- Efficiency – one of the promises of e-health is to increase effectiveness in health care, in that way of decreasing costs. One possible way of decreasing costs would be by avoiding duplicative or unnecessary diagnostic or therapeutic interventions, through enhanced communication possibilities between health care establishments, and through patient involvement.
- Enhancing quality of care – increasing efficiency involves not only reducing costs, but at the same time improving quality. E-health may improve the quality of health care for example by allowing comparisons between different providers, involving consumers as additional power for quality assurance, and directing patient streams to the best quality providers.
- Evidence based – e-health interventions should be evidence-based in a way that their effectiveness and efficiency should not be assumed but proven by exact scientific evaluation.
- Empowerment of consumers and patients – by making the knowledge bases of medicine and personal electronic records accessible to consumers over the Internet, e-health opens new avenues for patient-centered medicine, and enables evidence-based patient choice.
- Encouragement of a new relationship between the patient and health professional, towards a true partnership, where decisions are made in a common manner.
- Education of physicians through online sources and consumers.
- Enabling information exchange and communication in a standardized way between health care establishments.
- Extending the scope of health care past its conventional limits. This is meant in both a geographical sense as well as in a theoretical sense. E-health enables consumers to easily obtain health services online from global providers. These services can range from simple advice to more complex interventions or products such as pharmaceuticals.
- Ethics – e-health involves new forms of patient-physician interaction and poses new challenges and threats to ethical issues such as online professional practice, informed consent, privacy and equity issues.
- Equity – to make health care more equitable is one of the promises of e-health, but at the same time there is a considerable threat that e-health may deepen 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 are those who are the least likely to benefit from advances in information technology, unless political measures ensure equitable access for all.
The 10 E’s in E-health
E-health at EU level
At EU level, the introduction of e-Health services is facilitating access to healthcare, whatever the geographical location, thanks to innovative telemedicine and personal health systems. E-Health is also breaking down barriers, enabling health service providers (public authorities, hospitals) from different Member States to work more closely together. If a particular treatment can be provided to a patient more effectively in another country, e-Health systems make it easier to organize and carry out treatment abroad. Suppliers of e-Health tools such as databases for patient records, mobile monitors which transmit data automatically, or handling systems for patient call centers – also benefit from the development of a European market in the sector, which has enabled them to build a strong base from which they can tackle the global market.
ttp://ec.europa.eu/information_society/activities/health/index_en.htm
Principles, Infrastructure and Requirments of Telemedicine
The principles of health system are based on equity, efficiency, quality, affordability, sustainability and patient satisfaction.
There are several basic healthcare requirements such as quality of the service, effective use of limited resources, know-how sharing and access to medical or healthcare information. Another two important requirements are time and cost management.
The necessary infrastructure includes electronic medial records, communication network and software, medical workstation, specialized medical equipment and telemedicine clinical guidelines.
Telemedicine’s Standards
Under telemedicine, there is a wide range of technology and applications. This variety of technology and applications poses a significant difficulty for the establishment of standards. The lack of standards has implications for: telemedicine quality, safety, efficiency, privacy, investment, and security. Many of the telemedicine projects are based on existing video- conferencing and desk- top computer systems, which were originally designed for purposes other than health care delivery. Although, system’s individual components such as software were designed for medical applications, the entire telemedicine system is not necessarily evaluated objectively for its ability to safely provide diagnostic information.
Telemedicine and developing countries
A big number of telemedicine projects are already implemented in developing countries.
In most cases they are small by size and implemented with the support of different developed countries and international organizations. Potential benefit of telemedicine is more visible in developing countries. However, it is quite common that in the same country there are several incompatible telemedicine solutions. Here are some facts about developed countries according to ITU-T reports:
Due to the poor quality of life, developing countries are facing the lack of proper health care and sanitation.In least developed countries only 54% of the population has access to health services.The number of people per doctor in industrialized countries is 390 as against 6670 in developing countries and only 30% of births are attended by health personnel. The maternal mortality rate in developing countries is about 20 times higher than that in the developed world.
Health Telematics
Health telematics is a complex term for health- related activities, services and systems, carried out over a distance in a ways of information and communication technologies, for the purposes of global health promotion, disease control and health care, as well as education, management and research for health.
Telemedicine
Telemedicine is a term that has to do with any medical activity from distance. It is not something new and it has been around for years. A doctor- patient communication, which involves telecommunicion or satellite technology and video-conferencing equipment to make a real-time consultation. Healthcare could not be effectively delivered without telephone.
Who needs telemedicine? That will be patients that does not have an easy access for example: distance, preparation, transportation, medical conditions or emergency situations.
There are several reasons why we use telemedicine such as increasing access to continuing medical education and training or reduce professional isolation among doctors and other health care staff located remote and rural areas. Another reason is to provide and advanced medical services in emergencies and fair access to quality health care services. Patients with rare disease will also receive second- opinion consultation and more opportunities to get a better treatment.
Telecardiology
Nowadays with the development of advanced technologies, remote transmission and gaining of ECG via the telephone became possible, giving new possibilities for a wide range of applications, ranging from home care to defensive diagnosis and emergency services
From ITU reports its estimated that 2% -4% of the world population suffer from heart diseases.
10%-12% of the world population is considered to have two or more heart diseases risk factors, which would ideally require periodical diagnosis or preventive medical treatment.
It increases chances of recover by minimizing the instant damage, and a possible shorter hospitalization period following the attack.
It is possible to reduce the mortality rate by 50% by shortening the time between the heart attack and the beginning of treatment.
Reasons for E-Health
Heart disease is the single most fatal disease of modern society. Heart attacks became the number one killer in the world we live in today. According to ITU-T reports, 45% of the total mortality rate in the USA is due to cardiac related diseases. Many of these deaths are a result of the time elapsed between the cardiac event and the medical assistance provided to the patient.
One of the leading factors in the diagnosis of a person’s heart condition is his Electro Cardio Gram. The activity of the heart is regulated by electrical impulses, which can be measured and presented, for diagnostic purposes, in the form of an ECG.
Usually, ECG diagnostics were carried out at hospitals or clinics, where patient would be physically connected to the ECG machine and the doctor would simultaneously diagnose his condition.
E-Health
According to Wikipedia, E-Heath is a new term for healthcare practice which is supported by electronic processes and communication. E-health is defined as electronic information and interactions connecting people and communities to health services. 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. 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. E-Health is not a replacement of existing medical and health care service, but it is an additional tool to improve access to existing facilities and resources.
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