April 2006

e-Health Perspective

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The 'e' in e-Health does not only stand for 'electronic', but implies a number of other 'e's, which together perhaps best characterise what e-Health is all about. The other factors are efficiency in health care, enhanced quality of care, empowerment of consumer and patients, encouragement among care givers and patients, ease of use, excitment and extension of scope of health care beyond convientional boundaries.

What happens if you have a computer and it will be connected to various medical equipment and core of the whole thing is that you have special application, which captures all the information of the patient? What happens if e-Health is a process ready to provide health care via electronic means,  particularly over the Internet?


The American Cancer Society website provides a wide range of consumer information

e-Health is an emerging field in the intersection of medical informatics, public health and business that provides the opportunity for the patients to maintain independence longer and for the providers to monitor a condition more closely.

e-Health is a very important issue these days, but few people have come up with a clear definition of this comparatively new term. 

e-Health was rarely in use before 1999. e-Health had its place in most developed countries, and is being explored in many developing countries recently. It can be defined as 'a concerted effort, undertaken by leaders in health care and hi-tech industries to fully harness the benefits available through convergence of Internet and health-care', following the definition provided by Intel.



ICT use among health professionals in Ontario, Canada is a vibrant community activity

There are a number of Internet sites for providing services for the health care industry.  Some provide patient health and medical content.  Many sites serve multiple functions such as providing consumer information, hosting on-line support groups and providing business support services.  Some consumer information sites are run by non-profit organisations such as the American Cancer Society that provide a wide range
of contents.

Benefits of e-Health
By utilising e-Health, patients can get treatments, sitting at their home without going through all tedious exercises. The 'e' in e-Health does not only stand for 'electronic', but implies a number of other 'e's. This put together perhaps best characterise what e-Health is all about.

Some of the other 'e's are: More efficiency in health care, enhanced quality of care, empowerment of consumers and patients, encouragement of a new relationship between the patient and health professionals, extension of the scope of health care beyond its conventional boundaries, ease of use and excitement. 

With the advancement of ICT, use of 'telehealth' and 'telemedicine' is going to be familiar in both developed and developing countries. The concept is that the information to be transferred from patients' end to the health specialist, sitting at other end, who reads the problems and sends the required suggestions and information back; this is the way how telemedicine works. Telehealth services can be preventive, curative and promotive.

Barriers in using e-Health
Technological barriers are generally related to problems in communication. Telecommunications and connectivity issues such as bandwidth, telephone call charges, Internet access etc need to be addressed for growth and development of the services sector.

Barriers in financial sector are seen mostly with respect to delivery of health services and the e-Business environment involving the foreign direct investment, facilitation of e-Commerce, etc. Often it is not clear if the quality of health information and services being provided in the online websites are reliable and if they are run by non-medical professionals, they could result in un reliable information. Another key issue is that e-Health is currently accessible only for the educated, healthy and wealthy. Is it creating another digital divide? To overcome some of these challenges and barriers, innovative experiments have been undertaken in Africa, Asia, Latin America and Eastern Europe, primarily to address the digital divide question in e-Health.

Though e-Health has shown remarkable effectiveness for treating a variety of disorders, research has not shown the efficacy of any assessment instrument to rule out serious mental illness in the worldwide population, accessible through Internet sites. The next barrier is privacy. Many practitioners do not know how to completely remove patient files from their own computer hard drives or how to secure email transmissions to protect patients confidentiality. Legal protections for patients and practitioners are still in flux, while federal standards to protect the transmission and privacy of medical information are currently being developed.

From the clinician's perspective, it is more difficult to determine if a person is fully attentive or distracted during the interaction when using remote technology.  The practitioners need to be trained or otherwise gain experience in the various possibilities for misinterpretation when offering service to the public with worldwide connectivity brought by the Internet. Of further importance is the clinician's familiarity with colloquial expressions, idioms, and local variations or word usage, this can be crucial when working with mentally ill, suicidal or homicidal patients.Currently the e-Health world is still very much a 'consumer beware' environment. Identifying the appropriate e-Health site is not an easy task for most consumers. Health professionals can play an important role in helping patients in this issue. As such, the patients must take the opinion of other practitioners too.



e-Health practices and initiatives Ontario's e-Health initiatives are designed to give the right person access to the right information about the right individual at the right time. The Ontario Laboratories Information System (OLIS) is among the first e-Health initiatives and will allow the secure electronic exchange of laboratory information province-wide.

'e-Health International', a journal which look at technology from the perspective of the health professionals and patients using it. It focuses on applied technologies i.e. technologies with practical applications that have the potential to improve both quality and access to healthcare. This potential can only be achieved through the international exchanges of both successes and lessons learnt. This is the mission of both e-Health International and of the International e-Health Association.

e-Health-Care Foundation, an Indian based non profit organisation, is working on 'e-Health-Care' project. The project is to streamline the government's antiquated health care delivery system with use of ICT. There are numerous projects being carried in various countries all over the world. Some of those are as follows:

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