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Q: E-Health ( Answered,   0 Comments )
Subject: E-Health
Category: Computers > Internet
Asked by: zhreish-ga
List Price: $50.00
Posted: 31 Jan 2005 04:01 PST
Expires: 02 Mar 2005 04:01 PST
Question ID: 466268
What is e-health? IT Background of e-health? Impact of e-health?
Advangtages and disadvantages? Sollutions to problems?
Subject: Re: E-Health
Answered By: adiloren-ga on 31 Jan 2005 06:44 PST
Thank you very much for yet another interesting question. I'm sensing a theme ;)

I remember you noting that you value organization in your last
response, so I attempted to organize this answer strictly according to
the way in which you framed your questions. I hope that this layout
will be clear and concise for you.

Lets get to it...

What is E-health?

E-Health is a term that is becoming commonly used. However, at times,
it means different things to different people.

*Simply put, E-health involves using emerging technologies, especially
the internet, to better deliver and manage healthcare services.

Here are some examples of how E-health is defined in the literature:

"EHealth is a broad term that is used to describe most aspects of
healthcare delivery or management that is enabled by information
technology or communications."

*A more complex definition is provided here:

"e-health is an emerging field in the intersection of medical
informatics, public health and business, referring to health services
and information delivered or enhanced through the Internet and related
technologies. In a broader sense, the term characterizes not only a
technical development, but also a state-of-mind, a way of thinking, an
attitude, and a commitment for networked, global thinking, to improve
health care locally, regionally, and worldwide by using information
and communication technology."
(Journal of Medical Internet Research

*E-health involves the following elements of healthcare:

1. Scheduling systems (booking, human resource management)
2.	Logistics (supply of medicinal products], bed management and patient transfer
3.	Management information systems (DRGs, resource management))
4.	Hospital administration systems (accounting, inventory management, payroll)
5.	Patient administration systems
6.	Laboratory information systems
7.	Radiology information systems
8.	Pharmacy systems
9.	Nursing systems
10.	Networked Services such as 
electronic messaging between the hospital and other healthcare actors
for communication of clinical and administrative data
Telemedicine such as telepathology services, teleconsultation for remote areas"



* This excerpt provides a good overview of e-health and recent
e-health developments in the medical field.

"The shift in the nation?s attention, resources and interest toward
Internet-related healthcare activities, often called "e-health", is
dramatic and a most significant development in the healthcare
environment" It is becoming commonplace for healthcare systems to
deploy an extranet and intranet, and using the Internet, create
seamless access to data across a number of separate and different
systems. An intranet can be very useful in improving the flow of
information within an organization and can appear seamless to
end-users. To connect the healthcare organization to its business
partners, an extranet (the use of a shared network) supports users
needs to communicate seamlessly and securely. As a public network, the
Internet, enables an open flow of global communication and knowledge
sharing. The sum of these three "nets" is the movement of healthcare
organizations closer to a paperless enterprise in which access to
information is enhanced through the use of databases and groupware
collaboratively. In the very near future, healthcare will witness the
convergence of all three nets into one network."
-- Joint Healthcare Information Technology Alliance (JHITA), 2000 -

*E-health as a term stemmed from terms like e-commerce that were being
used in the corporate world. The healthcare industry was being
similarly fueled by emerging technologies and the term e-health became
a buzz-word.

"Intel, for example, referred to e-health as "a concerted effort
undertaken by leaders in health care and hi-tech industries to fully
harness the benefits available through convergence of the Internet and
health care." Because the Internet created new opportunities and
challenges to the traditional health care information technology
industry, the use of a new term to address these issues seemed

* The healthcare industry therefore sought to harness these
technologies. These were some of the elements of the industry that
technology could best impact:

"(1) the capability of consumers to interact with their systems online
(B2C = "business to consumer"); (2) improved possibilities for
institution-to-institution transmissions of data (B2B = "business to
business"); (3) new possibilities for peer-to-peer communication of
consumers (C2C = "consumer to consumer")."

*Here a doctor reflects on being in the middle of he e-health revolution.

<<The first time I heard the term "e-health" I was at the 7th
International Congress on Telemedicine and Telecare in London, at the
end of November 1999. John Mitchell from Sidney, Australia, spoke
about a national government study whose main result was the
recognition that "cost-effectiveness of telemedicine and telehealth
improves considerably when they are part of an integrated use of
telecommunications and information technology in the health sector."
[1]. This led to the identification of "e-health" as an umbrella term,
with definitions such as "a new term needed to describe the combined
use of electronic communication and information technology in the
health sector... the use in the health sector of digital data -
transmitted, stored and retrieved electronically - for clinical,
educational and administrative purposes, both at the local site and at
distance" >>
(Journal of Medical Internet Research



*What started out as a small influx of health websites 10 years ago,
has boomed into a major revolution in healthcare today.

"In 1995 things were easy. There were a few 1000 health-related
websites.  Most of these were of the informational content variety.
The giants of informational content entered the arena and the
landscape had its first change.

1996 saw the first major uplift of the number of people who have
access to the internet. It was the same year that we saw the first
attempts to set standards for health website from the Health on the
Net Foundation, the British Healthcare Internet Association and Bill
Silberg. That was followed a year later by the formation of the
Internet Healthcare Coalition.

The period 1997-1999 saw the emergence of the venture capitalist
feeding frenzy, the explosion of health websites and the events that
led to the second round of standards setting by the 'eHealth Ethics
Summit' and 'Hi-Ethics' in 2000."


Advantages/ Solutions to problems:

*They primary goal of E-health is to improve the efficiency of
healthcare delivery. Here are some of the goals of e-health and the
ways in which it addresses them:

"Improve health status by supporting healthy lifestyles, improving
health decisions, and enhancing health care quality;
*	Reduce health care costs by improving efficiencies in the healthcare
system and prevention;
*	Empower people to take greater control of their health by supporting
better-informed health decisions and self-care;
*	Enhance clinical care and public health services by facilitating
health professional practice and communication; and
*	Reduce health disparities by applying new approaches to improve the
health of underserved populations."

*Provides greater speed and efficiency:

"Results to the participants are immediate, with feedback on health
concerns and interests hyperlinked to more in-depth information and
interactive programs that can help the individual get started
immediately on health improvement.  This may be supplemented with
daily news feeds on health topics of interest, moderated chat rooms
and live video feeds from experts on health and behavioural change

* Video and internet conferencing allows for contact betwen patient
and doctor from great distances and/or from anywhere there is access
to the technology.

"Medical services and education delivered via videoconference simply
make live access to conventional healthcare possible without the need
to travel. By simply substituing videoconferencing for travel,
telehealth is not creating anything new and is not impacted by most of
the complexities usually associated with eHealth."

* 	"Budget and efficiency pressures are making Web-based strategies
ever more attractive to busy benefits managers..."

(more advantages in the "impact of E-health" section)



There are some ethical concerns over e-health. Some worry that using
widespread technologies and databases may lead to breaches in privacy,
as patients medical records are electronically available. Security
concerns further fuel the argument that peoples private personal
records may not be completely safe.

* Privacy concerns
* Confidentiality
* Security
* Data Integrity

"Some eHealth topics, such as accessing doctors'''' advice via the
internet or the Electronic Patient Record involve complex technical,
logistical and human issues that spark concerns surrounding privacy,
confidentiality, security, and data integrity."

Health Privacy Resources


Impact of E-health:

*E-health solutions have empircally improved efficiency and reduced
healthcare costs in the European Union.

"There are plenty of examples of e-Health in action in the Member
States. Health information networks, such as Denmark's medcom, are
supporting the work of hospitals, pharmacies, on-call doctors, general
practitioners, laboratories, and local authorities
It can deliver substantial savings in hospital costs, speed up
treatment and diagnosis and help to reduce the risk of medical errors.
Six million people have accessed the UK's NHS Direct Online in two
years to get health-related information. Europe is also at the
forefront of the use of electronic health records in primary care and
deployment of health (smart) cards, including the recent introduction
of an European Health Card to make it easier to obtain treatment in
other EU Member States."

*Studies show that doctors are relying heavily on the internet for
gathering medical information and in treating their patients.

"The study reveals that doctors are using the Internet in force for
gathering medical knowledge and that they are beginning to embrace
online tools that enhance patient care, such as electronic
prescribing, online communication with patients, and electronic
medical records. Even more importantly, doctors are reporting that the
information they find online is influencing?for some, in a major
way?the types of diagnoses they make and the prescriptions they write.
This has significant implications for the pharmaceutical companies,
managed care organizations, and health-care-delivery systems that seek
to influence physician behaviors."

*The internet has made it easier for doctors to respond to emergency situations

" Many people already look to the Internet for information during a
public health crisis, and information found online can positively
influence behavioral responses to such crises. However, the potential
of the Internet to convey accurate health information and advice has
not yet been realized. In order to enhance the effectiveness of
public-health communication, physician practices could use this
technology to pro-actively e-mail their patients validated

*Internet Based Consultations allow for more frequent contact with doctors.

"Telemedicine could improve health care by transferring knowledge from
centres of excellence to patients' doctors. Few studies have
systematically assessed the value of such internet based specialty
consultations. Patients can benefit from internet based consultations
between their doctor and consulting specialists. New recommendations
for treatment were discussed in 90% of cases, and change in diagnosis
occurred in 5% of cases. Patients can access a specialist's opinion
more quickly than waiting to see a specialist."

*E-health solutions are proving valuable in Latin America and the Caribbean.

"Heretofore designed for industrialized countries and large
organizations, eHealth solutions are being proposed as an answer to a
variety of health-system management problems and health care demands
faced by all health organizations including those in developing
societies. Particularly, eHealth is seen as especially useful in the
operational support of the new health care models being implemented in
many countries."


Additional Resources:

eHealth Initiative


Centre for Global eHealth Innovation

E-Health Conference 2005



Health on the Net Foundation

Internet Health Coalition

MedCERTAIN project


TNO Prevention and Health


World Wide Web Consortium

American Medical Informatics Society

British Computer Society Health Informatics Committee

British Medical Informatics Society

Care2x Open Source Integrated Healthcare Environment

CEN Medical Informatics group

European Federation for Medical Informatics

International Medical Informatics Association

Health Xchange Protocol HXP

Journal of Medical Internet Research

The Telemedicine Information Exchange (TIE)

The Center for Telemedicine Law (CTL)


Google Search Strategy:

"what is ehealth"
"benefits of ehealth" or "ehealth benefits"
"advantages of ehealth" or "ehealth advantages"
"impact of ehealth" or "ehealth's impact"
"emergence of ehealth"
"history of ehealth"

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