Research and projects at HIC

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At HIC the research focuses on clinical informatics in the areas Patient Centred Information Systems, Decision support and Decision making. The projects below are listed in alphabetical order.

Computer-interpretable guidelines through openEHR

Integration of computer-interpretable guidelines with openEHR

The focus of this research is to offer new ways of supporting clinical processes through the use of information technology that is based on reusable evidence-based data structures, models and components. In the long term this can lead to the creation of customizable e-services for patient-specific decision making in health care. In particular, computerisation of clinical practice guidelines will be explored using openEHR, a semantic technology for electronic health records.

The project is a collaboration between the KI departments LIME, MedSolna and Clinical Neuroscience as well as with the company Cambio Healthcare Systems. 

Project members are Sabine Koch, LIME; Michael Fored, MedSolna; Rong Chen, Cambio Healthcare Systems and LIME; Tiago Prazeres Moreira, Clinical Neuroscience.


Retrospective checking of compliance with practice guidelines for acute stroke care: a novel experiment using openEHR's Guideline Definition Language.
Anani N, Chen R, Prazeres Moreira T, Koch S
BMC Med Inform Decis Mak 2014 May;14():39

Early Experiences from a guideline-based computerized clinical decision support for stroke prevention in atrial fibrillation.
Chen R, Valladares C, Corbal I, Anani N, Koch S
Stud Health Technol Inform 2013 ;192():244-7

OpenEHR-based representation of guideline compliance data through the example of stroke clinical practice guidelines.
Anani N, Chen R, Prazeres Moreira T, Koch S
Stud Health Technol Inform 2012 ;180():487-91

Chronic knowledge

The project starts in the hypothesis that patients with more knowledge - use healthcare more efficiently and effectively - incurs a lower cost for society and - have better health.

The project parties include patients, researchers, healthcare providers, designers and entrepreneurs and in step 1, we want to use service design methods to develop a concept together with persons with Parkinson´s. This can be a ´one-stop-shop´ where the possibilities of the information society can be used to gather the knowledge needed - in and outside healthcare - to reach the best possible health. The concept will be tested, evaluated and developed and we predict that it will be applicable also for other chronic conditions and illnesses.

Contact person: Sara Riggare

Heart Rate Variability Biofeedback Game

Reduced heart rate variability (HRV) is an indicator of a malfunctioning autonomic nervous system, which could be a cause or consequence of disease.
Resonant frequency breathing is a potential non-invasive means of intervention for improving the balance of the autonomic nervous system and increasing HRV. However, such breathing exercises are regarded as boring and monotonous tasks. The use of gaming elements (gamification) or even the creation of a full gaming experience is a well-recognised method for achieving higher motivation and engagement in various tasks. However, there is limited documented knowledge on how to design a game for health purposes, e.g., breathing exercises. In particular, the influence of additional interactive elements on the main course of training has not yet been explored.

In a collaboration with the School of Technology and Health, Royal Institute of Technology, we evaluated the satisfaction levels achieved using different game elements and how disruptive they were to the main task, i.e., paced breathing training. An Android flight game was developed with three game modes that differ in the degrees of multitasking they require. Design, development and evaluation were conducted using a user-centred approach, including context analysis, the design of game principle mock-ups, the selection of game principles through a survey, the design of the game mechanics and GUI mock-up, icon testing and the performance of a summative study through user questionnaires and interviews. A summative evaluation of the developed game was performed with healthy participants (ages 40-67) in a controlled setting.

The results confirm the potential of video games for motivating players to engage in HRV biofeedback training. The highest training performance on the first try was achieved through pure visualisation rather than in a multitasking mode.  However, players had higher motivation to play the more challenging game and were more interested in long-term engagement. This project will be followed by recruiting people suffering from depression and stress to evaluate the games.  

Contact person: Aboozar Eghdam


The goal of IntegrIT is to develop an infrastructure for patient-oriented clinical research that integrates data collection from patient records, research templates and patients' self-reporting. The aim is to promote clinical research in the regular care while reducing administrative time for both researchers and patients.

My Care Pathways

The project 'My Care Pathways' strives towards the vision to enable citizens to track their health by providing them online access to past history, current state and prospective future events regarding their personal care pathways. Read more about the project on it´s separate pages.

My Care Plan

My care plan is a study on supporting self-care and collaboration in stroke care through information and communication technology. The main purpose of our research is to examine how health information systems (in this context 'My care plan') used by patients with chronic or long-term illnesses should be designed to improve collaboration, patient participation, autonomy and self-care. In this project we will therefore develop a prototype 'My care plan' that will be a tool with a focus on care and rehabilitation planning as a means to improve collaboration between patients and healthcare staff and a tool to enable long-term reporting and monitoring of individual's health status.

This project is financed by the Health Informatics Centre (HIC). Project time: 2011-2016. Contact person: Nadia Davoody

National study of eHealth in ambulance care 

A questionnaire study to describe how information and communication technology (ICT) or eHealth is used in ambulance care is performed during 2016. The questionnaire was sent out to ambulance nurses, with the purpose to explore how eHealth supports the nurses information needs during the different phases of the ambulance workflow. The study was performed on behalf of the Swedish eHealth Agency (eHälsomyndigheten) in collaboration between the Swedish Association of Health Professionals (Vårdförbundet), Riksföreningen för ambulanssjuksköterskor and Karolinska Institutet.

Vårdförbundet coordinates the work and distributes the questionnaires to all ambulance nurses in their membership registry. Researchers from the Health Informatics Centre and Sektionen för Omvårdnad at Karolinska institutet are responsible to analyzing the data and reporting the results.

Read more about it at ehälsomyndigheten (in Swedish)

Read more about it at Dagens Medicin (in Swedish)

Participating researchers from HIC: Maria Hägglund and Therese Scott Duncan


Collaborative interaction points in post-discharge stroke care.
Davoody N, Koch S, Krakau I, Hägglund M
Int J Integr Care 2014 Oct;14():e032

Patient Daily - active selfcare for chronic disease

The project ”Dagens patient” (”Patient Daily”) is a collaboration between Karolinska Institutet, Nerve AB and Neuro Sweden.

We want to enable people with chronic conditions to better manage their diseases. The project is based on research demonstrating that active and engaged patients fare better. We use tools like apps, sensors and other devices – as well as knowledge shared through online courses.

To date, most research on patients is focused on how healthcare can be developed to help patients better. In ”Patient Daily”, we start from how people can improve their own situation through active selfcare. Read more on the homepage of Dagens patient. Project time: 2014-2015, Contact person: Sara Riggare

Supporting persons with mild acquired cognitive impairments through e-services

The objective of this research is to present an overview of the mild/moderate acquired cognitive impairment (MACI) persons’ experience with e-services such as social media, mobile and assistive technology.

This project started with an exploratory study exploring the current assistive information and communication technology (ICT) as a systematic review of the existing literature about available ICT tools for MACI patients using 8 different medical, scientific, engineering, and physiotherapy library databases. The functionality of tools was analyzed using an analytical framework based on the International Classification of Functioning, Disability and Health (ICF). The research was followed by a postal self-administered questionnaire, asking a total of 600 members of a patient organization (Hjärnkraft) regarding the persons’ use of e-services and social media in addition to their cognitive failures level. The project will be followed by an evaluation of a public Facebook group established for people with fatigue after an injury to the brain in addition to a few focus groups meeting with a small number of persons with MACI. So far, the results of different studies of this project showed a lack of special ICT tools for supporting people with MACI in addition to what available services/tools have been used by them frequently (on their own). The results also indicated that communication is the most important aspect of e-services for them. 

Contact person: Aboozar Eghdam


Information and communication technology to support self-management of patients with mild acquired cognitive impairments: systematic review.
Eghdam A, Scholl J, Bartfai A, Koch S
J. Med. Internet Res. 2012 Nov;14(6):e159

Health Informatics