Month: August 2025

Från läkemedelsexperter till systemnavigatörer – kliniska apotekares utmaningar med journalsystem

Elektroniska journalsystem har förändrat sjukvården i grunden. De gör det möjligt att hantera stora mängder information, minska risker och skapa bättre överblick. Men för många yrkesgrupper innebär de också nya roller och arbetsuppgifter. En av de yrkesgrupper som påverkas mest är de kliniska apotekarna – de experter som arbetar för att säkerställa att läkemedelsanvändningen på sjukhus är säker och korrekt.

En ny studie av Celina Sving och Åsa Cajander vid Uppsala universitet visar hur kliniska apotekare på ett svenskt universitetssjukhus upplever arbetet med elektroniska journalsystem (EHR). Studien bygger på intervjuer och visar både på utmaningar och möjligheter.

Tre centrala utmaningar

  1. Komplexa ordinationer – Att hantera doseringsscheman och specialfall i journalsystemet är ofta tekniskt krångligt. Detta leder ibland till att läkemedelsordinationer skrivs in som fritext, vilket ökar risken för missförstånd.
  2. Bristfälligt beslutsstöd – Systemets varningar tar inte alltid hänsyn till patientens hela situation, vilket gör att många av dem blir irrelevanta eller ignoreras.
  3. Fragmenterad information – Viktig läkemedelsdata finns utspridd i flera system som inte alltid synkar med varandra, exempelvis mellan journalsystem och nationella databaser. Detta gör att apotekarna får ägna tid åt ”detektivarbete” för att skapa sig en helhetsbild.

Men det finns också möjligheter

Trots problemen framträder också flera positiva aspekter:

  • Säkerhetsfunktioner som interaktionskontroller och mallar hjälper till att förhindra misstag.
  • Samarbete med läkare stärks när apotekarna, tack vare sin systemkunskap, kan fungera som stöd och ibland ”superanvändare”.
  • Utökade rättigheter i systemen gör att apotekare själva kan justera ordinationer i vissa fall, vilket sparar tid och minskar belastningen på läkarna.

En ny roll i vården

Studien visar att kliniska apotekare i praktiken har gått från att vara rena läkemedelsexperter till att också bli systemnavigatörer. De hanterar inte bara medicinska frågor, utan kompenserar även för systemens brister. Detta ger dem en central roll för patientsäkerheten – men det är också ett tecken på att journalsystemen behöver utvecklas.

Slutsats

För att bättre stödja vårdens arbete behöver journalsystemen designas med apotekarnas erfarenheter och arbetsflöden i åtanke. Om systemen blir mer intuitiva och bättre integrerade kan apotekarna i högre grad ägna sig åt det de är bäst på – att vara experter på läkemedel och bidra till en tryggare och mer effektiv vård.

The point of conferences: Eating local food and discussing existential doomsday scenarios(?)

Going to conferences are always interesting experiences, and as with any endeavour I think it’s important to ask oneself what the point of doing it is. Attending HCII in Gothenburg [1] gave me the possibility to meet up with friends and family, attending ARPPID in London [2] gave me the possibility to acquire some top-notch cookies, and there are not really that many culinary experiences that reaches the hights of fish and chips or halv special med pucko.

Halv special med Pucko – the point of going to a conference in Gothenburg?

Despite the personal advantages when travelling for work, the point is still to work, to present ideas, to gather ideas, but the challenge remains to put these ideas into practice. At HCII, I presented our paper examining stakeholders’ views of potential future technologies at airports [3], while at ARPPID I presented our paper on the collaboration throughout our airport project TARA [4] [5]. During HCII, I also gathered notes and talked to people about improving my own research, new application possibilities at airports, AI in large organizations, AI in teaching, AI in design practice – many different perspectives that can be of use for our research.

And then what? An attempt to answer this question came in the form of ARPPID, where the focus was on papers about closing the gap between interaction design research and professional practice. One challenge I take with me is that it can be multiple and different steps, incentives, and definitions between researchers at universities, researchers in industry, designers, and people who are not designers, making discussions between the fields and roles difficult.

There were also articles and presentations focusing on the misunderstanding of HCI methods, which is somewhat ironic since a core idea of HCI that I’ve taken with me is that systems should be easy to use, and therefore a big part of the responsibility of how the technology is used should be on the designer. This idea should naturally translate to usability and HCI concepts as well, which of course is easier said than done. This taps into the central issue of having common language between academia and industry, which our paper largely is about. Maybe it’s not that important to be academically correct all the time, and letting go of the prestige around that our well-defined and (hopefully) well-cited concepts are being bastardized could be more pragmatic in settings when collaboration with people who are not in research is being established.

What does it mean?!

A more long-term perspective on the question “and then what?” was also discussed in ARPPID, mostly during a panel about the future of HCI in a world of (more) AI. A very interesting part of this discussion were the points that there are a lot of negative consequences that HCI research and practice have led to (one thought – the book The Anxious Generation [6]). P(doom) numbers [7] were discussed, some saying 100, some saying 0 – as well as solutions how to mitigate the challenges that potential existentially threatening technologies, like AI, can pose. However, I do believe that despite the best of intentions there is always a risk that the methods, technologies, and ideas will be bastardized or fill a purpose that was never the intent of the developer.

What I take with me from these conferences are therefore three questions: Who are the users (of the methods or technology etc.)? What is a metric of success? What are the trade-offs?

These questions will have different answers for different people, and the focus may, depending on the person, vary between better collaborations, better research, or managing of existentially catastrophic outcomes. This makes us come back to the original question: what is the point – of going to conferences, gathering ideas, developing methods, or creating technologies? The choice is (still, maybe, kind of, not really, never was) up to us (designers, researchers, practitioners, and other stakeholders and concerned citizens of the world).

References:

[1]: HCI International 2025

[2]: Academic Research and Professional Practice in Interaction Design 2025 – ARPPID 2025

[3]: Exploring the Future of AI, Autonomous Vehicles, and Emerging Technologies in Airport Operations: Stakeholder Perspectives | SpringerLink

[4]: Coming soon.

[5]: https://hto.blog.uu.se/current-research-projects/

[6]: The Anxious Generation – Free the Anxious Generation

[7]: P(doom) – Wikipedia

When Presence Isn’t Physical: Understanding Remote Situatedness in Train Traffic Control Work

In a new publication, my colleague Jessica Lindblom and I explore the work of train traffic controllers and information officers working in Sweden’s train traffic control centers to shed light on how they manage to monitor and control this complex, fast-moving railway system without ever stepping foot on the tracks.

Control rooms are often described as the coordination centre, the hub, of critical systems like aviation, shipping, and railway traffic. The atmosphere in such control rooms is often calm and the concentration is almost tangible. The space is filled with computer screens and the constant noise from ringing phones and low-voiced conversations. In Swedish train traffic, two main work roles are keeping things running. These are the traffic controllers and the information officers. The former ensure that trains move safely and on time by controlling switches and signals along the rail, adjusting timetables, and solving problems when something goes wrong. The latter provides travelling information to passengers in cases of delays, disruptions, or platform changes, etc. Together, these two roles are managing thousands of trains across Sweden every single day. They don’t see the rails outside their windows, yet they know them as if they were standing right there. How can that be? To answer that question, we conducted workplace studies in Sweden’s eight traffic control centres over a time period of 2,5 years. During this time, we observed everything from daily work routines to the handling of accidents and extraordinary events, and discovered subtle and highly skilled ways in which the workers interpret and act on digital and analogue information of situations unfolding far from their own location.

Prior research offers concepts like “professional vision,” “situated seeing,” and “tool-mediated seeing” to explain how people use artifacts and experience to interpret their work environment. We combined these with the idea of “sense of place”, a concept we borrowed from environmental and geographical studies that emphasizes how people develop meaning and attachment to specific locations. From this theoretical standpoint, we propose a new concept: remote situatedness. This concept describes how control room workers can develop a deep, practical knowledge and a sense of connection to remote places, although they are not physically present at those locations. This ability allows them to “see” the railway, predict problems, and act in meaningful ways from a distance.

In the paper, we illustrate remote situatedness with three examples:
1. Mutually Enacted Situated Seeing – how traffic controllers and information officers jointly interpret and act on pieces of information about events along the rail.
2. Mediated Sense of Place – how technology and collaboration shape the workers’ connection to locations far from their own.
3. Failed Sense of Place – what happens when this connection breaks down, and how it affects railway operations.
In each of these three cases, we show that the workers’ expertise isn’t just technical but social, spatial, and deeply embedded in the context of railway operations. It’s an intricate mix of technology and human skill!

Our findings highlight that effective railway management depends on more than screens, software, and procedures. It relies on workers’ ability to connect with and interpret remote environments through a combination of technology, collaboration, and lived experience. By recognizing and supporting this remote situatedness, we can design better tools, improve training, and strengthen the resilience of the complex railway system.

For those who want to read more, the full publication can be found here