eHealth holds the promise of revolutionizing health care by improving its efficiency; extending and enhancing its reach; energizing and engaging its practitioners and their patients; and in the process, democratizing, decentralizing, and even partially demystifying the practice of medicine. In emerging and developing countries, the use of eHealth and smart health-care planning has the potential to expand access to necessary treatments and prevention services that can serve as underpinnings of rapid economic development. In developed countries, the application of eHealth promises to restructure the business model of health-care delivery, while at the same time improving and personalizing the quality of care received. This article reviews the past, present, and future of eHealth in an effort to illuminate the potential of its impact.

https://www.annualreviews.org/doi/pdf/10.1146/annurev-bioeng-071812-152350

eHealth: Extending, Enhancing, and Evolving Health Care

As adoption of e-health solutions advances, new computing paradigms — such as cloud computing — bring the potential to improve efficiency in managing medical health records and help reduce costs. However, these opportunities introduce new security risks which can not be ignored. Based on our experience with deploying part of the Swedish electronic health records management system in an infrastructure cloud, we make an overview of major requirements that must be considered when migrating e-health systems to the cloud. Furthermore, we describe in-depth a new attack vector inherent to cloud deployments and present a novel data confidentiality and integrity protection mechanism for infrastructure clouds. This contribution aims to encourage exchange of best practices and lessons learned in migrating public e-health systems to the cloud.

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Security aspects of e-Health systems migration to the cloud

As Ghana embarks on a national e-Health initiative there is the need to explore its preparedness in terms of socioeconomic and development, technology infrastructure and operational preparedness, and skills and human resources. This paper reports on a literature review as part of a research program, which aims to inform the development of an effective roadmap for the successful implementation of the national e-Health initiative in Ghana. The literature was searched for factors of e-Health adoption in developing countries; and realization of the anticipated benefits through IEEE, Medline, Google scholar and Google search engines. Sixteen (16) articles were reviewed were from 176 related articles that were found. The literature review found the two highest priority objectives in in e-Health Africa: providing health education for health professionals (identified in 7 of the 16 projects reported on in the literature) and improvement of primary health care services 9 of the 16 projects). Six (6) or 39% each of the 16 projects reported a lack of skills and Human Resources Socioeconomic issues, and Technology infrastructure problems reported in 22% or the remaining four (4) projects. The paper concluded that the effects of these challenges could lead to Ghana like many other developing countries struggling to adopt e-Health, its inability to realize the potential benefits of e-Health and its ability to institutionalize and sustain e-Health.

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Preparedness for e-health in developing countries: the case of Ghana

In recent years, there has been considerable attention towards the development of information and communication technology (ICT) in health care delivery known as `E-Health'. The term "E-Health" is almost a new concept and the E-Health projects mainly aim to improve service delivery to people, though different countries might have different approaches in using E-Health. The focus of this study is to review factors influencing the development of E-Health projects, as these factors could lead to an extensive semantic variation. This study reviews the E-Health status in different countries based on existing reports and documents about E-health projects in developed and developing countries and also based on the reports and documents provided by WHO, International Telecommunication Union (ITU); and World Bank. The review of the documents showed that the E-Health status in different countries is depended upon three key factors including the potential of ICT, economic capacity and the level of health status. The review of the documents indicated that there might be different meanings for the concept of E-Health in different countries, and the semantic variation in E-Health concept is related to the level of E-Health developments and implementations. Therefore, developing a clear definition of E-Health is needed.

E-Health: A Global Approach with Extensive Semantic Variation

e-health is a process of providing health care via electronic means, in particular over the Internet. The term e-health has been used to describe the variety of activities related to the electronic exchange of health-related data, voice or video. e-health is an emerging field in the intersection of medical informatics, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies. In a broader sense, the term characterizes not only a technical development, but also a state -of-mind, a way of thinking, an attitude, and a commitment for networked, global thinking, to improve health care locally, regionally, and worldwide using information and communication technology. This paper is commissioned in light of the rising profile of e-health on the international policy agenda and the emerging Indian Programme for Information Technology and related developments in the National Health Service. Few developments in public health today create the sense of energy and opportunity embodied in the word "ehealth". The promise of e -health lies in the manner to build advancements in the development of a health infrastructure. India is actively developing and implementing technological solutions to deliver health information and health care services across the country. These solutions, while exciting and promising, also present new challenges, particularly in regard to acceptable standards, choice of technologies, overcoming traditional jurisdictional boundaries, up-front investment, and privacy and confidentiality. This paper will discuss how e-health provides the opportunity for the patients to maintain independence longer and for the providers to monitor a condition more closely. It also describes the barriers and challenges to and the current status of e health. Also, an attempt is made for presenting the e-health status in the Indian scenario. Further, its technological and financial barriers are illustrated and recommendations are provided for the improvement.

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E-health: A new perspective on global health

In developed countries, e-health has rapidly evolved from the delivery of online medical content toward the adaptation of generic e-commerce solutions to the processing of health-related administrative transactions and logistical support of clinical tasks. E-health is perceived as being particularly useful in the operational support of the new decentralised and collaborative healthcare models being implemented in many countries. Heretofore designed for large organisations and industrialised countries, e-health solutions are being increasingly proposed as an answer to the many health system management problems and healthcare demands faced by health organisations in developing societies. There are hard lessons to be learned from e-commerce, e-government, and e-health achievements and failures in developed countries and a careful examination of those experiences, vis-a-vis the characteristics of the health sector, organisational preparedness, and technological infrastructure of developing countries is a helpful exercise in the selection of appropriate e-health design and deployment strategies.

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Roberto J. Rodrigues

Papers

Opportunities and challenges in the deployment of global e-health