Telemedicine in primary health care is expected to address many of the issues currently challenging service delivery. However, the impact and effect will depend on who will use the new technology. ObjectiveThe objective of the study was to investigate differences between users and non-users of telemedicine integrated into traditional office-based primary health care. MethodsQuantitative registry-based population study in two regions in the southeast part of Sweden (n = 73,486), comparing users with non-users of telemedicine across the variables sex, age, socioeconomic status (SES), morbidity and health care seeking behaviour (HSB). Two study periods of six months were used (September 2019-February 2020 for Region & Ouml;sterg & ouml;tland, and September 2021-February 2022 for Region Kalmar County) to collect user data. A reference period of 36 months (September 2016-August 2019) was used, to collect data on HSB. ResultsUsers were more often women under the age of 60 and had higher morbidity (measured as resource utilisation) than non-users (p < .001). In contrast, no statistically significant differences were seen between the two groups regarding SES, measured as Care Need Index (CNI). Regarding HSB, a proxy measure (health record entries) showed more entries for users than non-users. ConclusionsOur findings suggest that users are more likely to be women and below the age of 60. Likewise, users also tend to have a greater need for health care services compared to non-users, and they seek health care more often compared to non-users. No differences regarding SES were found.

PurposePrevious research has identified associations between quality management and employee health. This study's purpose was to (1) examine those associations in a public healthcare organisation and (2) explore and describe the association between digitalisation and employee health.Design/methodology/approachAn online questionnaire including indices to measure quality management values, employee health and digitalisation was answered by 118 managers in Swedish public healthcare. Correlation analysis was used to analyse the data. Based on the survey results, 12 qualitative, in-depth interviews were conducted with healthcare managers.FindingsThe findings show that employee health is associated with quality management and digitalisation. Categories were defined to describe the managers' views of the relationship between digitalisation and health.Research limitations/implicationsCausality was not explicitly tested and cannot be assumed. However, the results strengthen the body of research showing that quality management is related to employee health, and associations between health and digitalisation were identified.Practical implicationsThe findings and model should be helpful for healthcare managers in a digitalising environment who aim to preserve or enhance employee health whilst ensuring high service quality.Originality/valueThe results were used to create an integrated conceptual model depicting the association between quality, digitalisation and health. This association has not previously been studied.

Purpose The purpose of this mixed-methods study was to explore how medical secretaries experience digital transformation in a Swedish healthcare organisation, with a focus on workplace climate and health.

Design/methodology/approach Data were collected using a sequential exploratory mixed-methods design based on grounded theory, with qualitative data collection (a Quality Caf & eacute; and individual interviews) followed by quantitative data collection (a questionnaire).

Findings Four categories with seven underlying factors were identified, emphasising the crucial need for effective organisation of digital transformation. This is vital due to the increased knowledge and skills in utilising technology. The evolving roles and responsibilities of medical secretaries in dynamic healthcare settings should be clearly defined and acknowledged, highlighting the importance of professionality. Ensuring proper training for medical secretaries and other occupations in emerging techniques is crucial, emphasising equal value and knowledge across each role. Associations were found between some factors and the health of medical secretaries.

Research limitations/implications This study adds to the knowledge on digital transformation in healthcare by examining an important occupation. Most data were collected online, which may be a limitation of this study.Practical implicationsSeveral aspects of the medical secretaries' experiences were identified. Knowledge of these is valuable for healthcare managers to make digital transformation more effective while avoiding excessive strain on medical secretaries.

Originality/value Medical secretaries are expected to contribute to the digitalisation of healthcare. However, minimal research has been conducted on the role of medical secretaries in workplace digitalisation, focusing on workplace roles and its dynamics.

För att möta dagens och morgondagens samhällsutmaningar krävs kunskap ur ett bredare och större perspektiv. På Linnéuniversitetet samlar vi därför framstående forskning, utbildning och samverkan i något vi kallar kunskapsmiljöer. Våra kunskapsmiljöer är tvärvetenskapliga för att ta ett mångsidigt grepp om utmaningarna.

Inom kunskapsmiljön Hållbar hälsa arbetar vi för att främja hälsa och välbefinnande för alla människor i alla åldrar. Några av de utmaningar som vi tar oss an är:

·        Demografiska förändringar

·        Ändrade mönster för funktionshinder och sjukdomar

·        Traumatiska händelser 

·        Brist på delaktighet 

·        Organisatoriska utmaningar

Men med en åldrande befolkning och fler personer som lever länge med kroniska sjukdomar både ökar och förändras vårdbehoven samtidigt. Dessa faktorer, tillsammans med ökad migration, globalisering samt förändrade behov av hälsovård, är de demografiska utmaningar vi behöver inrikta oss mot. De förändringar i livsstilar som vi ser idag, till exempel näringsbrist på grund av mindre hälsosamma matvanor och en ökande psykisk ohälsa måste också adresseras. 

Den digitala utvecklingen ger oss helt nya möjligheter till en mer effektiv global hälsovård. Men även här finns utmaningar; ökad digitalisering kan leda till att människor stängs ute på grund av att de saknar kompetens eller den digitala utrustningen som krävs.

För att svara upp mot dessa utmaningar arbetar vi inom kunskapsmiljön brett med forskning, utbildning och samverkan inom en rad olika forskningsområden såsom:

·        e-Hälsa 

·        Palliativ vård 

·        Livsmedelsvetenskap

·        Ögon, syn och optometri

·        Humaniora, hälsa och medicin

·        Åldrande och handikapp

Vanligtvis kommunicerar vi i kunskapsmiljön vår forskning genom artiklar i vetenskapliga tidskrifter, på konferenser eller genom pressmeddelande till media. Denna bok tar ett annorlunda grepp och använder konstens metoder för att illustrera kunskapsmiljöns arbete. Boken har kommit till genom ett samarbete med Det kulturella universitetet som arbetar med att koppla samman konst och vetenskap för en fördjupad förståelse av komplex komplexa och ibland motsägelsefulla förhållanden

Collaboration between various stakeholders is crucial for healthcare digitalisation and eHealth utilisation. Given that valuable outcomes can emerge from collaborative interactions among multiple stakeholders, exploring a quadruple helix (QH) approach to collaboration may be fruitful in involving the public sector, business, citizens, and academia. Therefore, this study aimed to explore stakeholder views on eHealth collaboration from a QH perspective using the grounded theory methodology. First, an inductive qualitative study involving all stakeholders in the QH was conducted. Subsequently, the findings were related to the actor-resource-activity (ARA) model of business relationships. The results emphasise the role of considering diverse perspectives on collaboration because digitalisation and eHealth require teamwork to benefit the end users within various settings. A model depicting the various aspects of the ARA model related to digitalisation in a healthcare QH setting is presented.

Our article is based on the diaries of Joseph Stephens, a 19th century Swedish railway contractor in British India. The Stephens' diaries, discovered in 2008, are the only one of their kind, offering an insight into the life of a railway contractor from that era. The diaries reveal a web of networks and relationships that helped Stephens achieve success as a small-scale railway contractor. We use the theoretical lens of Gummesson's entrepreneurial relationship marketing to analyse Stephens' network of social and work relationships and find a connection between his networks and Gummesson's framework. We contribute to literature by presenting a different perspective on railway contractors from that period and propose that business practices of the past can be studied vis-a-vis contemporary theories of entrepreneurship and marketing.

Objective The objective of the study was to explore the experiences of healthcare staff working with and being part of the implementation of a digital platform for patient-provider consultation across quality dimensions of access, efficiency, and patient safety. Design The study uses qualitative design to investigate experiences and the views of healthcare professionals. Data collection combined semi-structured individual and focus-group interviews. Content analysis was used to identify categories within the content areas 'access', 'efficiency', and 'patient safety'. Setting The basis for the study was an e-consultation platform introduced in three primary healthcare centres in the County of Kalmar in southeast Sweden in 2019. Results Healthcare staff experienced that the platform offered an open channel for communication with patients in need of frequent contact. This reduced anxiety and therefore the frequency of follow-up appointments. Healthcare staff also noted that the platform offered flexibility in contact benefitting patients with mental health problems. These patients were found to make contact through the platform after closing hours when problems were more acute or intense. However, the risk of digitally illiterate groups being excluded was also noted. Efficiency gains were identified among patients with simple cases which were handled more quickly through the platform. However, low uptake and the experience that the platform did not replace, rather was added on top of other already existing functions and procedures, negatively affected the overall efficiency. Standardized questions in automated medical history-taking contributed to patient safety. Conclusion The findings suggest that text-based e-consultation platforms may bring important quality improvements to primary healthcare service in terms of access, efficiency, and patient safety. Yet, areas where e-consultation does not contribute to quality improvements puts important quality gains at risk.

Many factors contribute to increasing the need for innovation in healthcare. Global demographic developments with falling birth rates and increasing lifespan mean that the proportion of elderly in society is expected to increase dramatically in all developed countries. Moreover, continuous scientific advances afford possibilities for higher effectiveness in healthcare processes. Innovation can and does take place in the form of medical discoveries which enhance the efficiency of treatments or in the form of technological advances, for instance, in ehealth, which provide increased options for healthcare delivery. However, innovation can also be of an organisational nature since healthcare organisations are complex organisations with legal and ethical constraints that are difficult to manage effectively. Organisational innovation requires change processes of various kinds. The purpose of this paper is to explore success factors for innovative change processes in healthcare organisations. Change processes related to digitalisation are of particular interest. Qualitative methodology was chosen in order to gain a deeper understanding of the area and not to exclude aspects based on preconceptions. A multiple case study has been carried out. To achieve focus, the study population was limited to public hospitals in Sweden. Change processes, usually involving digitalisation, in seven hospitals of various sizes have been studied. Individual qualitative interviews were chosen as the method of data collection. Between two and nine interviews were conducted, giving a total of forty interviews. The respondents were people who had participated in the change processes, mainly nurses, physicians, and administrative staff, some of whom had managerial positions on lower levels. The data from the interviews were analysed using the constant comparative method from the grounded theory approach. The analysis yielded a number of categories depicting success factors under different conditions. A framework was constructed depicting the factors and their internal relationships. The categories and the framework should be valuable for managers of healthcare organisations as well as for increasing the conceptual understanding of the field.

Stress and bullying create severe pressure on workplace health. Although the connection between quality management and health is beginning to be well established, the association to workplace stress and workplace bullying has not been previously studied. The purpose of the paper is to examine associations between quality management values, workplace health and workplace stress. A questionnaire based on theory and previous research was constructed and delivered to a sample of Swedish secondary school teachers. The questionnaire included previously developed constructs of quality management values and workplace health. In addition, constructs measuring stress, demand, control and bullying were included. Correlation analyses and cluster analysis were carried out. The findings confirm the connection between quality management and workplace health that previous research has identified. In addition, the results indicate that quality management can increase the level of control that the employees have over their work situation, thereby alleviating some of the effects of workplace stress. Furthermore, the results show an association between quality management and workplace bullying. Moreover, control but not demand was found to be related to workplace health. Four clusters of employees with different quality management, stress and health profiles were identified.

Hälsa och kvalitet i arbetslivet ger en heltäckande belysning av hälsa i arbetslivet och dess koppling till kvalitet. Boken utgår från ett bredare perspektiv än andra böcker inom arbetsrelaterad hälsa.

Organisatoriska och fysiologiska aspekter på arbetsrelaterad hälsa täcks i boken på ett konkret och praktiskt sätt, både från individens och ledningens perspektiv. Ergonomi, kost, hjärnfunktion och träning vävs samman med hälsopromotion, organisatoriskt lärande, ledar­skap och kvalitetsutveckling till en helhetsbild av hur arbetslivet kan bli en källa till hälsa.

Hälsa och kvalitet i arbetslivet riktar sig till studenter på utbildningar inom hälsovetenskap, hälsopedagogik samt personal- och arbetsmiljövetenskap. Boken lämpar sig även för grund- och påbyggnads­utbildningar inom ledarskap och är en utmärkt vägledning för alla som vill förbättra hälsan i arbetslivet – för sin organisation eller för egen del.