title: Development and implementation of IT require focus on user participation, acceptance and workflow.
abstract: The study "Online Care" follows a municipal project "Online Welfare" where a nurse's presence in the citizen's own home was replaced by online communication. The paper is based on a citizen's perspective and seeks to develop meaningful workflow for the benefit of citizens with medical problems. The study examines five citizens' opinions on whether online communication in a meaningful way supports the citizens in what they associate with a good life. In addition, relatives and the citizen's nurse were interviewed individually concerning the same issues as the citizens. The study has been approved by the Danish System of Ethics in Science and is conducted in collaboration with Aalborg University, Aalborg Municipality and DanAge, (NGO). The municipality's goal of efficiency and financial savings regarding "Online Welfare" was not honored due to insufficient network infrastructure and technical problems. An adoption barrier was that the municipality did not determine the efforts and the goal of the project, who could benefit from participating and the requirements of the professionals and the organization including ethical considerations.It was difficult to find citizens who were willing to participate. Citizens, who were included in the study accepted and adopted the technology however, "Online Welfare" could not replace the care they used to receive. Therefore, the offer was perceived as an "appendix" which tended to meaninglessness by some of the citizens.The nurses' perception of nursing care and their limited IT skills was a barrier to acceptance, adoption and development of technology opportunities in nursing. The citizens' disability, the screen appearance, and the technology setup meant that the citizens perceived poor usability of the equipment. The study showed a change in workflow, as the cooperation between the citizen and the professional developed. New roles occurred for the professionals.The citizens had many ideas concerning the development of the technology and the study recommends that users are involved in the development and implementation of welfare technology and telemedicine. The relatively small sample size of the study shows findings that must be clarified by further research.
authors.affiliation: Department of Nursing, University College of Northern Denmark.
authors.forename: Ina Koldkjær
authors.initials: IK
authors.lastname: Sølling
authors.affiliation: Department of Nursing, University College of Northern Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Carøe
authors.affiliation: Department of Nursing, University College of Northern Denmark.
authors.forename: Kirsten Siggaard
authors.initials: KS
authors.lastname: Mathiesen
mesh_terms: D001291:Attitude of Health Personnel; D003718:Denmark; D020407:Internet; D062527:Meaningful Use / Q000706:statistics & numerical data; D009726:Nurses / Q000706:statistics & numerical data*; D009862:Online Systems; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D013685:Telecommunications / Q000706:statistics & numerical data*; D017216:Telemedicine / Q000706:statistics & numerical data*; D057188:Workflow; D016526:Workload / Q000706:statistics & numerical data