Despite major investment, health information technology (HIT) implementation often tends to fail. One of the reasons for HIT implementation failure is poor leadership in healthcare organisations, and thus, more research is needed on leaders’ roles in HIT implementation. The aim of the review was to identify the role of healthcare leaders in HIT implementation. A scoping review with content analysis was conducted using a five-step framework defined by Arksey and O’Malley. Database searches were performed using CINAHL, Business Source Complete, ProQuest, Scopus and Web of Science. The included studies were written either in English or Finnish, published between 2000 and 2019, focused on HIT implementation and contained leadership insight given by various informants. In total, 16 studies were included. The roles of healthcare leaders were identified as supporter, change manager, advocate, project manager, manager, facilitator and champion. Identifying healthcare leaders’ roles in HIT implementation may allow us to take a step closer to successful HIT implementation. Yet, it seems that healthcare leaders cannot fully realise these identified roles and their understanding of HIT needs enforcement. Also, healthcare leaders seem to need more support when actively participating in HIT implementation.

Background: The popularity of web-based patient-professional communication over patient portals is constantly increasing. Good patient-professional communication is a prerequisite for high-quality care and patient centeredness. Understanding health care professionals’ experiences of web-based patient-professional communication is important as they play a key role in engaging patients to use portals. More information is needed on how patient-professional communication could be supported by patient portals in health care. Objective: This systematic review of qualitative studies aims to identify how health care professionals experience web-based patient-professional communication over the patient portals. Methods: Abstract and full-text reviews were conducted by 2 reviewers independently. A total of 4 databases were used for the study: CINAHL (EBSCO), ProQuest (ABI/INFORM), Scopus, and PubMed. The inclusion criteria for the reviewed studies were as follows: the examination of health care professionals’ experiences, reciprocal communication between patients and health care professionals, peer-reviewed scientific articles, and studies published between 2010 and 2019. The Joanna Briggs Institute’s quality assessment criteria were used in the review process. A total of 13 included studies were analyzed using a thematic synthesis, which was conducted by 3 reviewers. Results: A total of 6 analytical themes concerning health care professionals’ experiences of web-based patient-professional communication were identified. The themes were related to health care professionals’ work, change in communication over patient portals, patients’ use of patient portals, the suitability of patient portals for communication, the convenience of patient portals for communication, and change in roles. Conclusions: Health care professionals’ experiences contain both positive and negative insights into web-based patient-professional communication over patient portals. Most commonly, the positive experiences seem to be related to the patients and patient outcomes, such as having better patient engagement. Health care professionals also have negative experiences, for example, web-based patient-professional communication sometimes has deficiencies and has a negative impact on their workload. These negative experiences may be explained by the poor functionality of the patient portals and insufficient training and resources. To reduce health care professionals’ negative experiences of web-based patient-professional communication, their experiences should be taken into account by policy makers, health care organizations, and information technology enterprises when developing patient portals. In addition, more training regarding web-based patient-professional communication and patient portals should be provided to health care professionals.

Purpose: In Finland, a major health and social service system reform was implemented in 2023. The reform introduced macro-level organizational integration of health and social services as the responsibility for organizing the services was transferred from c. 300 municipalities to 22 well-being services counties which get their funding from the state. The purpose of this study is to describe different leadership actions to promote integration at the meso- and micro-levels of the service system after the macro-level organizational reform.Design/methodology/approach: The qualitative study utilized semi-structured interviews (n = 25) collected from the upper-level leaders of the well-being services counties. The study participants represented 11 well-being services counties in Finland. The data were collected in May–August 2023. Inductive content analysis was used for data analysis.Findings: Four leadership actions to promote integration at the meso- and micro-levels of the service system were identified: (1) service user-based leadership actions, (2) partnership-based leadership actions, (3) service system-based leadership actions and (4) knowledge-based leadership actions. Most of the interviewees combined several different leadership actions in their recount.Originality/value: The study highlights important information of the focus points set for leading integration in the unique context of reforming health and social services. With this paper, we provide a new way of comprehending integration from the leadership point of view. The conceptualization through the different leadership actions may facilitate forming a shared vision for integration among leaders and managers.

Aim: The study aimed to compare long‐ and short‐term frequent attenders' (FAs) perceptions of patient‐centredness and to assess the equivalence of the factor structure of patient‐centred primary care (PCPC) instrument for long‐ and short‐term FAs.Methods: A cross‐sectional survey of long‐term (n = 234) and short‐term (n = 261) FAs within the primary healthcare of one city in Finland. The data collected in January–July 2020 via ‘the 36‐item PCPC instrument’ were analysed using Pearson's chi‐squared test, Mann–Whitney U‐test, Cronbach's alpha, and multigroup confirmatory factor analysis (MGCFA).Results: Long‐term FAs had worse perceptions of patient‐centredness than short‐term FAs across all subscales: patients’ preferences, physical comfort, coordination of care, continuity and transition, emotional support, access to care, information and education, and family and friends. The MGCFA indicated a good fit for the predicted eight‐factor model.Conclusions: Long‐term FAs’ care needs are currently not being met, indicating the need for considering how the way healthcare services are arranged and care is provided affects prolonged and high care needs. Various dimensions of patient‐centredness need to be addressed when developing not only FAs’ care but also wider service paths. A distinction should be made between long‐ and short‐term frequent attendance when identifying and addressing FAs’ service needs.