eHealth (also written e-health) 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.
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.);
- Telemedicine: physical and psychological treatments at a distance;
- Consumer health informatics: use of electronic resources on medical topics by healthy individuals or patients;
- Health knowledge management: e.g. in an overview of latest medical journals, best practice guidelines or epidemiological tracking (examples include physician resources such as Medscape and MDLinx);
- Virtual healthcare teams: consisting of healthcare professionals who collaborate and share information on patients through digital equipment (for transmural care);
- mHealth or m-Health: 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 Grids: powerful computing and data management capabilities to handle large amounts of heterogeneous data.
- Healthcare Information Systems: also often refer to software solutions for appointment scheduling, patient data management, work schedule management and other administrative tasks surrounding health.
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-Patient).
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 be 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.
Successful 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) 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.
Chronic patients over time often acquire a high level of knowledge 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.
WikEhealth is a complete ehealth guide that anyone can edit, aimed at share knowledge and experience around the use of ehealth and related topics. WikEhealth (http://www.wikehealth.org) is free, world-wide Web 2.0 platform made by and for the Ehealth-community. Members could be healthcare providers, healthcare IT specialists, government agencies, research organisations, industry, consultants etc.
You can join for free and adding content is easy.
Categories combine ehealth information in certain areas like Electronic Health Records, PACS (Picture Archiving and Communication Systems).