1.INTRODUCTION:
Using information and communication technologies in healthcare systems is known as e-Health.It focuses on technical development and also on state of mind, global thinking, etc to improve healthcare using Information and Communication Technologies.
e-Health care:
Electronic healthcare system is defined as an area where the health facility providers, medical professionals, respective ICT’s through the base of Internet work together. It accounts not only to the technical growth but also focuses on global intelligence for improving health services on various levels of governance.
The WORLD HEALTH ORGANISATION (WHO) defined e-Health as:
‘….the cost effective and secure use of information and communication technologies in support of health and health related fields including healthcare, health-surveillance, health education, knowledge and research.’
Background:
In May 2005, the 58th World Health Assembly took up a resolution WHA58.28 establishing a e-Health strategy for WHO.This resolution advised the member states to plan for e-Health services in their countries.In the same year Global Observatory for e-Health(GOe) was launched by WHO. GOe is an initiative which is determines the study of e-Health such as evolution of e-Health and impact of e-Health in countries.Later it was recognized that e-Health was undergoing a great transformation of delivering health services around the world.Thus WHO became a central role in molding and monitoring the future of e-Health.
e-health unit is working with partners at international level, country level, and regional level in order to promote and also to build up the importance and use of information and communication technologies (ICT) in development of health by by applying it to the field of global government. This e-Health unit is mainly based in Safety in Cluster of Health of citizens, Department of Service Delivery to citizens,and innovations to build up a healthy environment.
RESOLUTIONS AND DELIBERATIONS ON e-HEALTH:
Some important resolutions and deliberations made to improve E-Health policy are:
In 1998
101st Executive Board, Geneva, Switzerland
They have identified a rapid increase in importance towards internet and that lead to a great impact on health like advertisements, promotion of medical products etc and made a resolution on ‘Cross Border advertisements,promotions and also on sales of medical products through internet.’
In 2005
58th World Health Assembly,Geneva, Switzerland
It recognized that the main aim of e-Health was to make the e-Health systems stronger, improve its quality,safety, and access to care, so encouraged all the Member states to include the e-Health system into their health systems and services.
In 2013
66th World Health Assembly,Geneva, Switzerland
It has identified the importance of data standardization, need of proper governance and operation of health related internet domain names and produced a ‘.health’ domain.
In 2016
139th Executive Board, Geneva, Switzerland
It identified the importance of m-Health-using mobile wireless technologies for healthcare systems for accessing the health related information, services which are being provided, to manage diseases, and to make positive changes in health behaviours.
e-Health COLLABORATIONS:
The e-Health unit is working in collaboration with :
WHO collaboration centers for telemedicine and health informatics in many parts of the world. WHO is encouraging to make networks among the centers for sharing knowledge and also experiences to build up the countries together.
Some NGOs who have an official relationship with WHO in the field of e-Health,telemedicine and health informatics.
e-Health Technical Advisory group which is called as eTAG was established in 2013.It was developed to support and guide the work which is being carried out at WHO.It has many experts appointed who will provide advice on the policies, standards, planning aspects, priority settings, resource building and evaluation on e-Health activities.
Need of ICT for Health:
As there is immense growth in population, the no.of citizens and chronic diseases are increasing day-by-day, particularly among elderly people.This turned out to be a great challenge for public health care systems.This gave rise to e-Health along with ICT to provide efficient services.
Citizens should have basic ICT knowledge to use mobile phones and computers..As there are many innovations taking place in this present generation there is need for acceptance of e-Health systems.The overall objective of ICT for eHealth systems is persuade people with the is chronical diseases and educate citizens to use eHealth technology to prevent diseases and make better health.
Why e-Health in developing countries:
To provide access to health knowledge and information to rural health workers.
Urgency is required to achieve the target and to reverse the poor health and development ratings.
As there is geographical barriers to access health service provision.
As connectivity is becoming accessible and available in all communities especially in rural communities.
There are many existing health problems which are costly so there is need of e-health in developing countries.
2.MISSION:
The main observatory mission of e-Health is to improve the health conditions and health status by providing a strategic information to all the Member states and guide them with effective practices and the standards of e-Health.
3.OBJECTIVES:
The main aim of the implementation of e-healthcare is to improve the health situation along with quality of life of the citizens. This can be achieved by delivering equal access to the health services with a better quality to the citizens using the ICT’s.
Objectives of e-Health are:
To provide an appropriate, felicitous, a high standardized quality of evidence and information to support all the International bodies, National Governments in improving this policy, how to put this in practice, and management of the e-Health system.
To increase awareness among the citizens.
To make commitments between government and private sectors to invest , promote in advanced e-Healthcare systems for global betterment.
To generate knowledge which will considerably contribute to the health improvement using information and communication technologies.
To make an effective communication between health specialists for preventing health issues and for treatments.
To provide information to all medical activities.
To enable access to the information related to health to all citizens.It increase the medical consciousness among all the citizens.
Data is given to the health care experts.It increases the efficient treatment to the citizens and it will also increase working capability of the people.
To publicize research findings by making publications on e-Health research topics as a reference for all the policy makers as well as the government's.
4.NATIONAL e-HEALTH STRATEGY:
4.1 NEED FOR PLANNING
4.2 PURPOSE
4.3 IMPLEMENTATION
4.1 NEED FOR PLANNING:
In order to achieve long-term goals like health sector efficiency there is a need to establish some important directions and planning them with detailed steps.There is a need for collaboration between ICT and health sectors, and also between public and private sectors.Ministries of health play a crucial role in preserving the health systems in uncertain times.Ministries of Telecommunications and ICT also play a important role in contributing to health sector.
4.2 PURPOSE:
National eHealth strategy Toolkit is a resource for developing eHealth strategy.This Toolkit can be used by the government health sector leaders in ministries, departments who are responsible for managing the development in eHealth strategy.
4.3 IMPLEMENTATION:
PART1: NATIONAL E-HEALTH VISION
Developing a National e-Health vision which responds to health and development goals.It also gives a clarity why a National approach is needed, what can be achieved through the plan and how should it be done.
Managing the process
Engaging with stakeholders
Establishment of a strategic context
Learning from trends and experiences
Drafting and initial vision
Identification of required components
Gathering information on eHealth environment
Assessment of opportunities and gaps
Development recommendations
PART2: NATIONAL E-HEALTH ACTION PLAN:
Developing a roadmap of implementation which will the priorities of counties and eHealth context.Structuring the medium-term activities,along with building a strong foundation for long-time basis.
Managing the process
Engaging with stakeholders
Development of e-Health action lines
Development of an integrated action plan
Determining the resources which are required
Applying for fund constraints to refine the plans
Defining implementation phases.
PART3:NATIONAL E-HEALTH MONITORING AND EVALUATION:
Establishment of a plan to monitor the implementations and to manage the risks associated with it.Progress and results of implementation are identified and aids to secure support and investments.
Indicators must be defined for monitoring and evaluation
Define the target measures and baseline of the process
5. E-HEALTH SOLUTION ARCHITECTURE:
It is developed as a modular system consisting of three layers:
FIRST LAYER: The first layer is for the business users who will integrate this system by using their business systems.
SECOND LAYER: It is a system which includes all the core models.
THIRD LAYER: This layer is for data exchange with registries.
E-HEALTH ENCIRCLES A WIDE RANGE OF SUB-DOMAINS OF DIGITAL HEALTH:
Electronic Health Records
Electronic Medical Records
Telehealth and Telemedicine
Health IT systems
Consumer health IT data
Virtual healthcare
Mobile Health
How is e-Health used?
Some broadest applications of e-Health are:
Electronic Health Records (EHR) and Electronic Medical Recorders:
These are digital version of records of patients,e-prescribing, digital imaging and
archiving systems.These records can also shared across different health care centers.
Telemedicine and Telehealth Systems: It makes a real-time video conferencing and streaming between a patient and a doctor through ECG signals.
It will transmit the medical information for diagnosis of patients at a low cost.This
system has optimized the use of digital health assets.
Mobile Health application:Provides information about healthcare to patients, practitioners.Consumer informatic applications were having many health related websites and mobile applications and these were becoming popular.It is giving a great support to e-health programs.
Some clinical Health IT systems like radiology, Health IT nursing systems, medical imaging, surgery training systems were helping physicians to provide correct treatment and diagnosis to patients.
Some specialized e-Health systems are used by researchers for analyzing and collection of public health data.
There are some tools and technologies for supporting Health It systems like pharmaceutical supply chain management, systems for billing, systems for scheduling, for management and administration of hospitals.
e-Health technologies are improving accountability in care process and transparency.
6. BENEFITS:
1.PRIVACY:
There will be a limited access to patients information
All the access are tracked electronically, they are monitored and also recorded.
2.HEALTHCARE PROFESSIONALS:
They have a very easy access to diagnostics and drug information of each and every individual patient.
This reduces the duplicate calls to doctors and labs.
There is huge reduction in transcription and omission errors.
Reduces the unnecessary administrative works, this gives more time to physicians to have a better communication with their patients about their needs.
3.HEALTH AUTHORITIES:
It reduces the operating cost in labs.
An organised and efficient availability of emergency room operations.
Collecting the patient's information becomes more easier.
4.PATIENTS:
Very less delays in treatment and more accurate diagnoses.
Patients information will be secured and it can only be accessed by those who need to know.
Reduces the length of stay time in hospitals as there is improvement in operational efficiency.
5.EHR (ELECTRONIC HEALTH RECORD):
Immediate transfer of information of a patient can be made in emergency times.
Safe and Fast access to healthcare.
6. It improves communication between stakeholders and healthcare.
7. This reduces medical errors.
8. It enhances the capabilities of reporting.
9. In case of urgent emergencies , the remote consultations are very helpful to save patients lives.
10. It creates more convenient, efficient, and cost effective way for delivering care.
11. It provides a fast access to a patient's medical history like patients personal documents and also reduces the poor response to course of treatment.
12. It creates a way to residents in the rural areas to go through a expertised diagnosis and also treatment from the medical centers which are located far away.
13. It increases the time for treatments, reduces the medical cost as there is availability of video technology, in turn reducing the transfer rates.
14. It enhances the senior-citizen wellness through Telemedicine and remote in home monitoring.
15.Improved decision-making.
16.Enhancement of self-managing the chronic diseases.
17.Safety in drug dispensing.
7.CHALLENGES:
1.CHALLENGES FACED FOR IMPLEMENTATION:
The implementation of e-Health isn’t a simple task for the government. There were many barriers which should be came across for the implementation of the e-Healthcare system.
At first, the obstacles to implementation of the healthcare setting may rise at the local, organisational and also the wider levels of the healthcare system.
The main challenges faced in users (citizens of Bulgaria) perspective can be listed as lack of awareness of the benefits, interoperability, security concerns etc.
Financial factor is the major hurdle for the healthcare system implementation.
2.ENSURING DATA SECURITY AND DATA PROTECTION:
Patients along with the Healthcare professionals should have trust on the confidentiality of this e-health system.
3.ENGAGING AND TRAINING:
Doctors, Nurses, and the Healthcare Professionals must be trained to use the new healthcare technology.By creating a digital savvy workforce patients should get educated to ensure the potential of healthcare systems.
4.APPS FOR HEALTHCARE:
There are many healthcare apps, more than 1,00,000 are available now.These should be rationalised, standardised and also should be simplified to assist value and make them usable.
5.RECRUITING NEW IT TALENTS:
There is a need for recruiting new talents in medical centers as there is a drastic change in technology which is used.Many professionals even though they have experience they are not aware of the new technologies which are emerging in present generation.
6.POOLING KNOWLEDGE:
There is a need for pooling knowledge and also the resources across hospitals and surgeries.Through this e-health systems can be integrated and this leads to fast development.
7.DIGITAL INNOVATION:
All the Healthcare Professionals and patients should be known about the application of new technologies to the practices which are already in process.
8.MEDICAL TECHNOLOGY GAP:
There are many devices which we do not use them upto the mark.
Many of the employees do not want to change their way which they are habituated to work.This is creating a gap between using the technology in a skillful way.
9.Financial challenge of purchasing the hardware equipment.
10.Implementing this health information systems in rural areas.
11.Interoperability and sustainability.
12.Transformation of all existing data into electronic records.
13.Lack of appropriate software availability and internet services at times.
14.Updating the EHR thoroughly.
15.Scalability and logistics.
8.APPLICATIONS:
1.ELECTRONIC HEALTH RECORDS:
To enable the data communication between patients and healthcare professionals.
2.TELEMEDICINE AND TELECARE APPLICATIONS:
A real-time video conferencing and streaming is made available between doctors and patients through ECG signals
Even though there is long distance between patient and a hospital the physical and psychological treatments are made possible through Telecare applications.
3.mHealth:
Many mobile health apps in devices are made available.
4.Decision support tools:
Care pathways and guidelines.
5.e-appointments.
6.e-prescribing.
7.Internet based services are made available.