Telemedicine and E-health
TIME AND SPACE CONSTITUTE BARRIERS between health-care providers and their patients and among health-care providers. Patients in rural areas, on a space shuttle flight, at accident scenes, en route to a hospital, in a submarine, etc., are often physically remote to appropriate care providers. Telecommunication technologies have presented themselves as a powerful tool to break the barriers of time and space. With the introduction of high-bandwidth, digital communication technologies, it is possible to deliver audio, video, and waveform data to wherever and whenever needed.
E-health (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.
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 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...