User:Ahrn1204/eHealth

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.[1] Usage of the term varies: some would argue it is interchangeable with health informatics with a broad definition covering electronic/digital processes in health[2] while others use it in the narrower sense of healthcare practice using the Internet.[3][4][5]

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.[7] Various authors have considered the evolution of the term and its usage and how this maps to changes in health informatics and healthcare generally.[1][8][9] 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).

Definition eHealth is the application of the Internet and other related technologies in the healthcare industry to improve the access, efficiency, effectiveness, and quality of clinical and business processes utilized by healthcare organizations, practitioners, patients, and consumers to improve the health status of patients.[3]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.[1]

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Forms 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 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; and Decision aids for patients facing difficult choices (eg, genetic screening) •	Information on the web and/or digital TV: public information and educational tools for specific clinical groups •	Clinician-patient communication tools: 1. Remote: Clinical email and web-based messaging systems for consultation, disease monitoring, service-oriented tasks (eg, appointment booking, prescription reordering). 2. Proximal: Shared decision making tools, informed consent aids 3. Mixed: On-line screening tools (eg, for depression) and therapeutic interventions (eg, cognitive behaviour therapy) •	Access and equity issues: (data protection issues, the Digital Divide) - Quality issues for health information on the net - “virtual” health communities •	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 input and outcomes using Grids: powerful computing and data management capabilities to handle large amounts of heterogeneous data.[6] •	Healthcare Information Systems: also often refer to software solutions for appointment scheduling, patient data management, work schedule management and other administrative tasks surrounding health. •	Healthcare Business Management - Billing and tracking systems - Audit & quality assessment systems. •	Professional Clinical Informatics - Decision aids for practitioners (eg, prompts, reminders, care pathways, guidelines). •	Electronic clinical communications tools - (eg, e-referral, e-booking, e-discharge correspondence, clinical email/second opinion, laboratory test requesting/results reporting, e-shared care) •	E-Mental Health – delivery of mental health services via the internet through videoconferencing, chat, or email web application.

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 practice 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 action 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 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.[11] Various medical practices 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.

Early adopters 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-Health also offers a wide variety of ways to promote wellness and disease prevention through access and education.

See also •	e-Patient •	European Institute for Health Records •	European Health Telematics Association •	EUDRANET •	Health 2.0 •	Health blog •	Health Informatics •	mHealth •	eHealth Ontario •	Technology and mental health issues •	eHealth, Inc. Parent company of eHealthInsurance •	Telemedicine

References Eysenback, G. (2001, June 18). Journal of Medical Internet Research. Retrieved April 13, 2012, from What is E-Health?: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1550637/ Pagliari, C., Sloan, D., Gregor, P., Sullivan, F., Detmer, D., Kahan, J., et al. (2005, March 31). Journal of Medical Internet Research. Retrieved April 13, 2012, from What Is eHealth (4): A Scoping Exercise to Map the Field: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1550637/ Smaltz, D., & Broderick, M. (2003, May 5). HIMSS E-Health SIG White Paper. Retrieved April 13, 2012, from HIMSS: http://www.himss.org/content/files/ehealth_whitepaper.pdf