A holistic view of an e-patient record :
dean.giustini@ubc.ca
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Last Update
19 May 2013
Introduction
See also Canada Health Infoway 
| Electronic health records (EHRs) | E-Patients | mHealth | Medical informatics
According to Health Canada, "eHealth is an overarching term used today to describe the application of information and communications technologies in the health sector. It encompasses a whole range of purposes from purely administrative through to health care delivery. " In 2001, Eysenbach defined e-health as "... 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." Some experts think of ehealth as a synonym for health informatics or medical informatics, although that is contested.
Scope of eHealth
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 sharing of patient data between different healthcare professionals (GPs, specialists etc.)
- Telemedicine or telehealth: 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: software solutions for appointment scheduling, patient data management, work schedule management and other administrative tasks
Mobile eHealth
Mobile eHealth or mHealth are terms that comprise the use of mobile telecommunication and multimedia technologies as they are integrated within mobile and wireless health care delivery systems. The field broadly encompasses the use of mobile telecommunication devices and multimedia technologies.
eHealth's potential
eHealth has the potential to strengthen health systems and improve the safety, quality and efficiency of care. This idea was supported by the World Health Assembly in its 2005 resolution and has raised expectations many of which continue to be unrealized. New solutions are continually being designed, implemented and evaluated for ehealth around the world.
- From what evidence base, if any, are these solutions developed?
- Can e-health solutions truly improve health equity?
- What types of disparities do they minimize or exacerbate? How are health systems and their governance influenced by these e-health solutions, policies and practices?
Evidence is needed to promote equity of access to information and health services, and to strengthen activities and programmes that support local, regional, national and global health communities. There is a critical need to communicate evidence and to provide examples of best practice in the development of effective and efficient solutions to major health challenges. These include: governance and multisectoral engagement, funding systems, system architectures, information systems implementation, capacity building, and areas such as equity in health systems, strategic planning, policy and regulatory frameworks, infrastructures, human capital development and system and data interoperability.
Objectives of ehealth
- provide authoritative, critical and independent overviews of methods and applications in eHealth; there have been considerable developments and experiences – social, technical and political – in the field in recent several years
- develop sources of evidence, authored by individuals representing different parts of the world to inform decisions on eHealth and its application. It should draw on examples from around the world of the successes of health informatics.
- domains include: governance and management of health systems; equity of access to health care; transferable and sustainable economic models; health policy development; information sharing and interoperability to improve the quality, efficiency and continuity of care; information collection and aggregation for public health support
- contributors from developing countries who typically do not have the opportunity to publish in international journals are needed; significant experiences and knowledge about many e-health issues do not make it to the mainstream scientific literature, as implementers and researchers involved in these projects may lack the resources, skills and/or contacts necessary to access these international communication channels. The International Medical Informatics Association will provide quality control and mentoring to ensure that these contributors get the appropriate level of support, if required.
- disseminate key findings to high-level decision-makers, promote stronger commitment on e-health interoperability and its wider application
Key websites
References
- Ahern DK, Kreslake JM. What Is ehealth: perspectives on the evolution of eHealth research. J Med Internet Res. 2006;8(1):e4.
- Alvarez RC. The promise of e-Health – a Canadian perspective. eHealth Int. 2002;1:4.
- Buijink AW, Visser BJ, Marshall L. Medical apps for smartphones: lack of evidence undermines quality and safety. Evid Based Med. 2012 Aug 25.
- Barron S, Manhas S. Electronic health record (EHR) projects in Canada: participation options for Canadian health librarians. JCHLA / JABSC. 2011;32(3):137-143.
- Black AD, Car J, Pagliari C, Anandan C, Cresswell K. The impact of eHealth on the quality and safety of health care: a systematic overview. PLoS Med. 2011;8(1):e1000387.
- Blaya JA, Fraser HS, Holt B. E-health technologies show promise in developing countries. Health Affairs. 2010;29:244-251.
- Car J, Black A, Anandan C. The impact of eHealth on the quality and safety of healthcare. 2008.
- Della Mea V. What is e-health: the death of telemedicine? J Med Internet Res. 2001;3(2):e22.
- Eysenbach G. What is e-health? J Med Internet Res. 2001;3(2):e20.
- Eysenbach G, Diepgen TL. The role of e-health and consumer health informatics for evidence-based patient choice in the 21st century. Clin Dermatol. 2001;19(1):11-7.
- Fingberg F, Hansen M. Integrating data custodians in eHealth grids: security and privacy aspects, NEC Lab Report, 2006.
- Giustini D. Social media trends for health librarians: a primer on using social media for clinical disease surveillance. JCHLA / JABSC. 2012;33:92-4.
- Glassman NR, Sorensen K. Citation management. J Elec Res Med Libr. 2012;9(3):223-231.
- Pagliari C, Sloan D, Gregor P. What Is eHealth: a scoping exercise to map the field. J Med Internet Res. 2005;7(1):e9.
- Oh H. What Is eHealth: a systematic review of published definitions. J Med Internet Res. 2005;7(1):e1.
- Leger M. Canada Health Infoway: a vital link to the future. Can Governm Exec. 2000;6(3).
- Jennett PA, Scott RE, Hunter J. Models of telehealth: an invitational workshop. Montreal: CANARIE and Canada Health Infoway; 2006.
- Office of the Auditor General of Canada. Report of the Auditor General of Canada. Electronic Health Records. 2009.
- Schweitzer J, Synowiec C. The economics of eHealth and mHealth. J Health Commun. 2012;17 Suppl 1:73-81.
- Showell C, Nøhr C. How should we define eHealth, and does the definition matter? Stud Health Technol Inform. 2012;180:881-4.
- Wikipedia. eHealth. http://en.wikipedia.org/wiki/EHealth
