Join us for a PhD thesis defence of Lilja Guðrún Jóhannsdóttir on her thesis Ensuring Patient Safety through Digital Health Technologies.

Defence committee:

Main Supervisor: 

• Anna Sigríður Islind, Associate Professor, Department of Computer Science, Reykjavik University, Iceland.

Co-Supervisor: 

• María Óskarsdóttir, Associate Professor, Department of Computer Science, Reykjavik University, Iceland & School of Mathematical Sciences, University of Southampton, United Kingdom.

Committee members: 

• Berglind Guðmundsdóttir, Professor, Department of Medicine, University of Iceland.
• Marta Kristín Lárusdóttir, Professor, Department of Computer Science, Reykjavik University.

Examiner:

• Daniel Fürstenau, Professor at Freie Universität Berlin, Germany. 

Master of ceremony:  Luca Aceto

Abstract

Patient safety is a core objective in healthcare, aiming to minimize risks, prevent avoidable harm, reduce errors, and mitigate the impact of adverse events. While some errors are easily identifiable, others require retrospective analysis to determine their consequences for specific patient groups. Patient safety is often discussed alongside quality of care, as both involve reducing harm and improving healthcare outcomes. Beyond being a fundamental goal, patient safety is a discipline that applies safety science to healthcare delivery. Safety science integrates engineering, psychology, human factors, risk management, and organizational behavior to improve systems, technologies, and human behavior, ultimately enhancing safety and reducing hazards. 

This thesis explores how digital health technologies can enhance patient safety, focusing on the National Hospital of Iceland’s digital health platform. The platform includes web and mobile applications for healthcare professionals and patients, integrating third-party solutions to modernize healthcare, streamline workflows, and improve access to patient data. A co-design approach involving healthcare professionals and patients has been used in its development, ensuring user needs are addressed. The effectiveness of medical treatments relies heavily on human behavior. The decision-making of both healthcare professionals and patients can be influenced by their environments, and even minor changes in how information is presented can significantly affect these user groups’ behavior. The concept, known as “choice architecture,” includes the use of “nudges” to guide decisions without restricting options. In healthcare, framing user interface design choices, such as physician recommendations for vaccines or default settings in electronic health records for prescriptions, can greatly impact treatment choices. As healthcare becomes increasingly digital, digital nudging offers a valuable tool for improving patient safety. 

This thesis examines digital nudging from the perspective of digital health platform designers working closely with healthcare professionals. While prior research has highlighted how digital nudges benefit patient care, there is limited exploration of how these nudges are designed and developed to enhance patient safety. The research is based on five papers that analyze different aspects of digital health technologies. Paper P1 investigates how the introduction of a mobile app for bedside documentation supports patient safety. Paper P2 examines how data collection through digital tools can improve the quality of care, particularly for patients with atrial fibrillation before and after surgery. Paper P3 shifts focus to patients with inflammatory bowel diseases, exploring how a digital health program influences health outcomes and literacy. Paper P4 systematically reviews digital nudges in healthcare, assessing their impact on treatment and patient management. Paper P5 explores user perceptions of digital nudges and develops design guidelines for their ethical implementation. 

A mixed-methods approach is used, incorporating both qualitative and quantitative research. Data from the National Hospital is analyzed to assess the impact of digital health technologies on patient safety. Usability questionnaires capture healthcare professionals’ perspectives, while comparative analyses examine changes in practice before and after system deployment. This thesis contributes to the information systems literature by conceptualizing a framework for patient safety in digital health platforms. It highlights key socio-technical dimensions and their interconnections, offering insights for future digital health platform development and ethical design.