Digitalisation is something most people have encountered in the last 20 years. People have gotten used to most of their life being digital, using phones every day, and working on computers. However, the healthcare system is falling behind in the field of digitalisation. The system does not work efficiently enough to facilitate the provision of care, hindering it instead. Patient - care provider interaction during transmural healthcare journeys can be improved to place the person once more at the centre of their own health care journey.

This project aims to create a strategy for the digital transition of patient – health care provider interaction during transmural health journeys. This is done by first completing a literature review and context analysis of the current system, followed by observations and interviews. The insights from this research were then summarised in a synthesis map, which highlights the interconnecting relations within the complex socio-technical system. Three system levels were analysed, splitting the system into macro, meso and micro influences. Macro influences come from legislation, meso influences from organisational strategy, and micro influences come from person-specific interactions.

The synthesis map identified six leverage points that can be used to improve the barriers for digitalisation at the Reinier de Graaf hospital:

1. Improve system interoperability
2. Improve system connections
3. Streamline the number of systems used in healthcare
4. Take ownership/ responsibility surrounding digitalisation at the RdGG
5. Make more space in the budget to spend time facilitating the digital interaction transition
6. Improve digital literacy

Using these points the following future vision was set up:

In the future, the RdGG simplifies patient - care provider interaction by using a shared data space for care plans, allowing patients to play an equitable part in their health journey.

Finally, a strategy was made for the digital transition of patient – care provider interaction at the hospital, visualised in a strategic roadmap and a tactical roadmap. The three main pillars of the future vision – patient clarity, time for care, and shared administrative burden – form the basis for the envisioned future of healthcare in the Netherlands.

To finalise the applicability of the digital transition strategy, it was tested with various involved stakeholders, including a director of the hospital, ICT staff, and care professionals. The thesis concludes with implementation recommendations, limitations and possibilities for future research.

Background:
Miscarriage is a common experience, affecting 15% of recognized pregnancies, but societal ignorance and taboos often downplay the mental distress and personal impact following a miscarriage. Emerging stories on social media in which women express their miscarriage grief are breaking such taboos. Research in the area of online health communities is increasingly focused on studying how people share their health experiences on social media. However, a clear understanding on the social support involved in this type of sharing of health experiences is lacking.

Objective:
This study explored the use of Instagram in sharing miscarriage experiences, guided by the following research question: How is social community support given to women who share their miscarriage experiences on social media? Considering that social media is increasingly used as a source of social support, in this study, we chose Instagram as the social media platform. The purpose of this research was to create a better understanding of how social media provides support in expressing personal miscarriage experiences and how people engage with such posts.

Methods:
This study used a qualitative inductive research method in which a phenomenological strategy and thematic analysis were followed to create a comprehensive understanding of the social community support phenomenon. The dataset was established from a sample of 258 Instagram posts and 736 comments collected over a period of 6 months after initial posts and from 6 different women. These data were categorized and clustered through a thematic analysis.

Results:
Three themes were identified: (1) storytelling of emotional turmoil and grief after miscarriage, (2) sharing positivity amidst miscarriage grief, and (3) mentioning personal medical information about miscarriage. Theme 1 represents the emotional experience of women who have had a miscarriage. It encompasses the initial posts that included miscarriage storytelling that express deep grief and mental distress and the emotional impact on both the posters and the commenters. Theme 2 highlights the importance of finding moments of joy and positivity in the midst of mental distress and pain. The posts shared with the online community convey a sense of moving forward and a refusal to let grief become the defining aspect of one’s life. Theme 3 focuses on sharing medical and practical advice. This theme includes posts and comments about medications, in vitro fertilization procedures, hospital experiences, and personal physical symptoms.

Conclusions:
As an overarching theme for this social support phenomenon, we introduce the term communal load sharing to describe the therapeutic role of social media in helping women cope with miscarriage by providing a platform for sharing similar experiences, breaking social taboos, and fostering load sharing.@en

Background: Coping with a health condition is an ongoing process that demands continuous self-care and social support. People increasingly engage in online health communities (OHCs) to share their health experiences (Sanger et al., 2023; Wang, Zhao, and Street, 2017). Research has kept pace with an accumulation of OHC studies (see figure 1). Although, a clear and systematic understanding on the social support involved is lacking. This study examines OHCs through a systematic scoping review in the field of design and health informatics. By analysing and charting existing research over the course of fifteen years, we were able to identify community engagement patterns and social support models. Hence, this paper contributes with principal knowledge on the design of social structures of OHCs and discusses novel implications for understanding social support in OHCs. […]@en