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; 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
• 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 & 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 conference proceedings. ISSN 978-1-7281-5584-5. p. 961–965. doi: 10.1109/CSCI49370.2019.00182. 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 conference proceedings. ISSN 978-1-7281-2999-0. p. 1077–1080. doi: 10.1109/ISCC47284.2019.8969693. Full text in Research Archive
• Smaradottir, Berglind; Sjaavaag, Ståle; Naley Ås, Inger-Alice; 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 978-91-7929-957-6. p. 87–92.
• 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 & 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
• 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. ISSN 1438-8871. 21(4). doi: 10.2196/12517. Full text in Research Archive
• 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 & Moe, Carl Erik (2018). Recommendations of a Laboratory Infrastructure for Simulation of Telemedicine Services, 2018 IEEE Symposium on Computers and Communications (ISCC) . IEEE conference proceedings. ISSN 9781538669501. doi: 10.1109/ISCC.2018.8538493. 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.

• 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. ISSN 1472-6947. 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. ISSN 1472-6963. 18(805), p. 1–13. doi: 10.1186/s12913-018-3586-8. Full text in Research Archive
• 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.
• 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 1-60132-479-0. 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.

• 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 & 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 & Fensli, Rune Werner (2018). Point of Care Solutions: Implementation of Sustainable Service Models. Studies in Health Technology and Informatics. ISSN 0926-9630. 250. 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.

• 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; Fensli, Rune Werner; Naley Ås, Inger-Alice & 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 978-1-5386-2652-8. p. 1779–1781. doi: 10.1109/CSCI.2017.311. 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. 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 978-91-7685-364-1. 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; 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.

• 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
• 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 1-60132-459-6. 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.
• 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 978-989-758-170-0. p. 306–313. doi: 10.5220/0005703603060313. 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.
• Gerdes, Martin; Reichert, Frank; Nytun, Jan Pettersen & Fensli, Rune Werner (2015). Reference Design for Smart Collaborative Telehealth and Telecare Services based on IoT Technologies. In Arabnia, Hamid R.; Deligiannidis, Leonidas & Tran, Qouc-Nam (Ed.), 2015 International Conference on Computational Science and Computational Intelligence. IEEE conference proceedings. ISSN 978-1-4673-9795-7. p. 817–820. doi: 10.1109/CSCI.2015.135.

View all works in Cristin

• Smaradottir, Berglind & Fensli, Rune Werner (2020). 3P-resultater fra arbeidspakke 6: Forskning på digitale løsninger.
• Smaradottir, Berglind & Fensli, Rune Werner (2020). The Research Project 3P: Results from the Evaluation of Digital Solutions for Patient-centred Care Teams (WP6).
• Smaradottir, Berglind & Fensli, Rune Werner (2019). A Case Study of Technology Use and Information Flow at a Danish E-clinic.
• Smaradottir, Berglind; Sjaavaag, Ståle; Naley Ås, Inger-Alice; 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.
• Smaradottir, Berglind & Fensli, Rune Werner (2019). The 3P-project: Evaluation of Telemedicine Solutions in Patient-centered Care Teams.
• Smaradottir, Berglind & Fensli, Rune Werner (2019). Patient Experiences and Digital Involvement in Patient-centred Care Models.
• Smaradottir, Berglind & Fensli, Rune Werner (2019). User Experiences and Satisfaction with an Electronic Health Record System.
• 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.
• Smaradottir, Berglind & Fensli, Rune Werner (2019). Evaluation of Technology Use in an Inter-disciplinary Patient-centered Health Care Team.
• 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.
• Smaradottir, Berglind & Fensli, Rune Werner (2018). Teknologistøtte og informasjonsflyt på innovasjonsarenaene-oppsummering fra feltbesøk i WP6.
• Bahus, Marianne & Fensli, Rune Werner (2018). Helseteknologi, juss og etikk .
• 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. 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; Eikeland, Randi; Reiso, Harald & Fensli, Rune Werner (2018). User-Centered Design of a National Medical Registry for Tick-Borne Diseases.
• Smaradottir, Berglind; Fensli, Rune Werner & Moe, Carl Erik (2018). Recommendations of a Laboratory Infrastructure for Simulation of Telemedicine Services.
• Smaradottir, Berglind & Fensli, Rune Werner (2018). Evaluation of a Telemedicine Service Run with a Patient-centred Care Model.
• Smaradottir, Berglind & Fensli, Rune Werner (2018). The Technology Use and Information Flow at a Municipal Telemedicine Service.
• Smaradottir, Berglind & Fensli, Rune Werner (2018). Point of Care Solutions: Implementation of Sustainable Service Models.
• Smaradottir, Berglind & Fensli, Rune Werner (2018). Integrasjon av en telemedisinsk sentral med kommunale helsetjenester, Erfaringer fra 3P-prosjektet.
• 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.
• 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.
• Smaradottir, Berglind; Fensli, Rune Werner; Naley Ås, Inger-Alice & Gallefoss, Frode (2017). Telemedicine follow up of Chronic Obstructive Pulmonary Disease Integrated into a Patient-centered Health Care Team Setting.
• Gerdes, Martin; Martinez, Santiago; Smaradottir, Berglind; Fensli, Rune Werner & Jortveit, Jarle (2017). Warfarin Guide: Co-design of a Mobile Computer-Assisted Anticoagulant Therapy.
• 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 .
• Smaradottir, Berglind & Fensli, Rune Werner (2017). Integrating Care Through Patient-Centred Health Team Working Across Organisational Borders.
• Smaradottir, Berglind & Fensli, Rune Werner (2017). A Case Study of the Technology Use and Information Flow at a Hospital-driven Telemedicine Service.
• 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.
• Karlsen, Tor-Ivar; Tveide, Marit Bolstad & Fensli, Rune Werner (2017). Factors affecting seniors' attitudes on the use of information technology.
• 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.
• 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.
• 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 .
• Aslaksen, Hildegunn Mellesmo & Fensli, Rune Werner (2016). Presentasjon av Agder Living Lab. [Internet]. Universitetet i Agder.
• Aslaksen, Hildegunn Mellesmo & Fensli, Rune Werner (2016). Presentation of Agder Living Lab. [Internet]. University of Agder.
• Fensli, Rune Werner (2016). Innføringskurs i forskningsmetodikk innen eHelse.
• Fensli, Rune Werner (2016). Agders satsing på European Innovation Partnership, EIP-AHA.
• Fensli, Rune Werner (2016). Senter for eHelse og arbeidet med European Innovation Partnership (EIP-AHA).
• Fensli, Rune Werner (2016). eHealth in Disaster e-health Telehealth and User-centered Design Standardization and challenges.
• Fensli, Rune Werner; Boysen, Elin Sundby & Svagård, Ingrid Storruste (2016). Evaluation of Organizational Models for Response Centres for Telecare Services of the Future.
• Smaradottir, Berglind & Fensli, Rune Werner (2016). User-centred Design of Health Information Technology.
• 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 .
• Smaradottir, Berglind & Fensli, Rune Werner (2016). User-centred Design of Health Information Technology. International Journal of Integrated Care (IJIC). ISSN 1568-4156. 16(5). doi: 10.5334/ijic.2587.
• Leifson, Ragni MacQueen & Fensli, Rune Werner (2016). Telemedisinsk oppfølging av KOLS-pasienter.
• 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. Studies in Health Technology and Informatics. ISSN 0926-9630. 216, p. 892–892. doi: 10.3233/978-1-61499-564-7-892.
• Gerdes, Martin; Reichert, Frank; Nytun, Jan Pettersen & Fensli, Rune Werner (2015). Future telehealth and telecare reference dDesign based on IoT technologies: from remote monitoring to smart collaborative services with decision support. Studies in Health Technology and Informatics. ISSN 0926-9630. 216, p. 891–891. doi: 10.3233/978-1-61499-564-7-891.
• 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.
• 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 approac .
• Smaradottir, Berglind; Håland, Jarle Audun; Martinez, Santiago; Somdal, Åsmund Rodvig & Fensli, Rune Werner (2015). Recommendations of a Test Infrastructure for Evaluation of Touchscreen Assistive Technology for Visually Impaired Users .
• Smaradottir, Berglind; Gerdes, Martin; Fensli, Rune Werner & Martinez, Santiago (2015). User Interface Development of a COPD Remote Monitoring Application- A User-centred Design Process.
• Smaradottir, Berglind; Gerdes, Martin; Fensli, Rune Werner & Martinez, Santiago (2015). Usability Evaluation of a COPD Remote Monitoring Application.
• Fensli, Rune Werner (2015). Fremtidens pasienter med Point-of-Care tjenester.
• Fensli, Rune Werner (2015). Behandlingshjelpemidler for bruk i telemedisin.
• Fensli, Rune Werner (2015). MTU og Cloud solutions er utfordrende løsninger, men har MTF noen rolle i disse skytjenestene når pasienten er hjemmeboende?
• Fensli, Rune Werner (2015). eHelse fremtidstrender og markedsmuligheter.
• Fensli, Rune Werner (2015). Nye forskningsprosjekt innen eHelse på Agder.
• Fensli, Rune Werner (2015). eHelse Innovasjon.
• Fensli, Rune Werner (2015). eHelse for hjemmeboende pasienter Med teknologi-støtte fra Behandlingshjelpemidler .
• 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?
• Fensli, Rune Werner & Gallefoss, Frode (2015). Erfaringer fra prosjektet United4Health.
• Fensli, Rune Werner (2015). UiA sitt arbeid knyttet til forskning og utdanning innen Telecare/Telehealth.
• Fensli, Rune Werner (2015). Hvordan kan hjemmeboende pasienter e-samhandle med helse- og omsorgstjenestene og varsle om hjelp når det trengs.
• Fensli, Rune Werner (2015). eHelse trender og forskningsprosjekter på Agder.
• Fensli, Rune Werner (2015). Home2Health Living Lab Konseptuell ide.
• Gerdes, Martin & Fensli, Rune Werner (2019). Holistic System Design for Distributed National eHealth Services. Universitetet i Agder. ISSN 978-82-7117-922-9. Full text in Research Archive Show summary

  The dynamic development of Information and Communication Technologies (ICT), Human-Computer-Interaction (HCI), Internet of Things (IoT) and Artificial Intelligence (AI), drive the ongoing Digital Revolution, that creates the ground for an Information Society. The Digital Age or Information Age affects all aspects of social organization, including particularly the health sector. eHealth systems and services utilizing information and communication technologies (ICT) have the potential to increase the efficiency of professional and informal caretakers when monitoring the healthcare status and assistance needs of patients and their relatives. Patients with chronic diseases and age related medical conditions receive support through technologies that allow them to live independently and securely with a high quality of life (QoL). Independent from the public health systems, further services and applications are emerging to promote individual fitness and wellness goals to maintain a healthy life style. This study covers the design, development and evaluation of a reference solution for integrated eHealth services and applications targeting remote monitoring and decision support in telehealth and telecare. The design of the proposed system is based on a holistic view, providing for the definition of Reference Requirements. Furthermore, the Reference Design as well as the development of a proof-of-concept trial system have followed a User Centered Design (UCD) process, involving all user groups in the trial system’s design and testing. The proposed solution seeks for the empowerment of citizens to carry out monitoring and self-assessment of their health and well-being over longer periods of time, and by that to contribute to their independence and self-management of health and wellness at their point-of-care. It includes an end-to-end eHealth system architecture, and outlines a solution to connect citizens’ point-of-care with formal and informal caregivers through a common, secure and reliable health information services infrastructure. The underlying reference requirements include functional, operational and socio-economic requirements, legal, ethical and regulatory policies, relevant emerging technologies, and interdependencies between the different requirement domains for its development and verification. The required logical functionalities, protocols for information exchange and graphical interfaces for user interaction have been implemented in a trial system, covering applications and services for monitored citizens, healthcare professionals, and for the health information service infrastructure. The components have been tested first in an academic test environment as part of the UCD process. Results have led to a successful deployment and integration of the system in the Norwegian Health Network for a 2-year-field trial, including more than 100 patients with Chronic Obstructive Pulmonary Disease (COPD), a municipality-operated telehealth service and medical specialists in a hospital. The validation of the proposed reference design considers aspects of the design methodology, the reference requirements and their elicitation methodology, the acceptance of the proposed solution by the different user groups, and the quality of the support provided to the healthcare professionals. The UCD process has implicitly been validated, as it was utilized in the system development from the initial design to the routine operation of the trial system. The evaluation of some important performance indicators (interoperability, cooperation aspects and applicability of standards for the information exchange through communication protocols between the different system domains; security and access control technologies; the accuracy of the automatic healthcare status assessment; potential advantages and efficiency gains achievable through the evaluation of continuous remote monitoring data; usability and user acceptance) ...

• 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 978-82-8291-009-5. 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.

• 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 978-82-8291-008-8. 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.

• 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 978-82-8242-067-9.
• 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, Fakultet for teknologi og realfag. ISSN 978-82-7117-830-7. Full text in Research Archive Show summary

  Health information technologies play an important role in exchange of information and coordination of continuity of care in health care services. This thesis explores the approach of user-centred design and evaluation in the development of health information technology, with the main research focus on end-user involvement. A study on user-centred design and evaluation in the externally funded research projects United4Health and eHealth- extended Care Coordination was conducted. In addition, the internal project Visually impaired users touching the screen - A user evaluation evaluated visually impaired users using mobile technology. In the EU project United4Health, a collaborative telemedicine system for remote monitoring of chronic obstructive pulmonary disease patients was developed. The regional project eHealth- extended Care Coordination addressed the information flow within inter-municipal health care teams to build a collaborative information system that facilitated coordination between municipalities. In both projects, end-users were involved in workshops in an early design phase and participated in usability evaluations during the iterative development. A mixed methods research approach including observations, semi-structured interviews and a questionnaire was used for data collection in the user-centred design process. The data analysis was based on a qualitative content analysis from a human-computer interaction perspective. This thesis also addresses the topic of the usability evaluation of health information technology from the perspective of the technical infrastructure necessary for optimisation of data collection and retrospective analysis of data. In this regard, a usability evaluation of a mobile touchscreen together with visually impaired users was made. The results from the user-centred design and evaluation research are presented in this dissertation through a collection of 9 scientific published papers in international peer-reviewed journals and conference proceedings. This study contributes to the knowledge of user-centred design in several ways. Firstly, this thesis provides an understanding on how to actively and efficiently involve users in design and development of health information technology by conducting empirical research. Secondly, it contributes to the knowledge on how to run usability evaluations of health information technology in high fidelity laboratory settings, health care environment and patients’ homes. Thirdly, it provides recommendations for a technical infrastructure in order to optimise the outcome of usability evaluations. The Norwegian Social Science Data Services approved the studies presented here.

• 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. 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

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