Array ( [0] => {{short description|Healthcare practice}} [1] => {{for|the private online marketplace|eHealthInsurance}} [2] => {{redirect-distinguish|Cyber Doctor|Doctor Cyber|robot doctor|cyberneticist|cybernetics}} [3] => {{lowercase title}} [4] => {{Use dmy dates|date=February 2020}} '''eHealth''' describes healthcare services which are supported by digital processes, communication or technology such as [[electronic prescribing]], [[Telehealth]], or [[Electronic health record|Electronic Health Records]] (EHRs). The use of electronic processes in healthcare dated back to at least the 1990s.{{cite journal |last1=Della Mea |first1=Vincenzo |date=22 June 2001 |title=What is e-Health (2): The death of telemedicine? |journal=Journal of Medical Internet Research |volume=3 |issue=2 |pages=e22 |doi=10.2196/jmir.3.2.e22 |pmc=1761900 |pmid=11720964 |doi-access=free}} Usage of the term varies as it covers not just "Internet medicine" as it was conceived during that time, but also "virtually everything related to computers and medicine".{{Cite journal |last=Eysenbach |first=G |date=2001-06-18 |title=What is e-health? |journal=Journal of Medical Internet Research |volume=3 |issue=2 |pages=e20 |doi=10.2196/jmir.3.2.e20 |issn=1438-8871 |pmc=1761894 |pmid=11720962 |doi-access=free}} A study in 2005 found 51 unique definitions.{{cite journal |last1=Oh |first1=Hans |last2=Rizo |first2=Carlos |last3=Enkin |first3=Murray |last4=Jadad |first4=Alejandro |date=24 February 2005 |title=What Is eHealth (3): A Systematic Review of Published Definitions |journal=Journal of Medical Internet Research |volume=7 |issue=1 |page=e1 |doi=10.2196/jmir.7.1.e1 |pmc=1550636 |pmid=15829471 |doi-access=free}} Some argue that it is interchangeable with [[health informatics]] with a broad definition covering electronic/digital processes in health{{cite web |author1=ICT Applications and Cybersecurity Division: Policies and Strategies Department |author2=ITU Telecommunication Development Sector |date=September 2008 |title=Implementing e-Health in Developing Countries: Guidance and Principles |url=http://www.itu.int/ITU-D/cyb/app/docs/e-Health_prefinal_15092008.PDF |access-date=2012-04-15 |website=[[International Telecommunication Union]]}} while others use it in the narrower sense of healthcare practice using the [[Internet]].{{cite journal |last=Griskewicz |first=M. |date=July 2002 |title=HIMSS SIG develops proposed e-health definition |journal=HIMSS News |volume=13 |issue=7 |page=12}}{{cite journal |last1=Eysenbach |first1=G |author1-link=Gunther Eysenbach |last2=Diepgen |first2=TL |date=Jan–Feb 2001 |title=The role of e-health and consumer health informatics for evidence-based patient choice in the 21st century |journal=Clinics in Dermatology |volume=19 |issue=1 |pages=11–7 |citeseerx=10.1.1.7.2559 |doi=10.1016/S0738-081X(00)00202-9 |pmid=11369478}}{{cite journal |last1=Ball |first1=Marion J. |last2=Lillis |first2=Jenifer |date=April 2001 |title=E-health: transforming the physician/patient relationship |url=http://www.ijmijournal.com/article/S1386-5056(00)00130-1/fulltext |journal=International Journal of Medical Informatics |volume=61 |issue=1 |pages=1–10 |doi=10.1016/S1386-5056(00)00130-1 |pmid=11248599 |url-access=subscription |via=Elsevier |access-date=16 June 2017 |archive-date=21 January 2019 |archive-url=https://web.archive.org/web/20190121213006/http://www.ijmijournal.com/article/S1386-5056(00)00130-1/fulltext |url-status=dead }} It can also include health applications and links on mobile phones, referred to as [[mHealth]] or m-Health.{{cite journal |last1=O'Donoghue |first1=John |last2=Herbert |first2=John |date=October 2012 |title=Data Management within mHealth Environments: Patient Sensors, Mobile Devices, and Databases |journal=Journal of Data and Information Quality |volume=4 |page=5 |doi=10.1145/2378016.2378021 |s2cid=2318649}} Key components of eHealth include electronic health records (EHRs), telemedicine, health information exchange, mobile health applications, wearable devices, and online health information. These technologies enable healthcare providers, patients, and other stakeholders to access, manage, and exchange health information more effectively, leading to improved communication, decision-making, and overall healthcare outcomes. [5] => [6] => ==Types== [7] => The term can encompass a range of services or systems that are at the edge of medicine/healthcare and information technology, including: [8] => [9] => * [[Electronic health record]]: enabling the communication of patient data between different healthcare professionals (GPs, specialists ''etc.''); [10] => * [[Computerized physician order entry]]: a means of requesting diagnostic tests and treatments electronically and receiving the results [11] => * [[Electronic prescribing|ePrescribing]]: access to prescribing options, printing prescriptions to patients and sometimes electronic transmission of prescriptions from doctors to pharmacists [12] => * [[Clinical decision support system]]: providing information electronically about protocols and standards for healthcare professionals to use in diagnosing and treating patients{{Cite web |title=Exploris - Cardio Explorer |url=http://www.exploris.info/Cardio-Explorer/ |url-status=dead |archive-url=https://web.archive.org/web/20190202212053/https://www.exploris.info/Cardio-Explorer/ |archive-date=2 February 2019 |access-date=2017-09-13 |website=www.exploris.info |language=de-CH}} [13] => * [[Telemedicine]]: physical and psychological diagnosis and treatments at a distance, including telemonitoring of patients functions and videoconferencing;{{Cite journal |last1=Zonneveld |first1=Michael |last2=Patomella |first2=Ann-Helen |last3=Asaba |first3=Eric |last4=Guidetti |first4=Susanne |date=2020-11-05 |title=The use of information and communication technology in healthcare to improve participation in everyday life: a scoping review |journal=Disability and Rehabilitation |language=en |volume=42 |issue=23 |pages=3416–3423 |doi=10.1080/09638288.2019.1592246 |issn=0963-8288 |pmid=30966833 |s2cid=106408490 |doi-access=free}} [14] => * [[Telerehabilitation]]: providing rehabilitation services over a distance through telecommunications. [15] => * [[Telesurgery]]: use robots and wireless communication to perform surgery remotely.{{Cite journal |last1=Choi |first1=P. J. |last2=Oskouian |first2=R. J. |last3=Tubbs |first3=R. S. |year=2018 |title=Telesurgery |journal=Cureus |volume=10 |issue=5 |pages=e2716 |doi=10.7759/cureus.2716 |doi-access=free |pmc=6067812 |pmid=30079282}} [16] => * [[Teledentistry]]: exchange clinical information and images over a distance.{{Cite journal |last1=Jampani |first1=N. D. |last2=Nutalapati |first2=R. |last3=Dontula |first3=B. S. |last4=Boyapati |first4=R. |year=2011 |title=Applications of teledentistry: A literature review and update |journal=Journal of International Society of Preventive & Community Dentistry |volume=1 |issue=2 |pages=37–44 |doi=10.4103/2231-0762.97695 |pmc=3894070 |pmid=24478952 |doi-access=free}} [17] => * [[Consumer health informatics]]: use of electronic resources on medical topics by healthy individuals or patients; [18] => * 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); [19] => * Virtual healthcare teams: consisting of healthcare professionals who collaborate and share information on patients through digital equipment (for [[transmural care]]) [20] => * [[MHealth|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); [21] => * Medical research using [[Grid computing|grids]]: powerful computing and data management capabilities to handle large amounts of heterogeneous data.{{cite report |url=http://www.ccrl-nece.de/publications/paper/public/LR-06-262.pdf |title=Integrating Data Custodians in eHealth Grids: Security and Privacy Aspects |last1=Fingberg |first1=Jochen |last2=Hansen |first2=Marit |date=2006 |last3=Hansen |first3=Markus |last4=Krasemann |first4=Henry |last5=Iacono |first5=Luigi Lo |last6=Probst |first6=Thomas |last7=Wright |first7=Jessica |archive-url=https://web.archive.org/web/20070929041307/http://www.ccrl-nece.de/publications/paper/public/LR-06-262.pdf |archive-date=29 September 2007 |url-status=dead |series=NEC Lab Report}} [22] => * [[Health informatics|Health informatics / healthcare information systems]]: also often refer to software solutions for appointment scheduling, patient data management, work schedule management and other administrative tasks surrounding health. There can be integrated data collection platforms for devices and standards and require extended research.{{cite journal |last1=Arjun |first1=R. |last2=D'Souza |first2=Sunil C. |date=2016 |title=Software Analytics Platform for Converged Healthcare Technologies |journal=Procedia Technology |volume=24 |pages=1431–1435 |doi=10.1016/j.protcy.2016.05.169 |doi-access=free}} [23] => * Internet Based Sources for Public Health Surveillance (Infoveillance).{{Cite journal |last1=Barros |first1=Joana M |last2=Duggan |first2=Jim |last3=Rebholz-Schuhmann |first3=Dietrich |date=2020-03-13 |title=The Application of Internet-Based Sources for Public Health Surveillance (Infoveillance): Systematic Review |journal=Journal of Medical Internet Research |language=en |volume=22 |issue=3 |pages=e13680 |doi=10.2196/13680 |issn=1438-8871 |pmc=7101503 |pmid=32167477 |doi-access=free}} [24] => [25] => ==Contested Definition== [26] => 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.{{cite journal |last1=Eysenbach |first1=G |author1-link=Gunther Eysenbach |date=18 June 2001 |title=What is e-health? |journal=Journal of Medical Internet Research |volume=3 |issue=2 |pages=e20 |doi=10.2196/jmir.3.2.e20 |pmc=1761894 |pmid=11720962 |doi-access=free}} Various authors have considered the evolution of the term and its usage and how this maps to changes in health informatics and healthcare generally.{{cite journal |last1=Pagliari |first1=Claudia |last2=Sloan |first2=David |last3=Gregor |first3=Peter |last4=Sullivan |first4=Frank |last5=Detmer |first5=Don |last6=Kahan |first6=James P. |last7=Oortwijn |first7=Wija |last8=MacGillivray |first8=Steve |date=31 March 2005 |title=What Is eHealth (4): A Scoping Exercise to Map the Field |journal=Journal of Medical Internet Research |volume=7 |issue=1 |pages=e9 |doi=10.2196/jmir.7.1.e9 |pmc=1550637 |pmid=15829481 |doi-access=free}}{{cite journal |last1=Ahern |first1=David K. |last2=Kreslake |first2=Jennifer M. |last3=Phalen |first3=Judith M. |date=31 March 2006 |title=What Is eHealth (6): Perspectives on the Evolution of eHealth Research |journal=Journal of Medical Internet Research |volume=8 |issue=1 |pages=e4 |doi=10.2196/jmir.8.1.e4 |pmc=1550694 |pmid=16585029 |doi-access=free}} 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, as in the [[e-Patient]] movement. [27] => [28] => ==eHealth literacy== [29] => eHealth literacy is defined as "the ability to seek, find, understand and appraise health information from electronic sources and apply knowledge gained to addressing or solving a health problem."{{Cite journal |last1=Norman |first1=C. D. |last2=Skinner |first2=H. A. |year=2006 |title=eHEALS: The eHealth Literacy Scale. |journal=Journal of Medical Internet Research |volume=8 |issue=2 |pages=e9 |doi=10.2196/jmir.8.2.e9 |pmc=1550701 |pmid=16867972 |doi-access=free}} According to this definition, eHealth literacy encompasses six types of literacy: traditional (literacy and numeracy), information, media, health, computer, and scientific. Of these, media and computer literacies are unique to the Internet context, with eHealth media literacy being the awareness of media bias or perspective, the ability to discern both explicit and implicit meaning from media messages, and to derive meaning from media messages. The literature includes other definitions of perceived media capability or efficacy, but these were not specific to health information on the Internet.{{Cite journal |last1=Miller |first1=E |last2=West |first2=D |year=2007 |title=Characteristics associated with use of public and private web sites as sources of health care information: results from a national survey. |journal=Med Care |volume=45 |issue=3 |pages=245–251 |doi=10.1097/01.mlr.0000244509.60556.49 |pmid=17304082 |s2cid=2521947}} Having the composite skills of eHealth literacy allows health consumers to achieve positive outcomes from using the Internet for health purposes. eHealth literacy has the potential to both protect consumers from harm and empower them to fully participate in informed health-related decision making. People with high levels of eHealth literacy are also more aware of the risk of encountering unreliable information on the Internet{{Cite journal |last1=Neter |first1=E |last2=Brainin |first2=E |year=2012 |title=eHealth literacy: extending the digital divide to the realm of health information. |journal=Journal of Medical Internet Research |volume=14 |issue=1 |pages=e19 |doi=10.2196/jmir.1619 |pmc=3374546 |pmid=22357448 |doi-access=free}} On the other hand, the extension of digital resources to the health domain in the form of eHealth literacy can also create new gaps between health consumers. eHealth literacy hinges not on the mere access to technology, but rather on the skill to apply the accessed knowledge. The efficiency of eHealth also heavily relies on the efficiency and ease of use regarding technology being used by the patient. A high understanding of technology will not overcome the obstacles of overcomplicated technology being used by patients that are physically and mentally hindered.{{Cite journal |last1=Leonardsen |first1=Ann-Chatrin Linqvist |last2=Hardeland |first2=Camilla |last3=Helgesen |first3=Ann Karin |last4=Grøndahl |first4=Vigdis A. |date=December 2020 |title=Patient experiences with technology enabled care across healthcare settings- a systematic review |journal=BMC Health Services Research |language=en |volume=20 |issue=1 |page=779 |doi=10.1186/s12913-020-05633-4 |pmid=32838784 |pmc=7446109 |issn=1472-6963 |doi-access=free }} [30] => [31] => The population of elderly people surpassed the number of children for the first time in history in 2018. A more multi-faceted approach is necessary for this age group, because they are more susceptible to chronic disease, contraindications of medication, and other age-related setbacks like forgetfulness. Ehealth offers services that can be very helpful for all of these scenarios, making an elderly patient's quality of life substantially better with proper use.{{Cite journal |last1=Stefanicka-Wojtas |first1=Dorota |last2=Kurpas |first2=Donata |date=2022-03-15 |title=eHealth and mHealth in Chronic Diseases—Identification of Barriers, Existing Solutions, and Promoters Based on a Survey of EU Stakeholders Involved in Regions4PerMed (H2020) |journal=Journal of Personalized Medicine |volume=12 |issue=3 |pages=467 |doi=10.3390/jpm12030467 |issn=2075-4426 |pmc=8954526 |pmid=35330466 |doi-access=free }} [32] => [33] => ==Data exchange== [34] => 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. Each medical practice has its own jargon and diagnostic tools, so to standardize the exchange of information, various coding schemes may be used in combination with international medical standards. Systems that deal with these transfers are often referred to as Health Information Exchange (HIE). Of the forms of e-health already mentioned, there are roughly two types; front-end data exchange and back-end exchange. [35] => [36] => 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 via email to the family doctor for control. Such an action may avoid the cost of an expensive visit to the hospital. [37] => [38] => 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. [39] => [40] => ===Thesaurus=== [41] => 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.{{cite web |title=e-Diabetes on the website of the Dutch Diabetes foundation |url=http://www.diabetesfederatie.nl/ndf/e-diabetes.html |access-date=2012-04-15 |publisher=Diabetesfederatie.nl}} 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. [42] => [43] => 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. [44] => [45] => ==Early adopters== [46] => Patients living with long term conditions (also called chronic conditions) 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. [47] => [48] => == E-mental health == [49] => {{See also|Use of technology in treatment of mental disorders|Telepsychiatry}} [50] => E-mental health is frequently used to refer to internet based interventions and support for [[mental health]] conditions.{{cite journal |last1=Bennett |first1=Kylie |last2=Reynolds |first2=Julia |last3=Christensen |first3=Helen |last4=Griffiths |first4=Kathleen M. |date=7 June 2010 |title=e-hub: an online self-help mental health service in the community |url=https://www.mja.com.au/journal/2010/192/11/e-hub-online-self-help-mental-health-service-community |journal=Medical Journal of Australia |volume=192 |issue=11 Suppl |pages=S48–S52 |doi=10.5694/j.1326-5377.2010.tb03694.x |pmid=20528710 |s2cid=38159263 |url-access=registration |via=MJA}} However, it can also refer to the use of information and communication technologies that also includes the use of social media, landline and mobile phones.{{cite book |last1=Johnson |first1=Peter Anto |title=E-Mental Health and the Modern Mind: Developments, Dangers, and Destruction |last2=Johnson |first2=John Christy |last3=Harline |first3=Shawna |last4=Robert |first4=McWeeny |date=13 May 2021 |publisher=Golden Meteorite Press |isbn=9781773692289 |edition=2 |location=Canada}}{{cite report |url=http://www.nhsconfed.org/resources/2013/01/e-mental-health-whats-all-the-fuss-about |title=E-Mental Health: what's all the fuss about? |last1=Cotton |first1=Rebecca |last2=Hyatt |first2=Jen |date=29 January 2013 |publisher=[[NHS Confederation]] |location=London, UK |volume=12 |last3=Patrick |first3=Matthew |series=Discussion Paper |access-date=16 June 2017 |archive-date=22 October 2020 |archive-url=https://web.archive.org/web/20201022234639/https://www.nhsconfed.org/resources/2013/01/e-mental-health-whats-all-the-fuss-about |url-status=dead }} E-mental health services can include information; peer support services, computer and internet based programs, virtual applications and games as well as real time interaction with trained clinicians.{{cite report |url=http://www.health.gov.au/internet/main/publishing.nsf/content/7C7B0BFEB985D0EBCA257BF0001BB0A6/$File/emstrat.pdf |title=E-Mental Health Strategy for Australia |author=Department of Health and Ageing |date=June 2012 |publisher=Australian Government |location=Canberra, Australia}} Programs can also be delivered using telephones and [[interactive voice response]] (IVR).{{cite web |date=1 May 2013 |title=Computerised cognitive behaviour therapy for depression and anxiety |url=https://www.nice.org.uk/guidance/ta97 |website=NICE |publisher=National Institute for Health & Clinical Excellence |orig-year=2006 |location=London, UK}} [51] => [52] => [[Mental disorders]] includes a range of conditions such as alcohol and drug use disorders, [[mood disorders]] such as depression, [[dementia]] and [[Alzheimer's disease]], delusional disorders such as [[schizophrenia]] and [[anxiety disorders]].{{cite book |author=American Psychiatric Association |title=Diagnostic and Statistical Manual of Mental Disorders |title-link=Diagnostic and Statistical Manual of Mental Disorders |date=2000 |publisher=American Psychiatric Publishing |isbn=978-0-89042-025-6 |edition=4th, text revision |author-link=American Psychiatric Association}}{{Page needed|date=June 2017}} The majority of e-mental health interventions have focused on the treatment of depression and anxiety. There are also E-mental health programs available for other interventions such as [[smoking cessation]],{{Cite journal |last1=Taylor |first1=Gemma M. J. |last2=Dalili |first2=Michael N. |last3=Semwal |first3=Monika |last4=Civljak |first4=Marta |last5=Sheikh |first5=Aziz |last6=Car |first6=Josip |date=2017 |title=Internet-based interventions for smoking cessation |journal=The Cochrane Database of Systematic Reviews |volume=2017 |issue=9 |pages=CD007078 |doi=10.1002/14651858.CD007078.pub5 |issn=1469-493X |pmc=6703145 |pmid=28869775}} [[gambling]],{{cite journal |last1=Hodgins |first1=David C. |last2=Fick |first2=Gordon H. |last3=Murray |first3=Robert |last4=Cunningham |first4=John A. |date=8 January 2013 |title=Internet-based interventions for disordered gamblers: study protocol for a randomized controlled trial of online self-directed cognitive-behavioural motivational therapy |journal=BMC Public Health |volume=13 |page=10 |doi=10.1186/1471-2458-13-10 |pmc=3545736 |pmid=23294668 |doi-access=free}} and post-disaster mental health.{{cite journal |last1=Ruggiero |first1=Kenneth J. |last2=Resnick |first2=Heidi S. |last3=Paul |first3=Lisa A. |last4=Gros |first4=Kirstin |last5=McCauley |first5=Jenna L. |last6=Acierno |first6=Ron |last7=Morgan |first7=Mark |last8=Galea |first8=Sandro |date=January 2012 |title=Randomized Controlled Trial of an Internet-Based Intervention Using Random-Digit-Dial Recruitment: The ''Disaster Recovery Web'' Project |journal=Contemporary Clinical Trials |volume=33 |issue=1 |pages=237–46 |doi=10.1016/j.cct.2011.10.001 |pmc=3253875 |pmid=22008248}} [53] => [54] => ===Advantages and disadvantages=== [55] => E-mental health has a number of advantages such as being low cost, easily accessible and providing anonymity to users.{{cite journal |last1=Andrews |first1=Gavin |last2=Titov |first2=Nickolai |date=25 May 2010 |title=Treating people you never see: internet-based treatment of the internalising mental disorders |journal=Australian Health Review |volume=34 |issue=2 |pages=144–7 |doi=10.1071/AH09775 |pmid=20521437}} However, there are also a number of disadvantages such as concerns regarding treatment credibility, user privacy and confidentiality.{{cite journal |last1=Musiat |first1=Peter |last2=Goldstone |first2=Philip |last3=Tarrier |first3=Nicholas |date=11 April 2014 |title=Understanding the acceptability of e-mental health: attitudes and expectations towards computerised self-help treatments for mental health problems |journal=BMC Psychiatry |volume=14 |page=109 |doi=10.1186/1471-244X-14-109 |pmc=3999507 |pmid=24725765 |doi-access=free}} Online security involves the implementation of appropriate safeguards to protect user privacy and confidentiality. This includes appropriate collection and handling of user data, the protection of data from unauthorized access and modification and the safe storage of data.{{cite journal |last1=Bennett |first1=Kylie |last2=Bennett |first2=Anthony James |last3=Griffiths |first3=Kathleen Margaret |date=19 December 2010 |title=Security Considerations for E-Mental Health Interventions |journal=Journal of Medical Internet Research |volume=12 |issue=5 |page=e61 |doi=10.2196/jmir.1468 |pmc=3057317 |pmid=21169173 |doi-access=free}} Technical difficulties are another potential disadvantage. With almost all forms of technology, there will be unintended difficulties or malfunctions, which doesn't exclude tablets, computers, and wireless medical devices. Ehealth is also very dependent on the patient having functional Wi-Fi, which can be an issue that cannot be fixed without an expert. [56] => [57] => E-mental health has been gaining momentum in the academic research as well as practical arenas{{cite journal |last1=Sprenger |first1=Michaela |last2=Mettler |first2=Tobias |last3=Osma |first3=Jorge |date=12 July 2017 |title=Health professionals' perspective on the promotion of e-mental health apps in the context of maternal depression |journal=PLOS ONE |volume=12 |issue=7 |page=e0180867 |bibcode=2017PLoSO..1280867S |doi=10.1371/journal.pone.0180867 |pmc=5507525 |pmid=28704442 |doi-access=free}} 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.{{cite web |title=ISHMO |url=http://www.ismho.org/ |publisher=International Society for Mental Health Online}} However, e-Mental health implementation into clinical practice and healthcare systems remains limited and fragmented.{{cite journal |last1=Gehring |first1=ND |date=21 June 2017 |title=Pediatric eMental healthcare technologies: a systematic review of implementation foci in research studies, and government and organizational documents |journal=Implementation Science |volume=12 |issue=76 |pages=76 |doi=10.1186/s13012-017-0608-6 |pmc=5479013 |pmid=28637479 |doi-access=free}}{{cite journal |last1=Wozney |first1=L |date=December 2017 |title=Implementation of eMental Health care: viewpoints from key informants from organizations and agencies with eHealth mandates |journal=BMC Medical Informatics and Decision Making |volume=17 |issue=78 |pages=78 |doi=10.1186/s12911-017-0474-9 |pmc=5455087 |pmid=28577543 |doi-access=free}} [58] => [59] => ===Programs=== [60] => There are at least five programs currently available to treat [[Anxiety disorder|anxiety]] and [[Major depressive disorder|depression]]. Several programs have been identified by the UK [[National Institute for Health and Care Excellence]] as cost effective for use in primary care. These include ''Fearfighter'',{{cite web |title=FearFighter |url=http://fearfighter.cbtprogram.com/ |publisher=CCBT Ltd |access-date=16 June 2017 |archive-date=2 August 2019 |archive-url=https://web.archive.org/web/20190802044122/http://fearfighter.cbtprogram.com/ |url-status=dead }} a text based [[cognitive behavioral therapy]] program to treat people with phobias, and ''Beating the Blues'',{{cite web |title=Beating the Blues |url=http://www.beatingtheblues.co.uk/ |publisher=365 Health and Wellbeing Ltd}} an interactive text, cartoon and video CBT program for anxiety and depression. Two programs have been supported for use in primary care by the [[Government of Australia|Australian Government]].{{Cite web |title=Online Programs for Stress, Anxiety, and Depression |url=https://thiswayup.org.au/programs/ |access-date=2022-06-20 |website=THIS WAY UP |language=en-AU}} The first is ''Anxiety Online'',{{cite web |title=Mental Health Online |url=http://www.anxietyonline.org.au/ |publisher=[[Swinburne University of Technology]]}} a text based program for the anxiety, depressive and eating disorders, and the second is ''THIS WAY UP'',{{cite web |title=THIS WAY UP |url=http://thiswayup.org.au |publisher=[[St Vincent's Hospital, Sydney|St Vincent's Hospital Sydney Limited]]}} a set of interactive text, cartoon and video programs for the anxiety and depressive disorders. Another is ''iFightDepression''{{cite web |title=iFightDepression® |url=https://ifightdepression.com/ |publisher=European Alliance Against Depression}} a multilingual, free to use, web-based tool for self-management of less severe forms of depression, for use under guidance of a GP or psychotherapist. [61] => [62] => There are a number of online programs relating to [[smoking cessation]]. ''QuitCoach''{{cite web |title=QuitCoach |url=http://www.quitcoach.org.au/ |publisher=Quit Victoria}} is a personalised quit plan based on the users response to questions regarding giving up smoking and tailored individually each time the user logs into the site. ''Freedom From Smoking''{{cite web |title=Freedom From Smoking® Online |url=http://www.ffsonline.org/ |publisher=[[American Lung Association]] |access-date=9 June 2013 |archive-date=24 April 2021 |archive-url=https://web.archive.org/web/20210424150416/http://www.ffsonline.org/ |url-status=dead }} takes users through lessons that are grouped into modules that provide information and assignments to complete. The modules guide participants through steps such as preparing to quit smoking, stopping smoking and preventing relapse. [63] => [64] => Other internet programs have been developed specifically as part of research into treatment for specific disorders. For example, an online self-directed therapy for [[problem gambling]] was developed to specifically test this as a method of treatment. All participants were given access to a website. The treatment group was provided with behavioural and cognitive strategies to reduce or quit gambling. This was presented in the form of a workbook which encouraged participants to self-monitor their gambling by maintaining an online log of gambling and gambling urges. Participants could also use a smartphone application to collect self-monitoring information. Finally participants could also choose to receive motivational email or text reminders of their progress and goals. [65] => [66] => An internet based intervention was also developed for use after [[Hurricane Ike]] in 2009. During this study, 1,249 disaster-affected adults were randomly recruited to take part in the intervention. Participants were given a structured interview then invited to access the web intervention using a unique password. Access to the website was provided for a four-month period. As participants accessed the site they were randomly assigned to either the intervention. those assigned to the intervention were provided with modules consisting of information regarding effective coping strategies to manage mental health and health risk behaviour. [67] => [68] => eHealth programs have been found to be effective in treating [[borderline personality disorder]] (BPD).{{cite journal |last1=Köhne |first1=Sandra |last2=Schweiger |first2=Ulrich |last3=Jacob |first3=Gitta A. |last4=Braakmann |first4=Diana |last5=Klein |first5=Jan Philipp |last6=Borgwardt |first6=Stefan |last7=Assmann |first7=Nele |last8=Rogg |first8=Mirco |last9=Schaich |first9=Anja |last10=Faßbinder |first10=Eva |date=2019 |title=Therapeutic Relationship in eHealth—A Pilot Study of Similarities and Differences between the Online Program Priovi and Therapists Treating Borderline Personality Disorder |journal=International Journal of Environmental Research and Public Health |language=en |volume=17 |issue=17 |pages=6436 |doi=10.3390/ijerph17176436 |pmc=7504280 |pmid=32899432 |doi-access=free}} [69] => [70] => ==Cybermedicine== [71] => Cybermedicine is the use of the [[Internet]] to deliver [[Medicine|medical]] services, such as medical consultations and [[Medical prescription|drug prescriptions]]. It is the successor to [[telemedicine]], wherein [[Physician|doctors]] would consult and treat [[patient]]s remotely via [[telephone]] or [[fax]]. [72] => [73] => Cybermedicine is already being used in small projects where images are transmitted from a [[primary care]] setting to a [[medical specialist]], who comments on the case and suggests which intervention might benefit the patient. A field that lends itself to this approach is [[dermatology]], where images of an eruption are communicated to a hospital specialist who determines if referral is necessary. [74] => [75] => The field has also expanded to include online "ask the doctor" services that allow patients direct, paid access to consultations (with varying degrees of depth) with medical professionals (examples include [[Bundoo|Bundoo.com]], [[Teladoc]], and [[Ask The Doctor]]). [76] => [77] => A Cyber [[Physician|Doctor]],{{cite web |last=Allday |first=Erin |date=27 May 2007 |title=Online visits a boon for far-off patients |url=http://www.sfgate.com/health/article/Online-visits-a-boon-for-far-off-patients-In-2558574.php |work=SFGate |publisher=San Francisco Chronicle}} known in the UK as a Cyber [[Physician]],{{cite web |last=Butler |first=Patrick |date=7 December 2000 |title=Future care to be provided by cyber doctors |url=https://www.theguardian.com/society/2000/dec/07/health.healthandwellbeing |work=The Guardian |quote=Patients' first contact with the NHS in 20 years time will be via interactive 'cyber-physicians' accessed through domestic television sets, according to a government-sponsored study.}} is a medical [[professional]] who does [[wiktionary:consultation|consultation]] via the internet, treating virtual patients, who may never meet face to face. This is a new area of medicine which has been utilized by the armed forces and teaching [[hospitals]] offering [[online]] consultation to patients before making their decision to travel for unique medical treatment only offered at a particular medical facility. [78] => [79] => == Self-monitoring healthcare devices == [80] => Self-monitoring is the use of sensors or tools which are readily available to the general public to track and record personal data. The sensors are usually wearable devices and the tools are digitally available through mobile device applications. Self-monitoring devices were created for the purpose of allowing personal data to be instantly available to the individual to be analyzed. As of now, fitness and health monitoring are the most popular applications for self-monitoring devices.{{cite web |last=Paddock |first=Catharine |date=15 August 2013 |title=How self-monitoring is transforming health |url=http://www.medicalnewstoday.com/articles/264784.php |website=Medical News Today |publisher=Healthline Media UK Ltd}} The biggest benefit to self-monitoring devices is the elimination of the necessity for third party hospitals to run tests, which are both expensive and lengthy. These devices are an important advancement in the field of personal health management. [81] => [[File:NikeFuelband.jpg|thumb|Nike FuelBand]] [82] => Self-monitoring healthcare devices exist in many forms. An example is the [[Nike+ FuelBand]], which is a modified version of the original [[pedometer]]. This device is wearable on the wrist and allows one to set a personal goal for a daily energy burn. It records the calories burned and the number of steps taken for each day while simultaneously functioning as a watch. To add to the ease of the user interface, it includes both numeric and visual indicators of whether or not the individual has achieved his or her daily goal. Finally, it is also synced to an [[iPhone]] app which allows for tracking and sharing of personal record and achievements.{{Cite web |last=Bishop |first=Bryan |date=2012-06-29 |title=Nike+ FuelBand app for iOS updated with background syncing and battery meter |url=https://www.theverge.com/2012/6/29/3125318/nike-updates-fuelband-app-ios-background-syncing |access-date=2019-12-31 |website=The Verge |language=en}} [83] => [84] => Other monitoring devices have more medical relevance. A well-known device of this type is the [[Blood glucose monitoring|blood glucose monitor]]. The use of this device is restricted to diabetic patients and allows users to measure the blood glucose levels in their body. It is extremely quantitative and the results are available instantaneously.{{cite web |date=22 December 2016 |title=Blood Glucose Monitoring Devices |url=https://www.fda.gov/medicaldevices/productsandmedicalprocedures/invitrodiagnostics/glucosetestingdevices/default.htm |website=U.S. Food and Drug Administration |publisher=U.S. Department of Health and Human Services}} However, this device is not as independent of a self-monitoring device as the Nike+ Fuelband because it requires some [[patient education]] before use. One needs to be able to make connections between the levels of glucose and the effect of diet and exercise. In addition, the users must also understand how the treatment should be adjusted based on the results. In other words, the results are not just static measurements. [85] => [86] => The demand for self-monitoring health devices is skyrocketing, as wireless health technologies have become especially popular in the last few years. In fact, it is expected that by 2016, self-monitoring health devices will account for 80% of wireless medical devices.{{cite web |last=Dolan |first=Brian |date=31 May 2012 |title=By 2017: 50M consumer wireless health devices to ship |url=http://mobihealthnews.com/17498/by-2017-50m-consumer-wireless-health-devices-to-ship/ |website=MobiHealthNews |publisher=HIMSS Media}} The key selling point for these devices is the mobility of information for consumers. The accessibility of mobile devices such as smartphones and tablets has increased significantly within the past decade. This has made it easier for users to access real-time information in a number of peripheral devices. [87] => [88] => There are still many future improvements for self-monitoring healthcare devices. Although most of these wearable devices have been excellent at providing direct data to the individual user, the biggest task which remains at hand is how to effectively use this data. Although the blood glucose monitor allows the user to take action based on the results, measurements such as the pulse rate, EKG signals, and calories do not necessarily serve to actively guide an individual's personal healthcare management. Consumers are interested in qualitative feedback in addition to the quantitative measurements recorded by the devices.{{cite web |last=Gruman |first=Jessie |date=16 April 2014 |title=Self-Monitoring Health IT Falls Short of Providing the Information We Need |url=http://www.cfah.org/blog/2014/self-monitoring-health-it-falls-short-of-providing-the-information-we-need |website=Center for Advancing Health: Prepared Patient Blog |publisher=George Washington University}} [89] => [90] => == eHealth During COVID-19 == [91] => [[File:蕭中正院長進行Telecare conference.jpg|thumb|Online healthcare appointment via webcam]] [92] => The pandemic that impacted the entire world made it extremely difficult for vast amounts of people to receive adequate healthcare in person. Elderly citizens and people with chronic health conditions were at more risk than the average healthy human, therefore they were more adversely affected than most. The switch from in-person to telehealth appointments and interventions was necessary to reduce the risks of spreading and/or contracting the disease.{{Cite journal |last1=Bitar |first1=Hind |last2=Alismail |first2=Sarah |date=2021-04-19 |title=The role of eHealth, telehealth, and telemedicine for chronic disease patients during COVID-19 pandemic: A rapid systematic review |journal=Digital Health |volume=7 |pages=20552076211009396 |doi=10.1177/20552076211009396 |issn=2055-2076 |pmc=8060773 |pmid=33959378}} The forced use of telehealth during the pandemic highlighted its strengths and weaknesses, which accelerated the progression of this medium. The user feedback on eHealth during the [[COVID-19 pandemic]] was very positive, and consequently many patients and healthcare providers reported that they will continue to use this method of healthcare following the pandemic. [93] => [94] => == In developing countries == [95] => eHealth in general, and telemedicine in particular, is a vital resource to remote regions of emerging and developing countries but is often difficult to establish because of the lack of communications infrastructure.{{cite web |last=Iluyemi |first=Adesina |date=14 April 2009 |title=Refocusing Europe-Africa Strategy: Strategic Importance of eHealth |url=https://www.slideshare.net/Adesina/euafrica-ict-forumv2 |website=SlideShare}} For example, in Benin, hospitals often can become inaccessible due to flooding during the rainy season{{cite press release |last=Payer |first=Markus |publisher=SES |date=4 June 2015 |location=Luxembourg |url=http://www.ses.com/4233325/news/2015/21260022 |title=SES Improves Quality Healthcare Access in Benin |access-date=26 February 2016 |url-status=dead |archive-date=5 March 2016 |archive-url=https://web.archive.org/web/20160305000119/http://www.ses.com/4233325/news/2015/21260022}} and across Africa, the low population density, along with severe weather conditions and the difficult financial situation in many African states, has meant that the majority of the African people are badly disadvantaged in medical care. In many regions there is not only a significant lack of facilities and trained health professionals, but also no access to eHealth because there is also no internet access in remote villages, or even a reliable electricity supply.{{cite web |last=Bethscheider |first=Gerhard |date=2 September 2015 |editor-last=Barney |editor-first=Randall |title=Satellite is vital for a unified, global, E-Health system... An SES Techcom Services Perspective |url=http://www.worldteleport.org/news/249029/Satellite-Is-Vital-For-A-Unified-Global-e-Health-System...-An-SES-Techcom-Services-Perspective-.htm |access-date=28 January 2016 |website=World Teleport Association}} [96] => [97] => Approximately 13 percent of people who live in Kenya have health insurance. A majority of the total health expenditure in sub-Saharan Africa was paid out-of-pocket, which forces millions into poverty yearly. A Kenyan service by the name of [[M-Pesa|M-PESA]] may offer a solution to this problem. This mobile platform provides full transparency of patients needs and allows access to medical products and the ability to efficiently manage their funding.{{Cite journal |last1=Rakers |first1=Margot |last2=van de Vijver |first2=Steven |last3=Bossio |first3=Paz |last4=Moens |first4=Nic |last5=Rauws |first5=Michiel |last6=Orera |first6=Millicent |last7=Shen |first7=Hongxia |last8=Hallensleben |first8=Cynthia |last9=Brakema |first9=Evelyn |last10=Guldemond |first10=Nick |last11=Chavannes |first11=Niels H. |last12=Villalobos-Quesada |first12=María |title=SERIES: eHealth in primary care. Part 6: Global perspectives: Learning from eHealth for low-resource primary care settings and across high-, middle- and low-income countries |journal=The European Journal of General Practice |date=2023 |volume=29 |issue=1 |pages=2241987 |doi=10.1080/13814788.2023.2241987 |issn=1381-4788 |pmid=37615720|pmc=10453992 }} [98] => [99] => Internet connectivity, and the benefits of eHealth, can be brought to these regions using [[Satellite Internet access|satellite broadband]] technology, and satellite is often the only solution where terrestrial access may be limited, or poor quality, and one that can provide a fast connection over a vast coverage area. [100] => [101] => == Evaluation == [102] => While eHealth has become an indispensable facet of healthcare in the past 5 years, there are still barriers preventing it from reaching its full potential. Knowledge of the socio-economic performance of eHealth is limited, and findings from evaluations are often challenging to transfer to other settings. Socio-economic evaluations of some narrow types of mHealth can rely on health economic methodologies, but larger scale eHealth may have too many variables, and tortuous, intangible cause and effect links may need a wider approach.{{cite journal |last1=Greenhalgh |first1=Trisha |last2=Russell |first2=Jill |date=2 November 2010 |title=Why Do Evaluations of eHealth Programs Fail? An Alternative Set of Guiding Principles |journal=PLOS Medicine |volume=7 |issue=11 |page=e1000360 |doi=10.1371/journal.pmed.1000360 |pmc=2970573 |pmid=21072245 |doi-access=free}} {{open access}} There are no international guidelines for the usage of eHealth due to many variables such as ignorance on the matter, infrastructure issues, quality of healthcare professionals and lack of healthcare plans. It should also be stated that the effectiveness of eHealth is also dependent on the patient's condition. Some researchers believe that online healthcare may be most efficient as a supplement to in-person care. [103] => [104] => ==See also== [105] => {{div col|colwidth=40em}} [106] => *[[Center for Telehealth and E-Health Law]] [107] => *[[eHealthInsurance]] [108] => *[[EUDRANET]] [109] => *[[European Institute for Health Records]] [110] => *[[Health 2.0]] [111] => *[[Health blog]] [112] => *[[Technology and mental health issues]] [113] => *[[Telehealth]] [114] => {{div col end}} [115] => [116] => == References == [117] => {{reflist}} [118] => [119] => == Further reading == [120] => {{refbegin}} [121] => * {{cite book |last1=Miah |first1=Andy |last2=Rich |first2=Emma |date=2009 |title=The Medicalization of Cyberspace |url=https://archive.org/details/medicalizationof0000miah |url-access=registration |publisher=Routledge |location=London |oclc=978360846 |isbn=978-0-415-39364-5 }} [122] => * {{cite book |last=Slack |first=Warner V. |title=Cybermedicine: how computing empowers doctors and patients for better healthcare |date=2001 |publisher=Jossey Bass |location=San Francisco |isbn=978-0-7879-5631-8 |edition=Revised, updated |oclc=806149793 }} [123] => * {{cite book |editor1-first=Magdalene |editor1-last=Rosenmöller |editor2-first=Diane |editor2-last=Whitehouse |editor3-first=Petra |editor3-last=Wilson |date=2014 |title=Managing eHealth: From Vision to Reality |location=Basingstoke |publisher=Palgrave Macmillan |isbn=978-1-137-37942-9 |oclc=870285603 }} [124] => * {{cite journal |last1=Dunlop |first1=Sally |last2=Freeman |first2=Becky |last3=Jones |first3=Sandra |title=Marketing to Youth in the Digital Age: The Promotion of Unhealthy Products and Health Promoting Behaviours on Social Media |journal=Media and Communication |volume=4 |issue=3 |pages=35 |doi=10.17645/mac.v4i3.522 |year=2016 |url=https://ses.library.usyd.edu.au/bitstream/2123/14967/2/social%20media%20and%20health%20review.pdf |doi-access=free }} [125] => {{refend}} [126] => [127] => == External links == [128] => * {{cite web |url=http://www.nweh.org.uk/ |title=NorthWest EHealth |publisher=NWEH |date=January 2019 |access-date=24 June 2013 |archive-date=16 October 2015 |archive-url=https://web.archive.org/web/20151016214509/http://nweh.org.uk/ |url-status=dead }} [129] => * {{cite web |url=http://internetmedicalsociety.weebly.com/ehealthq.html |title=The eHeatlhQ Seal |website=Internet Medical Society }} [130] => * {{cite web |url=http://online.sju.edu/resource/health-human-services/digital-health-care-environment |title=The Digital Health Care Environment |website=Saint Joseph's University |date=2017-02-13 }} [131] => * {{cite web |url=https://www.gov.uk/government/collections/evaluating-digital-health-products |title=Evaluating digital health products |website=GOV.UK |date=January 2020 }} [132] => [133] => {{Telemedicine navbox}} [134] => {{Authority control}} [135] => [136] => [[Category:Health informatics]] [137] => [[Category:Telemedicine]] [] => )
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EHealth

eHealth describes healthcare services which are supported by digital processes, communication or technology such as electronic prescribing, Telehealth, or Electronic Health Records (EHRs). The use of electronic processes in healthcare dated back to at least the 1990s.

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