What is eHealth?

Updated Sept 15, 2016                Svensk version

What is eHealth and why is it important? How should good eHealth services work?

The term eHealth is often used for all types if IT services in health care. Online booking of visits, EMR systems (Electronic Medical Records), electronic prescriptions and remittances etc.

To me, all these IT services are useful IT and important to implement. But they are more about making the health care processes more effective than about directly improving health. So I think these types of services should be called Health IT instead.

Time for a new term?

The EU is defining eHealth as ”information and communication technologies (ICTs) that can improve prevention, diagnosis, treatment, monitoring and management.”

The letter e in eHealth means electronic, but no human health is really electronic, and to indicate that some types of health services are electronic now feels somewhat irrelevant. We no longer call our appliances “electric” as we did in the early days of electrification.

So it may be time to start using a new term that emphasizes that it is about new types of health services that improves health care, wellfare, self care and preventive care. Perhaps find a new, less nerdy term than “Health 2.0”, which is already being used.

But until we find a better term, let’s use eHealth and start by explaining why eHealth is important and how good eHealth services should work.

Background and the status today

Our health care systems are experiencing major challenges due to the increasing health care needs from growing and aging populations, overstepped budgets and staff shortages. Also, there are increasing demands from the citizens to get quicker and more personal access to health care. They are calling for similar digital functionalities that they are now used to from banking, travel and other service sectors.

eHealth is now globally seen as one of the most important tools for meeting these challenges. Therefore we must encourage the development of useful eHealth applications that enable useful and more resource-efficient health care services.

Today, most eHealth services are used for fitness activities and various forms of self-care. But the biggest benefit is for patients with chronic diseases. This group stands for more than 75% of the total health care budget in most countries! So there is an enormous potential here to save on health care resources and increase the patient satisfaction.

eHealth also creates benefit for the health care professionals, since it is an efficient tool for personalized, continuous monitoring of treatments.

Medical data that is generated by eHealth services also provides valuable input for medical research.

What is a good eHealth service?

eHealth is about digital services via internet, using computers, tablets and smartphones. A fundamental goal should be that all eHealth applications should be useful and beneficent for both patients and health care professionals and at the same time save money. So we must strive to develop eHealth services that are:

1. Patient-centered

Empowering the patient in her care process and enabling a better control of her health status through continuous follow up by herself and health care professionals.

2. Improving the health

Good eHealth services can optimize medication effects by increasing patient adherence and enabling more individually optimized medication plans.

Patients with chronic diseases can report their health statuses and medical data continuously via their smartphones, instead of only during doctor visits. eHealth apps and sensors in the home can also trigger an alarm when monitored data show a critical trend, this allows for early intervention that can prevent many cases of hospitalization, (74% decrease in the US).

This enables the patients to be much more engaged in their own health care and learn about lifestyle habits that are affecting their personal health.

3. Streamlining the health care process

eHealth services can lower the pressure from patients that used to come regularly for routine visits. Instead, many patients can signal when they need to see their doctor and get more personal meetings that are based on the patients’ reported self-care data and prepared questions. The staff can then also focus more on the types of health care services and patients that specifically require in-person care.

eHealth applications can also enable earlier detection of chronic diseases with public online screening test that shortens the journey from first symptoms to diagnosis and proper treatment. This can lead to a better health throughout life and large savings for society. It can be achieved with interactive online tests that guides people with early symptoms through the health care process and streamlines, or in some cases, eliminates the remittance process.

There are already online services where anyone can buy medical tests and blood panels at their own expense, have them done at a nearby medical lab and then own and control the resulting medical data. This gives valuable insights to those that want to know and learn more about their health status. But what is missing now is a way for the patients to transfer this data to their health care providers.

Coming soon are also medical devices for use at home, with which anyone can perform various medical tests themselves, for example blood sedimentation rates in order to verify possible infections. This will save a lot of time for people and reduce the workload for the staff in both primary and specialist care.

There are also eHealth Dermicus that let primary care doctors send imaging and medical data to specialists for quick analysis, enabling much faster access to specialist care for those that need it. This also saves costs in both primary and secondary care.

4. Saving money and staff time

eHealth saves money and staff time. Both patients and the health services’ staff get shorter lead times and more optimized meetings. The patients are saving travel time and reducing their lost income due to healthcare visits. Patients with chronic diseases can often stay in the work force for much longer, this also means great savings for the society.

5. Co-operating

eHealth services should be able to, when it is beneficial to the patients, be able to exchange data with other relevant e-services, such as personal health accounts, medical health records and decision support systems in the health services. In many cases, eHealth services can help the patient to enable family and relatives to give active health support, even when they live far away.

Examples of eHealth services

Air Smart Spirometer, smartphone-connected,  developed by the Swedish design firm Pond

Coala Life Personal smartphone-connected heart monitor for ECG and heart sounds

Dermicus, Sweden Telemedicine platform for effective diagnosis of skin cancer

DiabetesTools, Sweden. Self care for diabetics

Focus Cura, the Netherlands and other countries. Home care system for patients with chronic diseases

Health Tap, USA. 65 000 doctors offering telemedicine consultations

Joint Pain? Sweden. Online test and guide for people with potential arthritis symptoms (disclamer: this is one of my babies)

Livanda, Sweden. Cognitive behavioural therapy online

PatientsLikeMe, USA. Community for patients

RxEye, Sweden. Platform for radiology diagnostics

Symptom Checker, UK. Online screening tests by the NHS

WebMD, USA. Health information portal

See also my articles about the need for new eHealth reimbursement models