EHealth
Encyclopedia
eHealth is a relatively recent term for healthcare practice supported by electronic processes and communication, dating back to at least 1999. Usage of the term varies: some would argue it is interchangeable with health informatics
with a broad definition covering electronic/digital processes in health, while others use it in the narrower sense of healthcare practice using the Internet
.
).
Front-end exchange typically involves the patient, while back-end exchange does not. A common example of a rather simple front-end exchange is a patient sending a photo taken by mobile phone of a healing wound and sending it by email to the family doctor for control. Such an actions may avoid the cost of an expensive visit to the hospital.
A common example of a back-end exchange is when a patient on vacation visits a doctor who then may request access to the patient's health records, such as medicine prescriptions, x-ray photographs, or blood test results. Such an action may reveal allergies or other prior conditions that are relevant to the visit.
In general, explanatory diagnostic information (such as the standard ICD-10
) may be exchanged insecurely, and private information (such as personal information from the patient) must be secured. E-health manages both flows of information, while ensuring the quality of the data exchange.
E Mental Health has been gaining momentum in the academic research as well as practical arenas in a wide variety of disciplines such as psychology, clinical social work, family and marriage therapy, and mental health counseling. Testifying to this momentum, the E Mental Health movement has its own international organization, The International Society for Mental Health Online. It also has its own academic peer review journals, such as the Journal of Medical Internet Research. The efficacy and effectiveness of E Mental Health approaches are currently being studied by Universities around the world. For instance, University of California Davis has initiated a series of studies based on E Mental Health.
There are a number of E Mental Health Centers now operating around the world, particularly in the USA and Australia. These centers offer services to disabled populations, rural populations, weather inclement populations, as well as populations who are comfortable using the internet and world wide web.
Health informatics
.Health informatics is a discipline at the intersection of information science, computer science, and health care...
with a broad definition covering electronic/digital processes in health, while others use it in the narrower sense of healthcare practice using the Internet
Internet
The Internet is a global system of interconnected computer networks that use the standard Internet protocol suite to serve billions of users worldwide...
.
Forms of e-health
The term can encompass a range of services or systems that are at the edge of medicine/healthcare and information technology, including:- Electronic health records: enabling the communication of patient data between different healthcare professionals (GPs, specialists etc.);
- TelemedicineTelemedicineTelemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities...
: physical and psychological treatments at a distance; - Consumer health informaticsConsumer health informaticsConsumer Health Informatics helps bridge the gap between patients and health resources. The Kaiser model is an example of allowing patients to remotely communicate with their physicians or other healthcare professionals....
: use of electronic resources on medical topics by healthy individuals or patients; - Health knowledge managementKnowledge managementKnowledge management comprises a range of strategies and practices used in an organization to identify, create, represent, distribute, and enable adoption of insights and experiences...
: e.g. in an overview of latest medical journals, best practice guidelines or epidemiological tracking (examples include physician resources such as MedscapeMedscapeMedscape is a web resource for physicians and other health professionals. It features peer-reviewed original medical journal articles, CME , a customized version of the National Library of Medicine's MEDLINE database, daily medical news, major conference coverage, and drug information—including a...
and MDLinxMDLinxMDLinx is an internet-based service that offers physicians and other healthcare professionals a quick means of staying current with academic literature. The typical medical specialist would have to read 30 to 80 journal articles every day to keep up with the flow of information in his/her specialty...
); - Virtual healthcare teams: consisting of healthcare professionals who collaborate and share information on patients through digital equipment (for transmural careTransmural careTransmural care is the interface between primary and secondary care in medicine....
); - mHealth or m-HealthMHealthmHealth is a term used for the practice of medicine and public health, supported by mobile devices. The term is most commonly used in reference to using mobile communication devices, such as mobile phones and PDAs, for health services and information...
: includes the use of mobile devices in collecting aggregate and patient level health data, providing healthcare information to practitioners, researchers, and patients, real-time monitoring of patient vitals, and direct provision of care (via mobile telemedicine); - Medical research using GridsGrid computingGrid computing is a term referring to the combination of computer resources from multiple administrative domains to reach a common goal. The grid can be thought of as a distributed system with non-interactive workloads that involve a large number of files...
: powerful computing and data management capabilities to handle large amounts of heterogeneous data. - Healthcare Information SystemsHealth informatics.Health informatics is a discipline at the intersection of information science, computer science, and health care...
: also often refer to software solutions for appointment scheduling, patient data management, work schedule management and other administrative tasks surrounding health.
Contested definition
Several authors have noted the variable usage in the term, from being specific to the use of the Internet in healthcare to being generally around any use of computers in healthcare. Various authors have considered the evolution of the term and its usage and how this maps to changes in health informatics and healthcare generally. Oh et al., in a 2005 systematic review of the term's usage, offered the definition of eHealth as a set of technological themes in health today, more specifically based on commerce, activities, stakeholders, outcomes, locations, or perspectives. One thing that all sources seem to agree on is that e-Health initiatives do not originate with the patient, though the patient may be a member of a patient organization that seeks to do this (see e-PatientE-Patient
e-Patients are health consumers who use the Internet to gather information about a medical condition of particular interest to them, and who use electronic communication tools in coping with medical conditions...
).
E-Health data exchange
One of the factors blocking the use of e-Health tools from widespread acceptance is the concern about privacy issues regarding patient records, most specifically the EPR (Electronic patient record). This main concern has to do with the confidentiality of the data. There is also concern about non-confidential data however. Each medical practise has its own jargon and diagnostic tools. To standardize the exchange of information, various coding schemes may used in combination with international medical standards. Of the forms of e-Health already mentioned, there are roughly two types; front-end data exchange and back-end exchange.Front-end exchange typically involves the patient, while back-end exchange does not. A common example of a rather simple front-end exchange is a patient sending a photo taken by mobile phone of a healing wound and sending it by email to the family doctor for control. Such an actions may avoid the cost of an expensive visit to the hospital.
A common example of a back-end exchange is when a patient on vacation visits a doctor who then may request access to the patient's health records, such as medicine prescriptions, x-ray photographs, or blood test results. Such an action may reveal allergies or other prior conditions that are relevant to the visit.
Thesaurus
Successfull e-Health initiatives such as e-Diabetes have shown that for data exchange to be facilitated either at the front-end or the back-end, a common thesaurus is needed for terms of reference. Various medical practises in chronic patient care (such as for diabetic patients) already have a well defined set of terms and actions, which makes standard communication exchange easier, whether the exchange is initiated by the patient or the caregiver.In general, explanatory diagnostic information (such as the standard ICD-10
ICD-10
The International Statistical Classification of Diseases and Related Health Problems, 10th Revision is a medical classification list for the coding of diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases, as maintained by the...
) may be exchanged insecurely, and private information (such as personal information from the patient) must be secured. E-health manages both flows of information, while ensuring the quality of the data exchange.
Early adapters
Chronic patients over time often acquire a high level of knowlegde about the processes involved in their own care, and often develop a routine in coping with their condition. For these types of routine patients, front-end e-Health solutions tend to be relatively easy to implement.E Mental Health
E Mental Health refers to the delivery of mental health services via the internet through videoconferencing, chat, or email web applications. E Mental Health encompasses online talk therapy, online pharmaceutical therapy, online counseling, computer-based interventions, cyber mental health approaches, and online life coaching. This form of psychological intervention modality offers a series of benefits as well as challenges to providers and clients. Most notable of all challenges is online security.E Mental Health has been gaining momentum in the academic research as well as practical arenas in a wide variety of disciplines such as psychology, clinical social work, family and marriage therapy, and mental health counseling. Testifying to this momentum, the E Mental Health movement has its own international organization, The International Society for Mental Health Online. It also has its own academic peer review journals, such as the Journal of Medical Internet Research. The efficacy and effectiveness of E Mental Health approaches are currently being studied by Universities around the world. For instance, University of California Davis has initiated a series of studies based on E Mental Health.
There are a number of E Mental Health Centers now operating around the world, particularly in the USA and Australia. These centers offer services to disabled populations, rural populations, weather inclement populations, as well as populations who are comfortable using the internet and world wide web.
See also
- e-PatientE-Patiente-Patients are health consumers who use the Internet to gather information about a medical condition of particular interest to them, and who use electronic communication tools in coping with medical conditions...
- European Institute for Health RecordsEuropean Institute for Health RecordsThe European Institute for Health Records or EuroRec Institute is a non-profit organization founded in 2002 as part of the ProRec initiative. On 13 May 2003, the institute was established as a non-profit organization under French law. Current President of EuroRec is Prof. Georges De Moor...
- European Health Telematics AssociationEuropean Health Telematics AssociationThe European Health Telematics Association is a European non-profit organization, which provides a platform to all European eHealth stakeholders to exchange information on eHealth...
- EUDRANETEUDRANETEUDRANET, the European Telecommunication Network in Pharmaceuticals , is an IT platform to facilitate the exchange of information between regulatory partners and industry during submission and evaluation of applications...
- Health 2.0Health 2.0Health 2.0 are terms representing the possibilities between health care, eHealth and Web 2.0, and has come into use after a recent spate of articles in newspapers, and by Physicians and Medical Librarians...
- Health InformaticsHealth informatics.Health informatics is a discipline at the intersection of information science, computer science, and health care...
- mHealthMHealthmHealth is a term used for the practice of medicine and public health, supported by mobile devices. The term is most commonly used in reference to using mobile communication devices, such as mobile phones and PDAs, for health services and information...
- eHealth OntarioEHealth OntarioeHealth Ontario is the agency tasked with facilitating the development of Ontario's proposed public Electronic Health Record system. Health Informatics in Canada is run provincially, with different provinces creating different systems, albeit sometimes under voluntary Pan-Canadian guidelines...
- Technology and mental health issuesTechnology and mental health issuesThe use of communicative and other new technologies as a supplement to mainstream therapies for mental disorders is an emerging mental health treatment field which, it is argued, could improve the accessibility, effectiveness and affordability of mental health care...