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Background and motivation

The public sector is faced with the challenges of an ageing population, patients with chronic conditions and complex healthcare needs including mental health issues, immigration, and restricted resources to address future healthcare challenges. An enhanced digitalization of health and healthcare has been highlighted as an important remedy to these challenges and as a transformational force within healthcare. In Sweden, key organizers in healthcare thus describe the planned development and deployment of e-health as a paradigm shift that will enable patients to have increased access to and influence over their health situation by emphasizing “patient authorization”, “patient transparency” and “patient empowerment”. At the same time, it is believed that e-health will increase efficiency and many see it as a panacea for the impending shortage of healthcare resources. On an international level, e-health is viewed as the largest wave of change in healthcare since New Public Management between 1980 and 2000, and as a part of the new era of “e-government”.

E-health strategies, on the EU level and national level in Sweden, concern primarily public sector services while the private market is being flooded with health apps and “gadgets” such as Fitbit, which we also define as e-health. These body media and consumer products are aimed at the individual for monitoring, documenting and processing information about sleep, nutrition, exercise and even medical conditions. New digital providers, like Min Doktor and Kry, as well as the development of home screening methods are also changing the landscape in healthcare, blurring the boundaries between public and private sector services and redefining time, space and forms for when, where, by whom and how care can be performed and delivered. Other examples of areas where e-health development is changing practice and/or communication are: advanced care in the home environment of care recipients, assistant robots for elderly people, mobile healthcare information, booking online, remote monitoring of patients and health conditions, electronic support systems for healthcare professionals and even cognitive treatment through the Internet along with patient online access to their health records. Additionally, e-health is seen as an important means for health promotion and a key ingredient in the increasing portion of healthcare that is performed in care recipients’ homes.

Albeit e-health entails opportunities for enhanced efficiency and improvement in healthcare, its capabilities are far from being fully utilized. There is a large untapped potential in e-health development, and in March 2016, the Swedish Government and the Swedish Association of Local Authorities and Regions together decided on a new e-health vision for healthcare and social services. The vision, Vision e-health 2025, states that by 2025 Sweden will be world-leading in using digitalization to promote equity in healthcare and social services. In the beginning of 2017 Region Skåne, in turn, formulated its vision to become the best region in Sweden in e-health.

These visions indicate the ambitions of the Swedish authorities and Region Skåne regarding e-health development and of an even larger focus and allocation of resources to accelerate the pace of digitalization over the next ten years. In the Effective Care Report, the Government’s investigator also concluded that the number of inpatients must be reduced; that care should be directed to primary care and care at home; and that increased digitalization in healthcare is key in achieving these goals. The high degree of digitalization and use of media technology in Sweden also paves the way for this development.

Considering the aim and ambition of the Swedish Government, authorities and Region Skåne regarding e-health development and digitalization over the next ten years, it is not only very important but also a unique opportunity for researchers at Lund University to participate and have a considerable impact on this vast digital transformation of wellness health and healthcare.