E-health
E-health refers to the integration of digital technology into health care to enhance health services and access. It encompasses various components, such as telemedicine, telecare, electronic health records (EHR), and online health information systems. The aim of e-health is to improve patient care, increase efficiency, and facilitate communication between health providers and patients through tools like mobile devices and the Internet. Key elements include online support groups, health portals, and multimedia tools, which empower patients to manage their health more actively.
However, while e-health promises lower costs and improved access to medical care, challenges persist, such as the digital divide and concerns over the technology's accessibility for disadvantaged populations. There are also legal and ethical implications regarding data privacy and the effectiveness of e-health systems. Moreover, the field is still evolving, with ongoing debates about its actual impact on health outcomes and cost-effectiveness. Overall, e-health represents a transformative approach to health care, but further research and development are needed to fully realize its potential benefits.
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Subject Terms
E-health
Health is normally defined as a process rather than an outcome. It has no common definition and can mean anything from the absence of disease or infirmity to a total state of social, mental, and physical well-being. E-health is defined as the use of digital technology to improve health and health care using common technologies such as the Internet and mobile devices. Elements of e-health include “telemedicine” and “telecare” and the use of technology for electronic health records (EHR), prescriptions, appointments, imaging, archiving, and administration. Tools to enhance decision making and information technology (IT)-based services and technologies are also included in e-health. Other e-health areas cover multimedia tools, computer-assisted surgery, monitoring systems that are portable and/or wearable, and robotics. Health portals also are included.
E-health resources include online support groups and communities, online access to personal health records and health-care providers, and online health information and health self-management tools. E-health involves the use of the Internet and telecommunications to deliver health information to and from health providers and consumers, improvement of public-health services through using e-commerce and IT to train and educate health workers, and the use of e-business and e-commerce practices in managing health systems.
Background
In a 2003 report for the European Commission’s (EC’s) first high-level conference on e-health in May of 2003, Denise Silber reported that “eHealth is the single-most important revolution in healthcare since the advent of modern medicine, vaccines, or even public health measures like sanitation and clean water.” The term “e-health” dates to 2000 and includes medical informatics with delivery of information, care, and services being a higher priority than technological function. There is no consensus, but most definitions share common elements.
The World Health Organization (WHO) defines e-commerce as the production, distribution, marketing, and sales and delivery by electronic means of goods and services. Other definitions stress organization and delivery information and services, emphasizing that e-commerce is a new way of working, a new attitude, and a dedication to global and networked thinking for local health-care improvement.
The EC definition of e-health includes the use of modern communications and IT to serve the health-care needs of citizens, patients, providers, professionals, and policy makers. Telemedicine is the use of telecommunications for diagnosis and treatment. The WHO term “telematics for health” encompasses telemedicine and telehealth, or any health-related activity conducted over distance by means of information technology. The WHO adds that e-health includes cost-effective and secure informaton technology and communications to support health care, health surveillance, and health-related elements.
E-health infrastructure and systems are regarded by many Western health-care services as integral to the future delivery of effective, safe, and efficient health care with a patient focus. E-health is a worldwide topic but is developed as a country asset. The United Nations World Summit on the Information Society in 2003, the 2005 WHO Global Observatory for eHealth, and the 2005 World Summit on the Information Society (with 175 countries participating) reflected the growing commitment of nations to e-health delivery systems and to global cooperation in the delivery of emergency aid, networking among professionals, and general health and environmental improvement.
Overview
E-health involves health, commerce, and technology. Other aspects of e-health include surveillance of patients, public health, and health promotion. Varying definitions emphasize different aspects; all include health and technology, but not all involve e-commerce. Stakeholders, the influence of distance, places, attitudes, and expected benefits are elements of most definitions. E-health is more than telemedicine because it uses computer-aided telecommunications to enhance observation, management, and access to medical knowledge.
E-health offers a new way of using information, medicine, and financial resources more efficiently. It can tailor care to individual patients, improve accountability and transparency, promote shared care, help reduce errors, increase diagnostic accuracy, and reduce barriers to access due to physical location or disability. Patients gain greater control of their own care and make better decisions. E-health streamlines health-care delivery and reduces wasted time and resources.
E-health resources allow caregivers and users to collect the information they need for medical decisions, communicate with providers, and manage chronic conditions. The Internet enhances dissemination of information as well as interaction and collaboration among institutions, providers, professionals, and the public.
However, there are some concerns about the use of e-health, including the accessibility of tools. The US federal e-health web page links to information on how to create websites, how to educate elderly users unfamiliar with technology, how to broaden access to cover those with limited resources, and how to provide online information for American Indians and Asian/Pacific Islanders. E-health offers lower costs, more information, and faster service, but the technology is unavailable to some. Africa, for instance, has only 4 million e-mail users out of a population of 800 million, and half of those users are in South Africa.
Technology is not a substitute for human improvement but a tool for helping, increasing, and generally improving human activities. The commercial aspect is often ignored in definitions of e-health, which almost universally are optimistic and positive. There is no hard evidence, however, that e-health actually generates cost or, for that matter, general effectiveness. Systems are not sufficiently interoperable, although steps are being taken to standardize them. Additional research is needed on organizational and human factors affecting implementation. There are also concerns about the digital divide, with special concern for the disabled and elderly and the effectiveness of e-health in different settings (e.g., kiosk versus workplace).
Additionally, there are legal and ethical issues concerning possible harmful effects arising from the use of e-health technologies and decision support systems. The US ten-year Health Information Technology Plan seeks to establish a clear, regulatory framework for electronic records, since patient safety and quality assurance are still uncertain.
Political misconduct is also a concern in the context of e-health. In 2009, the Ontario, Canada, auditor general Jim McCarter reported that the provincial e-health system was overly dependent on consultants, played favorites in awarding contracts, had underutilized computer assets, lacked strategic direction, and was a $1 billion waste of taxpayer money. The health minister resigned as a result. McCarter noted that effective e-health systems could save $6 billion if implemented throughout Canada. E-health offers many potential benefits, but the field has not yet realized them, and its value remains undetermined.
Bibliography
“EHealth Scandal a $1B Waste: Auditor.” CBC News. CBC, 7 Oct. 2009. Web. 18 Dec. 2013.
Househ, Mowafa, Elizabeth Borycki, and Andre Kushniruk. "Empowering Patients Through Social Media: The Benefits and Challenges." Health Informatics Journal 20.1 (2014): 50–58. Print.
Maheu, Marlene M., et al. E-Health, Telehealth, and Telemedicine: A Guide to Startup and Success. New York: Jossey, 2001. Print.
Nelson, Ramona, and Nancy Staggers. Health Informatics: An Interprofessional Approach. Boston: Mosby, 2013. Print.
Noar, Seth M. E-Health Applications: Promising Strategies for Behavior Change. New York: Routledge, 2012. Print.
Oh, Hans, et al. “What is eHealth? A Systematic Review of Published Definitions.” World Hospitals and Health Services 41.1 (2005): n. pag. Print.
Silber, Denise. “The Case for eHealth.” Proceedings of the European Commission’s First High-Level Conference on eHealth. 22–23 May 2003. Maastricht, Neth.: European Institute of Public Administration, 2003. Print.
US Department of Health and Human Services. “What Is e-Health?” Health.gov. US Dept. of Health and Human Services, n.d. Web. 19 Dec. 2013.
World Health Organization. “E-Health.” World Health Organization. WHO, n.d. Web. 18 Dec. 2013.