WHO defines eHealth as the use in the health sector, of digital data – transmitted, stored and retrieved electronically – in support of healthcare, both at the local site and at a distance (2003). In developed regions like Europe, Electronic Patient Records, Practice Management and Patient Management Systems are in place. But in other regions, eHealth is interspersed and in its infancy. National Medical Associations of the Commonwealth Medical Association are being sensitised to take up the issue of eHealth actively in their countries.

Broad areas of application

  1. Data base: Data base of all doctors, para medicals and public can be prepared and uploaded. This will provide ready information of details like the availability of manpower, relief requirements, and the types of services rendered. Since we are moving towards re-certifications, this database can provide details of certified manpower and the progressive training requirements. This database can also be useful in planning and uting disaster relief. It will help to forecast budget and other health requirements, vaccination campaigns, management of epidemics, easier tracking of disease trends and patterns, and ultimately help in providing transparency. Electronic patient record management system can be generated and centrally stored, at the Districts and State headquarters, and can be easily retrieved at a click of a mouse by using passwords. Diseases can be suitably classified according to the ICD system and confounding diagnosis can be eliminated to a large extent. It shall help in better monitoring and follow up care, as also proper and prompt extension of preventive care services. Likewise, multicentric research and trials can also be easily carried out and the system can also be helpful in assimilating research findings and in generating research focus.

  2. Training: on use of the eHealth systems will have to be imparted and modalities for the same have to be worked out. As a start, computer literacy can be imparted in medical college and training institutes, for doctors, administrators and paramedics. The younger generation is already becoming computer literate and could take a leading role in improving communication throughout the health system.
  3. Distant Learning: Learning is a continuous process and more so in the medical arena where the concepts and techniques are changing very fast and becoming difficult to keep pace with. Distance learning can be a useful method that can allow doctors and para medical staff to upgrade their skills. Duly certified distance learning programs can be prepared which are easy to comprehend and assimilate. These programs can be streamed live or can be made avaliable through the medical intranet, and can be accessed through specific passwords by the doctors and para medicals at their own convenience without interrupting the normal day to day functioning.
  4. Conferences: Conferences are necessary for exchange of ideas and information, and their importance lies in their being interactive and it helps in fostering links. However, time is at a premium these days and travel is also somewhat cumbersome. Moreover, organising a conference is a tedious task, besides being a costly affair. If conferences were to be streamed live, it can become a two way affair and can be attended by multiple participants sitting across their computers with a web camera and video streaming facility. If there is an important discovery, invention or technique that has been developed, or a breakthrough research, an impromptu conference can also be organised to disseminate the findings immediately and gather feedback.
  5. Patient consultation: Medical Intranet (MI) can help in patient consultation with the help of live video streaming. Dedicated teams of medical experts can be created to man telemedicine centres round the clock, and these telemedicine centres can be created at a state or union territory level and all such centres throughout the country can remain linked with each other. A free or paid access into the Medical Intranet can be granted to the broadband service providers where any patient can walk in and get access to online telemedicine centre of his/her state. This will also help in decongesting the hospital OPDs. It can also be used to seek and confirm appointments.
  6. Internet kiosks: There may be provision for downloadable information on various aspects of diseases, which even a layman can download and be able to comprehend. The information can be prepared in local languages, with appropriate photographs and figures, omitting the medical jargon, so as to be able to provide needful information. These Internet kiosks can become a good health education medium and thereby help in raising the health standards of a community. Online support groups, discussion sites and interactive forums can also be formed and a patient can remain in contact with a doctor via email, if so desired. Easy to use softwares are readily available or can be created to suit the requirements by the vast trained and competent manpower available. These softwares can also be designed to be used in different regional languages and also by the illiterate.
  7. Classroom teaching: Medical Intranet will have the capability to revolutionise classroom teaching. Our own experts can be tasked to vet, edit and update the available information, conforming to our culture, needs and available resources. Audio-visual teaching has been found to be more effective than just passing on the information from a dais. The updated literature can be downloaded and this shall contain all needed information presented in a easy to comprehend fashion, which shall be easier to memorise. By accepting Medical Intranet into classrooms, conformity of standards in medical and para medical education can be achieved, which shall be at par with any of the top overseas university. It will also help in curtailing expenditure in procurement of costly books and maintenance of library, as all latest medical journals and text books can also be made available on the MI, through central subscription.
  8. Guiding surgery and other procedures: The MI can help in learning latest surgical procedures and techniques. These procedures can be streamed live and stored in the MI and can be accessed by the medical staff in their own free time also. Through this MI, a complicated case can be witnessed live by an expert sitting even a thousand miles away and in turn he/she can guide the surgery, if the patient can not be evacuated to another centre. Likewise other procedures can be guided from a far off place with convenience and precision, allowing even the complicated procedures to be taken up in small centres and in the remote areas. Although it will take some more time for the robotic surgery to come to our country, but robots have already stepped into the medical arena.Within a medical setup or a hospital, all departments can be interconnected so that there is a better utilisation of available information and resources, correct and fast disposal, better follow up actions, automatic data and statistics generation and transmission, monitoring, etc, can all be achieved. Enormous amount of benefits are to be harvested once this MI is in place [Table 1].

Issues for health professionals

  • Lack of access to appropriate hardware
  • Lack of education and training
  • Lack of interoperability of information systems across sectors
  • Lack of nursing input into the design of systems
    Concern about confidentiality, security, legal issues
    and accountability
  • Fear that computers will take nurses away from patient care
  • Fear that computerised data may be inappropriately used for performance management
  • Lack of an independent professional voice on eHealth issues

Barriers to overcome

  • Inability to accept and manage change
  • Changes in the professional-patient relationship which are perceived as a threat to professional authority
  • Concerns about confidentiality and security of information
  • Lack of or inappropriate, education and training

Recommendations

  • Good health is a public issue
  • Access to health professionals to ICT devices and technical support
  • Involve the users – in designing, development and uation
  • Educate and train health professionals
  • Change management processes

To conclude, eHealth will become the order of the day. Every country in the Commonwealth can form a system to link the healthcare administrators, providers and beneficiaries. Best practices from developed countries are available; resources are available within each country.

What CMA intends to do is to promote eHealth system through member countries’ National Medical Associations. In addition it will push the agenda through Commonwealth Secretariat, WHO, Commonwealth Heads of Government and Health Ministers.

Be a part of Elets Collaborative Initiatives. Join Us for Upcoming Events and explore business opportunities. Like us on Facebook , connect with us on LinkedIn and follow us on Twitter , Instagram.

Related November 2008


whatsapp--v1