fensli, Rune Werner (2015). Nye forskningsprosjekt innen eHelse på Agder. Full text in Research Archive
• Gerdes, Martin & Fensli, Rune Werner (2019). Holistic System Design for Distributed National eHealth Services. Universitetet i Agder. ISSN 9788271179229. Full text in Research Archive
• Fensli, Rune Werner; Smaradottir, Berglind & Boysen, Elin Sundby (2017). Inter-organisatoriske problemstillinger knyttet til etablering og drift av velferdsteknologi, telemedisin og responssenter tjenester. Prosjekt: Modell for Alarmmottak, M4ALMO Delrapport 3 – 2017. Universitetet i Agder. ISSN 9788282910095. Full text in Research Archive Show summary

  Denne rapporten er en sluttrapport fra FoU-prosjektet M4ALMO og gir en oppsummering av erfa-ringsinnhenting gjennom en serie workshops som er avholdt med representanter for brukere og tjenestene i de 10 kommunene som har deltatt in prosjektet. Det belyses viktige deler av prosedy-rer og samarbeid mellom de kommunale pleie- og omsorgstjenester og responssenter tjenester som organiseres på interkommunal basis. Det er viktig med strukturert informasjonsflyt og god sammenheng i tjenestetilbudet. Rutiner for kvalitetssikring av tjenestene må innarbeides. Det er utarbeidet forslag til prosedyrer for behovskartlegging og vedtak om teknologiske tiltak, der også involvering av pårørende og frivillige tjenester kan være viktige elementer ved praktisk bistand og oppfølging. En oppsummering av erfaringer fra prosjektet kan danne grunnlag for videre utvikling av tjenestene.

• Berntsen, Gro Karine Rosvold; Strisland, Frode; Rotvold, Gunn-Hilde; Reitan, Jarl; Røhne, Mette & Pedersen, Rune [Show all 9 contributors for this article] (2016). Forskningsprotokoll -VerDig Verdiskapende Digitale Samhandlingsløsninger for Pasientens helsetjeneste. Nasjonalt senter for e-helseforskning. ISSN 9788282420679. Full text in Research Archive
• Svagård, Ingrid Storruste; Boysen, Elin Sundby; Fensli, Rune Werner & Vatnøy, Torunn Kitty (2016). Responssentertjenester i helse og omsorgstjenesten: behov og fremtidsbilder. Delrapport 1- 2016 fra prosjektet M4ALMO. SINTEF Digital. ISSN 9788214059342. Full text in Research Archive Show summary

  Rapporten er en delleveranse fra RFF-prosjektet "M4ALMO - Modeller for alarmmottak". Rapporten sammenfatter funn og dokumentere kunnskap som er utviklet gjennom en serie workshops i prosjektet avholdt høsten 2015 og våren 2016. Målet har vært å kartlegge dagens utfordringer, fange ulike synspunkter og identifisere målbilder for fremtidens alarmmottak og organisering, samt diskutere nye mulige løsninger for organisering av responssentertjenester. Bidragsytere har vært representanter fra prosjektets kommunepartnere Skien, Larvik, Drammen, Oslo, Grimstad, Kristiansand, Risør og Kvinesdal på vegne av Lister-kommunene; leverandører av responssentertjenester SOS International og Telenor Object/Aleris, teknologileverandør og prosjektpartner Imatis samt forskningspartnerne Universitetet i Agder og SINTEF. Det er lite tilgjengelig kunnskap om hvordan trygghetsalarmtjenesten faktisk fungerer i helse- og omsorgstjenestene i dag. Omfang og resultater av alarmer dokumenteres bare i liten grad, og faktisk og praktisk gjennomføring er i all hovedsak "taus kunnskap", kjent og delt kun innenfor hvert tjenestested. Rapporten bidrar dermed med et kvalitativt kunnskaps-grunnlag for fremtidige beslutninger vedrørende responssentertjenester, både på nasjonalt og kommunalt nivå. Oppdragsgiver: Regionale Forskningsfond

• Siqveland, Elisabeth S; Kilen, Elin; Ludvigsen, Ann-Elisabeth; Henriksen, Bjørnar; Brossamain, Thomas & Gudlaugsson, Gunnar [Show all 8 contributors for this article] (2016). Integrating Telemedicine Solutions with Electronic Health Records; Evaluation of Alternatives based on the Proposed Reference Architecture for Norway. Universitetet i Agder. ISSN 9788282910088. Full text in Research Archive Show summary

  This report studies the way forward for how a telemedicine solution can be integrated for exchange of data with an existing Electronic Health Record (EHR) system. The solution used an example for this report is based on a telemedicine solution for COPD patients (Chronic Obstructive Pulmonary Disease) developed in the project “Collaborative Point-of-Care Services Agder: Follow-up of COPD patients as part of the United4Health EU Project», with financial support from the Research Council of Norway. In addition, the EHR solution from DIPS ASA is used as an example of an existing system for integration. Important parameters for choosing way forward on how to are: • urgency with regards to timeline • level of structuring of the data. • compliance with the reference architecture proposed by the Norwegian Directorate of eHealth (NDE) Three alternative ways forward are discussed in this report, based on four different scenarios with their respectively defined use-cases. Possibilities of integration exists already today which may support one of the use cases in the simplest way, but may not be a futureproof solution regarding functionality and recommended standards. Such a solution is supported by DIPS Classic as well as DIPS Arena by using HL7 V3 interface in DIPS. The journal data may be stored in an unstructured way as a PDF document in a patients EHR. To send structured data from a Telemedicine System to an EHR will be the preferred way for the future, and will support several use cases in a more efficient way. This will require more work in total and is dependent on other parties (external storage, DIPS etc) for building infrastructure and new interfaces. Such solutions will still be of high interest in the future. This report describes two different scenarios for how such solutions can be implemented in the future using either external storage and XDS.b or using FHIR/OpenEHR. Which of these alternatives that will be the leading standard or best practice is hard to predict, since it will highly depend on how the user requirements from the health care market will request such solutions, and how the standardization requirements from National authorities evolves in the next years. In addition, it depends on how the developers/vendors of both telemedicine solutions and EHR-systems will responds to these requirements.

• Smaradottir, Berglind; Fensli, Rune Werner & Oleshchuk, Vladimir (2016). User-centred Design and Evaluation of Health Information Technology : Doctoral Dissertation for the Degree Philosophiae Doctor (PhD) in Information and Communication Technology. Universitetet i Agder. ISSN 9788271178307. Full text in Research Archive

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