title: Patient perceptions of a Virtual Health Room installation in rural Sweden.
abstract: The Virtual Health Room (VHR) is an ehealth initiative in the village of Slussfors in northern Sweden. Construction of VHRs in other locations is taking place, and the Centre for Rural Medicine in the Västerbotten County Council primary care department has implemented a VHR evaluation framework. This research focuses on evaluation of patient perceptions of the usability of the VHR and its contribution to their health care.
  
  
  
  Nineteen of the 25 unique users of the VHR during 2014/15 completed a survey asking about their attitudes to their own health (using the 13-question version of the Patient Activation Measure (PAM)), their demographic attributes, and their satisfaction with their visit to the VHR.
  
  
  
  Respondents with lower PAM scores were less satisfied with the technical performance of the VHR, but equally likely to think the VHR made a good contribution to access to health care. In contrast, older patients were less likely to value the contribution of the VHR, but no less likely to be satisfied with its technical performance. There were no relationships between level of education and distance travelled and perceptions of the VHR.
  
  
  
  The research clearly demonstrated the distinction between technical performance of an ehealth initiative and its overall contribution to health care and access. Evaluation frameworks need to consider both aspects of performance. Transferability of these findings to other settings may depend at least in part on the nature of the catchment area for the VHR, with the Slussfors catchment being quite small and the impact of distance on access consequently limited.
authors.affiliation: School of Family Medicine, Umeå University, Storuman, Sweden. simon.w.eriksson@gmail.com.
authors.forename: Simon
authors.initials: S
authors.lastname: Näverlo
authors.affiliation: Charles Darwin University, Darwin, Northern Territory, Australia. dean.carson@umu.se.
authors.forename: Dean B
authors.initials: DB
authors.lastname: Carson
authors.affiliation: Västerbotten Läns Landsting, Storuman, Sweden.. anette.liljegren@vll.se.
authors.forename: Anette
authors.initials: A
authors.lastname: Edin-Liljegren
authors.affiliation: Royal Institute of Technology, Stockholm, Sweden. mirjam.ekstedt@ki.se.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Ekstedt
mesh_terms: D003194:Computer-Assisted Instruction / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013548:Sweden; D017216:Telemedicine / Q000458:organization & administration*
keywords: Consumer perspectives; Europe; Medical; Primary Health Care; Public Health; Qualitative Research; Researcher