E-Health

toc

=**Introduction**=

With the emergence of the internet in the 1990’s, we have seen the proliferation of many “e-terms”. Probably the most famous of all the e-terms are “email” and “ecommerce”. These two terms are perhaps the most familiar to all Internet users since they have been around since the beginning. Nevertheless, there are many new e-terms that are being used more and more as the Internet ages. Among these include “e-health”. The term may be familiar to most people, however understanding “e-health” and what it does or what it is capable of doing may not be as easy, since it has so many connotations.

[a]

=The Meaning=

The definition of “e-health” is constantly being changed and updated. However, according to a systematic review of published definitions by Hans et al., the term e-health “encompasses a set of disparate concepts, including health, technology, and commerce” [1]. More specifically, the early days when e-health was first introduced to the internet, it was defined as follow:// // //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.// [2]

=Telemedicine vs. E-Health=

E-health might have arisen from telemedicine and these two concepts deal with the issues of communication technology and health-related matters; however, it should be kept in mind that these two concepts are separable and do not mean the exact same thing.

Telemedicine has been defined as the use of telecommunications to provide medical information and services [3]. For example, the most common use of telemedicine is the storing and transferring of X-Rays, CT scans, or MRI images between two buildings. Telemedicine is limited to what it can do. E-health, on the other hand, comprises a broader scope than telemedicine and provides services such as:

A) Health portals or health information websites

 * 1) For general health and wellness information
 * 2) For a specific population such as women’s health
 * 3) For specific diseases such as cancer
 * 4) For non-profit organizations such as the [|American Cancer Society]
 * 5) For government agencies, e.g., National Library of Medicine maintains [|Medline], which offers one of the most comprehensive databases of medical information in the world [6]

B) Connectivity and communications solutions

 * 1) Support group
 * 2) News group
 * 3) Discussion forum

C) E-commerce: online insurance and drug prescription

 * 1) [|drugstore.com]
 * 2) Over-the-counter medication

The first generation of e-health is mostly concerned with offering users health-related information and support. However, we are now into the next generation of e-health services, which is providing access to practitioners and direct service delivery online. Moreover, we are starting to see live interaction between practitioners and patients in a secured internet environment, though this activity is still in its infancy and has yet to be accepted by most people. What are gaining popularity, however, are health websites in the WWW.

=E-Health on the Horizon=

With the growing number of internet health-related websites, people are now using this online medium as a way to seek out health-related information. This way of seeking out information has some benefits. First of all, it allows people to easily and quickly search for only the information that they need, and does not require a visit to a clinic. Secondly, patients can prepare for appointments that they have with their doctors by accessing the information available online. This permits more effective communication with the doctors once they meet at the office.

According to [|Datamonitor research], women use the internet to look for health information for themselves and their family more than men [4]. Furthermore, about 57% of those who look for health information consult internet sources and the most common searched topic is “healthy living lifestyle” [4].

The internet allows anyone to access and find information about any health-related issues. Undoubtedly one of the major concerns for patients is whether the information at each site is reliable. To address this issue, the [|Internet Healthcare Coalition] has formulated a guideline called “eHealth code of ethics” so that everyone–and this includes patients, health care professionals and administrators, researchers, those who create or sell health products or services, and other stakeholders–can join together to create a safe environment and enhance the value of the Internet for meeting healthcare needs [5].

=E-Health Code of Ethics:=


 * 1) Disclose all relevant information about a product or service, even though it may affect the consumer’s desire to purchase the product or service.
 * 2) Be truthful and not deceptive.
 * 3) Provide health information that is accurate, easy to understand, and up to date.
 * 4) Respect a user’s right to a) choose whether their personal data may be collected, used, or shared, and b) determine how it will be done.
 * 5) Respect the obligation to protect a user’s privacy.
 * 6) Respect fundamental ethical obligations to patients and clients.
 * 7) Ensure that organizations and sites with which they affiliate are trustworthy.
 * 8) Provide meaningful opportunity for users to give feedback to the site.

=E-Health Innovation=

E-health has become more than just a stand-alone website that provides consumers, practitioners, and others with access to a database of information. One of the newest practices for the e-health industry is the ability for users to subscribe to online medical news and then automatically receive files for download (and to do so whenever they choose to). This new communication technology is called podcast. A podcast is an audio recording posted online, much like a short radio show. Podcasting is a method of publishing audio and video programs via the Internet that lets users subscribe to a feed of new files (usually MP3s) [7]. An example of medical news podcasting is provided by [|John Hopkins medicine].

[b]

Another innovative tool that has contributed to the world of e-health is “wearable” technology. This amazing technology is provided in the garment called “Life Shirt” and is developed by [|VinoMetrics Inc]. This garment can save lives. It contains tiny sensors that can help health-care givers remotely monitor the vital signs and other important bio-metric readings of the chronically ill, elderly cardiac, and other patients who have potentially life-threatening conditions [8]. The data collected can be sent to a secure Wi-Fi device and transmitted via the web for real-time patient caring [8]. These two new innovations further shape the field of e-health and provide a new and exciting outlook.

[c]

=The Future of E-Health=

In the health-related industry, there have been many discussions about the possibility that someday we will have ePrescribing. As you can see by now, email, ecommerce, e-health, and esolution are not the only “e-terms” that are out there on the web; we are seeing even more “e’s” being added to the frontier of the internet. According to the [|CHCF] (California Healthcare Foundation) ePrescribing (eRx) is currently practiced by only about 15 percent of physicians [9]. There are still many obstacles and difficulties in adopting eRx; however, the potential benefits include cost and time savings; staff and office efficiency; better patient safety; and improved compliance with formularies and chronic-care treatment programs [9].

=Conclusion=

The term “e-health” is constantly being redefined. The letter “e” in “e-health” is generally thought to have one meaning, and that is “electronic”, and this is probably leaving a lot of people confused and thinking that the term has something to do with health that is being done online. However, the “e” in “e-health” means much more: here are the 10 meanings represented by the “e” in e-health according to an article that was published in the [|Journal of Medical Internet Research]: [2]


 * 1) **Efficiency** –increases efficiency in healthcare and decreasing costs
 * 2) **Enhancing quality** (of care) – allows consumers to compare different providers, to perform their own quality assurance checks, and then to pick the best quality providers according to their own research
 * 3) **Evidence based –** provides information that is based on scientific evaluation and evidence
 * 4) **Empowerment** (of consumers and patients) - makes the knowledge bases of medicine and personal electronic records accessible to consumers over the Internet
 * 5) **Encouragement** – enhances the relationship between patients and healthcare professionals through the sharing of ideas and decisions
 * 6) **Education –** provides information and training to physicians through online sources (continuing medical education) and consumers (health education, tailored preventive information for consumers)
 * 7) **Enabling –** allows information exchange and communication in a standardized way between healthcare establishments
 * 8) **Extending -** enables consumers to easily obtain health services online from global providers
 * 9) **Ethics -** involves new forms of patient-physician interaction and poses new challenges and provides solutions to ethical issues such as online professional practice, informed consent, privacy, and equity
 * 10) **Equity -** makes healthcare more equitable (which is one of the promises of e-health), but at the same time there is a considerable threat that e-health may widen the gap between the "haves" and "have-nots". People who do not have the money, skills, and access to computers and networks, cannot use computers effectively. As a result, these patient populations (which would actually benefit the most from health information) are those who are the least likely to benefit from advances in information technology, unless political measures ensure equitable access for all. The digital divide currently runs between rural vs. urban populations, rich vs. poor, young vs. old, male vs. female, and patients with neglected/rare vs. patients with common diseases.

The current services provided by “e-health” are a benefit to all. Besides the issues of ethics and equity (as mentioned in the 10 e’s above) that need to be resolved, the future for e-health is bright and there is much optimism that some day “e-health” will be as popular and widely accepted as email and ecommerce.

=References=

[1] Oh, Hans, Carlos Rizo, Murray Enkin, and Alejandro Jadad. "What Is eHealth (3): A Systematic Review of Published Definitions." __Journal of Medical Internet Research__. 24 Feb. 2005. Journal of Medical Internet Research. 23 Feb. 2006 http://www.jmir.org/2005/1/e1/

[2] Eysenback, Gunther. "What is e-Health?" __Journal of Medical Internet Research__. 18 June 2001. Journal of Medical Internet Research. 23 Feb. 2006 http://www.jmir.org/2001/2/e20/

[3] Wysocki, Michael. "EHealth/Telemedicine." __What is e-Health?__ Creative Marketeam Canada Ltd. 23 Feb. 2006 http://www.suite101.com/article.cfm/9670/57010

[4] "Health websites gaining popularity." __BBC News Health__. 14 Sept. 2002. BBC. 23 Feb. 2006 .

[5] "EHealth Code of Ethics." __EHealth Ethics Initiative__. Internet Healthcare Coalition. 23 Feb. 2006 http://www.ihealthcoalition.org/ethics/ehealthcode0524.html

[6] "A Guide to E-Health for the Healthcare Professional." __E-Health__. American Telemedicine Association. 23 Feb. 2006 http://www.atmeda.org/ehealth/guide.htm

[7] "Johns Hopkins Medicine Podcasts." __Johns Hopkins Medicine__. Johns Hopkins University. 23 Feb. 2006 http://www.hopkinsmedicine.org/mediaII/Podcastsinstructions.html

[8] McGee, Marianne K. "Wearable Technology Can Save Lives." __Health-Care IT__. 13 Feb. 2006. CMP Media LLC. 23 Feb. 2006 http://www.informationweek.com/industries/showArticle.jhtml;jsessionid=OF1KNFDUDAYS0QSNDBCSKH0CJUMEKJVN?articleID=180200704

[9] Sarasohn-Kahn, Jane, and Mathew Holt. "The Prescription Infrastructure: Are We Ready for ePrescribing?" __The Prescription Infrastructure: Are We Ready for ePrescribing?__ Jan. 2006. California HealthCare Foundation. 23 Feb. 2006 

Images Cited
[a] [|eWeek.com] - Health Care Industry Center [b] [|Johns Hopkin Medicine] [c] [|InformationWeek] - Health Care IT

E-Health Related Links

 * A. Consumer Information and Services**
 * 1) [|Health Encyclopedia]
 * 2) [|Consumer and Patient Health Information]
 * 3) [|iVillage: Health & Well-Being]
 * 4) [|Health Finder]


 * B. Portals**
 * 1) [|Discovery Health]
 * 2) [|Dr.Koop]
 * 3) [|WebMD]
 * 4) [|National Institute of Health]


 * C. Articles on the Net**
 * 1) [|Wireless Leaders & Laggards: Health Care]
 * 2) [|The Doctor Is Online (Almost)]
 * 3) [|How SMS Could Save Your Life]
 * 4) [|E-Health for the Information Age]

Relevant Links to other Wikis' Entries
1. Podcasting 2. WWW 3. Digital Divide 4. E-Commerce 5. E-Mail 6. E-Book 7. E-Learning 8. MP3 software 9. WiFi 10. Wearable Computers: (1) and (2) 11. Global Divide 12. Internet Explorer

Last updated February 28, 2006