Telehealth, eHealth and
mHealth
Surahyo Sumarsono, B.Eng., M.Eng.Sc.
“In the history of telemedicine, various definitions have been published and numerous terminologies have been coined. The introduction of new technologies played an important role in the
changing definitions. After four decades of experience in telemedicine and its variations, the need for a single taxonomy that is detailed
enough to define all the terms introduced until today is evident…..” B. Tulu, S. Chatterjee, and S. Laxminarayan, 2005
Definitions
•
eHealth (WHO 2005)
– “the use of information and communication technologies (ICT) for health. Examples include treating patients, conducting
research, educating the health workforce, tracking diseases and monitoring public health”
•
Telehealth (various sources)
– eHealth conducted by two or more points separated by distance
•
mHealth (various sources)
Telemedicine
•
Subset of telehealth practiced by medical professionals
•
“the use of medical information exchanged from one
site to another via electronic communications to
improve a patient’s clinical health status” (American
Telemedicine Association)
•
“the practice of medicine over a distance, in which
interventions, diagnostics and treatment decisions and
recommendations are based on data, including voice
and images, documents and other information
- the simultaneously high prevalence of both chronic
degenerative and acute communicable diseases
- the limited number of and access to healthcare
professionals
- further accompanied by the typical limitation in the
telecommunication infrastructure
- the application of pervasive computing technologies in healthcare to facilitate the delivery of healthcare service anywhere, anytime and to anyone
- include monitoring of bodily signals, their transfer through
communication networks (wireless or cellular) and immediate healthcare response or advice received by the user
- The key enabling technology of pervasive healthcare is a network-connected sensor system:
- sophisticated dedicated sensors, such as wearable or environmental sensors
- simpler smartphone-based sensors
- even simpler smartphone-based applications accepting manual input from offline sensors
Categories of Pervasive Healthcare
- The wellness category focuses on providing the users with healthy lifestyle advice and encouragement to exercise while promoting the respective health benefits.
- The risk management and prevention category offers tailored health
advice to an at-risk population based on routine monitoring of generic bodily signals, such as body weight, blood pressure, heart rate, temperature, etc. - The chronic disease management applications cater to a specific patient
category (e.g. hypertension, diabetes, asthma) and their clinical care providers by facilitating continuous monitoring of specific physiological
Categories of Pervasive Healthcare
- The acute disease management category offers the clinical care provider with the possibility to monitor their patients during the relevant time course of the disease regardless of their location, assuring timely receipt of relevant information immediately after the onset of the disease.
There is not a consensus on what mHealth is.
Questions to Consider:
1) What kind of connection does it have to have?
Broadband? Wifi? Wired Internet?
2) What technology does it include?
Cell phones? PDAs? Devices? Computers?
3) What’s the application?
Clinical Data? Community Health? Personal
Health?
4) What’s it part of?
Telehealth? eHealth?
http://vimeo.com/17125591
All the definitions focus on mobile communications and healthcare.
Broader definitions seem to be gaining more steam.
“The integration of mobile technology, computing devices, and emerging delivery system capabilities into a patient-centered model of care.”
– Indian Health Service US Department of Health and Human Services
Applications: Management
• Patient-centered personal health management. • Patient or care-giver driven.
• Typically includes a device or smartphone application. • PHR and EHR integration is possible.
Applications: Promotion
• Educational messages targeted at behavior modification. • Third Party driven (public health depts, governments,
insurance companies)
• Usually utilizes cell phone messaging because it’s quick,
easy, and cheap.
• May be one way or two way messaging. • Particularly beneficial for chronic.
Smoking Cessation Sexual Health
Applications: Surveillance
Allows people to design forms for data collection on the
internet.
Data is entered into the forms using either a smart phone
application or SMS messaging.
Allows for real-time data uploads and analysis. Been used to evaluate:
anti-malarial bednet distribution and vaccination
campaigns in sub-Saharan Africa
clean water initiatives in Vietnam
drug supplies in several African countries health delivery systems in Guatemala
* 2011 World Bank Report:
http://siteresources.worldbank.org/INTLAC/Resources/257803-1269390034020/EnBreve_166_Web.pdf
"drastically cut costs while facilitating quality
control and improving implementation speed.“
Current trends show that the utilization of mHealth will increase.
Its applications are numerous and widely encompassing:
Management: Connecting mHealth applications with traditional health IT systems
will provide a groundbreaking continuum of personal care, particularly for those with chronic conditions, keeping them out of hospitals.
Promotion: Wide scale education and behavior modification will improve the health
of the public due to its ability to be anywhere the person is at anytime.
Surveillance: Real-time health tracking and data aggregation leads to actionable
information for preventing disease outbreaks and improving population health.
Source:
http://www.healthcareitnews.com/news/mhealth-apps-forecast-increase-threefold-2012-0
