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Software and systems development is a multifaceted skill that defies simple definition. It can be considered an engineering art, albeit a very young one, where it's about creating and following clear methods for software and IT-system development. It can also be seen as an art form, impossible to reduce to concrete rules, where the creativity, knowledge, and intuition of the developer guide the process. Additionally, today's software development involves many different stakeholders and work often occurs in projects, often agile ones, which also places high demands on collaboration and social skills of the practitioners.

With this in mind, in our course in Object-Oriented Systems Development and Systems Integration, our approach was to transcend traditional assessment methods. Rather than focusing solely on programming patterns and isolated systems development, we introduced novel examination formats. Specifically, we replaced some individual tasks with a day-long creative seminar and a preparatory writing assignment.

The writing assignment involved students preparing in advance for the questions that would be raised during the seminar. This could involve explaining various systems development methods, demonstrating familiarity with visualizing system design, and explaining how systems today can be integrated through cloud-based techniques. Students were allowed to bring their notes to the seminar.

The creative seminar was designed to be an innovative and engaging task that integrated principles from:

1) relationship-based pedagogy,

2) experiential learning, and

3) kinesthetic learning.

By applying relationship-based pedagogy, the seminar aimed to create a favorable learning environment where interaction and relationships between students and teachers were fostered. By exploring real problems and situations, the seminar creates a meaningful learning experience that goes beyond theoretical concepts and promotes deeper understanding; the seminar format promotes collaboration and dialogue, stimulating knowledge exchange. Experiential learning was a central component of the creative seminar, where students were encouraged to practically apply their theoretical knowledge from the course and the preparatory writing assignment by developing collages. Students had whiteboards, paper, colored pens, Magic-Charts, and free access to all kinds of craft materials to assist them. Our primary learning technique therefore became kinesthetic learning, which emphasizes bodily movement and practical exercises. This method allows for physical interaction and creates memory anchors, increasing students' retention and engagement by physically working with their hands to create and co-create in interaction with others. This in turn acts as a tool that feeds relation-based learning. Formal evaluation and feedback from students affirmed the success of this setup.

Another effect of the creative seminar was that we could achieve a more fair and just assessment of students' performances. By allowing for different learning styles and providing space for creativity, an assessment process was created that recognizes and values the diversity of students' competencies.

In summary, through our creative seminar, we found a successful examination format that suited the creative, knowledge-based, and intuitive nature of systems development, while also providing ample opportunity for students to practice collaboration and social skills.

Background: The utilisation of digital technology in primary healthcare, particularly digital patient management platforms, has gained prominence, notably due to the global pandemic. These platforms are positioned as substitutes for face-to-face consultations and telephone triage. They are seen as a potential solution to the escalating costs associated with an aging population, increasing chronic conditions, and a shrinking healthcare workforce. However, a significant knowledge gap exists concerning the practical aspects of their implementation and their effect on the utilisation of digital patient management in primary healthcare.

Methods: This study addresses this gap by conducting a comprehensive analysis of three case studies involving the implementation of a specific digital patient management platform. Over a period of three years, we examine how the practicalities of implementation shape the adoption and utilisation of a digital patient management platform in three different clinics.

Results: Our findings revealed that differences in implementation strategies directly influenced variations in utilisation. The successful utilisation of the platform was achieved through a bottom-up decision-making process that involved the employees of the primary healthcare clinics. Onsite training, close collaboration with the eHealth provider, and a structured patient onboarding process played crucial roles in this utilisation. In contrast, a top-down approach at two of the primary healthcare clinics led to limited utilisation of the platform into daily workflows. Furthermore, making the platform a part of everyday work meant putting accessibility, by working as a team of physicians, at the forefront of continuity of care, with patients being managed by their designated physician. Additionally, it was observed that digital patient management proved most effective for addressing simple patient issues such as skin rashes, rather than complex cases, and did not reduce the demand for phone triage.

Conclusion: Only one of the three clinics studied effectively integrated digital patient management into its daily operations, and did so by aligning objectives among management and all categories of healthcare professionals, employing a bottom-up decision-making process, collaborating with the eHealth service provider for regular platform adjustments to clinic needs, and implementing active patient onboarding. This sociotechnical integration resulted in high platform utilisation. In contrast, the other two clinics faced challenges due to incoherent objectives among diverse healthcare professional employees and top management, a top-down decision-making approach during implementation, limited collaboration with the eHealth service provider, and passive patient onboarding. The findings indicate that these factors negatively affected utilisation and led to low platform adoption as well as disrupted the sociotechnical balance.

Continuous use of cloud computing and cloud sourcing has received limited research attention compared to cloud adoption. There are indications that cloud sourcing benefits are not easy to reap in continuous use for companies, calling for more research on the continuance use of cloud computing. The current study is one of the first studies of the continuance use of cloud computing processes at the organizational level, contributing to the management and business research literature on cloud computing. In particular, the present study has contributed with two case studies verifying the existence of barriers and more importantly identifying an additional type of barrier: management process barriers (MP), i.e., lack of objectives and strategies for cloud sourcing and lack of organizing cloud vendor communication. Overcoming or reducing management process barriers guides the continuance use of cloud computing process in a strategic direction for the company and enables cloud-related innovation. As a contribution, our research builds on and extends extant research by providing a TOMPE framework of barriers to the continuance use of cloud computing (based and modified from the technology–organization–environment (TOE) framework, by complementing it with the identified management process barriers).

Background: Digitally mediated primary healthcare is increasingly influencing working conditions, raising questions about how digitally mediated patient management is experienced.

Aim: The aim of this study was to generate insights, through the lens of postphenomenology, into how digitally mediated primary healthcare affects the work and working environment, by gathering perspectives from primary healthcare professionals who regularly manage patient errands through a digital platform.

Methods: Two rounds of interviews were conducted with a diversified sample of primary healthcare professionals at a primary healthcare centre. The first round of interviews was conducted during the initial phase of the deployment of a digital platform for patient management, with the second round conducted a year later (n = 24). The interview transcripts were analysed using reflexive thematic analysis.

Results: Four themes relating to digitally mediated care work were identified: ‘positive feelings towards digitally mediated primary healthcare’, ‘seeing a positive work atmosphere as a prerequisite for change’, ‘experiencing increased control over the pace of workflow’ and ‘reconfiguration of previous problems’.

Conclusion and relevance to clinical practice: Building on postphenomenology, our study adds to the understanding of how material and symbolic aspects mutually affect the mediating role of a digital platform for patient management. Thus, the results indicate that the experience of using digitally mediated care processes is conditioned by the discourse towards digitalisation at the workplace and the management's approach to and inclusion of employees in the digital transition of primary healthcare, as well as the usefulness and usability of the digital platform. The findings can inform both practice and policy.

Background: Traditional primary care is characterized by patient consultations via phone and physical visits. However, the current development in Swedish primary care is to blend digital solutions with traditional solutions. This paper addresses this development by examining the normalization of embedding and integrating a digital health care platform into everyday care routines in a primary care clinic. The digital health care platform enables both synchronous (video calls) and asynchronous (chat) communication, as well as self-registration of patient data using automated questions and forms requiring the patient's input.

Objective: This study aims to explore the work that health care professionals (HCPs) have to undertake to implement and sustain a digital health care platform as part of their everyday work practice. Methods: HCPs were observed and interviewed to assess their individual and collective engagement and the mechanisms involved in the implementation of the digital platform and its effects on everyday work routines. The normalization process theory (NPT) was used to frame the data analysis.

Results: The analysis identified several themes related to the four NPT constructs: coherence, cognitive participation, collective action, and reflexive monitoring. The use of these constructs enabled the analysis to identify ways of supporting implementation. For example, it showed the benefits of having implementation champions and scheduling work hours for HCPs to use the platform. The analysis also revealed a theme of materiality that deviated from the NPT constructs, as NPT gives ontological priority to human actors and social structures.

Conclusions: Digital health care platform implementation is a complex process. Our findings provide insights into how individual and collective actions can be supported to embed and integrate a digital platform into everyday care routines. Primary health care organizations need to involve HCPs throughout the implementation process by reorganizing work and providing frequent feedback loops. HCPs are more likely to engage with and commit to changing practices if they perceive the digital platform to be beneficial compared with the current practice. However, they also need resources (eg, time, training, and continuous support) to put the platform into practice. Patient engagement and appraisal are important elements in implementation. Unless patients are willing to use the platform, there is no motivation for HCPs to embed the digital platform into everyday care practice.

Against the backdrop of eHealth solutions increasingly becoming a part of healthcare professionals’ ways of doing care work, this paper questions how the solutions mediate the experience of healthcare professionals when deployed. We undertook a qualitative study of three eHealth solutions, conducting qualitative interviews with a diverse sample of 102 healthcare professionals from different care settings across the south of Sweden. Materiality and postphenomenology serve as analytic tools for achieving an understanding of the mediating roles of eHealth solutions. The analysis emphasises the mediating roles consisting of interrelated paradoxes: (1) changing and perpetuating boundaries between patients and professional groups, (2) (dis)enabling augmented information and knowledge processes and (3) reconfiguring professional control over work. This contribution provides critical insights into materiality as a category of analysis in studies on the deployment of eHealth solutions, as these technologies have both intended and unintended consequences for care work. Our study identified general positive consequences of all three solutions, such as the increased feeling of closeness to patients and colleagues over time and space; increased ‘understanding’ of patients through patient-generated data; and increased autonomy, due to the fact that asynchronous communication makes it possible to decide when and which patient to attend to. We also identified general unintended consequences of the solutions, such as maintenance of power relations maintained due to organisational structures and professional relations, disabled information and knowledge processes due to the lack of non-verbal clues, reduced professional autonomy due to technical scripts determining what data is collected and how it is categorised, and uneven workload due to the dependency on patient input and compliance.