EHEALTH MARKETPLACE, TELEMEDICINE, TELECARE, CONNECTED HOME CARE
The extraordinary developments that are occurring in such fields as computing, communications and medical technologies are now making possible long-foreseen advances in telemedicine and telecare. The convergence of these technologies along with those associated with information management have lead to much wider benefits, now encompassed in the term eHealth. eHealth is a wide and fast-growing field with many implications on how healthcare will be delivered in the future.
Due to developing demographics, social changes, lack of resources and the rising costs of health care and social care – there is an increasing need to rethink how care services are delivered and made available. Connected home care provides the ability to deliver health and social care to individuals within the home and wider community – with the support of systems enabled by new technologies.
REAL TIME EHEALTH, VIDEO CONSULTATION, STORE AND FORWARD EHEALTH, DERMATOLOGY SECOND OPINIONS
Current eHealth activities can be classified according to the technology used, the type of activity or the target group. One of the most important aspects of classification is the distinction between real time, and store and forward. In real time eHealth, the classic example of which is video consultation, the interaction between the participants is ``live`` and they can interact immediately. The advantage of this approach is that it enables optimum transfer of information between the participants. The disadvantages are that it is logistically difficult to manage large-scale services and they tend to be relatively expensive.
Store and forward eHealth is less expensive and easier to manage as there is no ``live`` interaction. One participant gathers information (text, data, images, etc) in electronic form and sends it to the other participant, who views it at a subsequent convenient time and reports back. The classic example here is dermatology second opinions. New deployments of telemedicine are occurring with increasing rapidity. Telemedicine will be part of the movement towards a model of care based around the individual, rather than around institutions, a topic discussed in Telemedicine for the Future.
NHS DIRECT, ELECTRONIC PATIENT RECORD, TRAUMA CENTRES, VIDEOCONFERENCE, MULTIMEDIA KIOSKS
Traditionally to access medical care or advice, you have had to travel to the doctor or hospital. The more complex or rare the problem, the further it has been necessary to go. Ehealth, by making use of computers and telephone technologies, now makes it possible for an increasing range of medical services to be available locally. An example of a current telemedicine service is NHS Direct, has been extended to provide advice services to the whole country.
In some parts of the country, traditional hospital based outpatient clinics are being replaced with nurse-run clinics in GP practices. The nurses talk to the patient, collect all the information required on a computer and send this ``electronic patient record`` over the phone lines to a specialist who could be located anywhere. The specialist views the record (which could include photographs, X-rays, ECGs or other details as well as text) and uses his computer to send a report back to the patient`s GP.
Minor injury units are now being linked to trauma centres. If you attend such a unit, the nurse can send X-rays over the phone line, for a radiologist to view and report back. She can also videoconference with a consultant in the trauma centre in order to discuss how to manage an injury. Access to good quality health information over the Internet, digital TV and via multimedia kiosks will give us all an opportunity to maintain better health.
EHEALTH FUTURE, PAPER BASED MEDICAL RECORDS, INTERACTIVE DIGITAL TELEVISION, NHS, MEDICAL CHANNEL, MOBILE VIDEO TELEPHONY
EHealth is likely to change delivery of medical and social care beyond all recognition. The technology is developing at a staggering pace and there will be developments we have not yet even dreamt of. Over the next few years, as eHealth is deployed more widely, one of the main challenges will be to manage the change that this will cause. There will be new ways of working which will cut across traditional boundaries. The boundaries between primary, secondary and social care will become blurred and eventually disappear. Medical and nursing staff will collaborate in new ways, with areas of responsibility being redefined.
There will be need to train and retrain staff on an ongoing basis. The days of paper based medical records and X-rays being on film are numbered. Staff in medical records departments are more likely to be running quality control programmes on electronic records than hunting for missing notes. The aged are large users of medical care. Most wish to remain at home rather than be in an institutional setting and eHealth will assist in this. Ehealth can enable a patient`s home to become a virtual hospital ward. Vital signs can be transmitted to monitoring centres, which can detect possible problems. A nurse, based in the monitoring centre could be available 24 hours a day to provide reassurance and advice. A GP or specialist could be contacted if there are signs causing concern.
Our medical history could also be stored in our multi-purpose ``credit card``. Integration of interactive digital television, computers and the Internet is likely to change how we access medical care. How will the NHS adapt to this scenario? Will patients with long-term health problems feed information from portable monitors into a medical channel at home, rather than visit a hospital clinic? Developments in portable telephones will mean that mobile video telephony becomes routine.
Work is ongoing into incorporating health-monitoring devices into clothing. Link these to your videophone and no matter where you are, you could gain access to high quality medical advice. Issues such as data protection, legal status and licensing will require international agreements.
