eHealth – The Effective Application of Information and Communication Technologies E.T. Kldiashvili Georgian Telemedicine Union (Association) Med-e-Tel 2008, Luxembourg April, 2008

Recent technological advancements and the accompanied performance-price improvement have fostered the development of eHealth significantly. eHealth broadly refers to the use of information technologies to distribute information or expertise necessary for providing or delivering healthcare services among geographically separated participants, including physicians and patients. eHealth has a great potentiality; however there are unfortunately today few examples of large services.

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The benefits of expanding its use are threefold: it can improve the quality of healthcare services; it allows a better exploitation of limited hospital resources and of expensive medical equipment; and it helps to address the problem of unequal access to healthcare. Throughout the world the number of people requiring special care is increasing as the proportion of elderly people rises, at the same time, in a high-tech age the expectations of the society for a better healthcare are also rising. eHealth offers the opportunity for improving healthcare services and for making healthcare expertise available to underserved locations. The application of information technology for medical purposes is considered as an economical means of development of healthcare sector in countries with middle and low incomes and of achieving national health policy objectives with regards to the improvement and the extension of healthcare.

In general, the uses of eHealth are for 1) primary diagnosis, 2) second opinion, 3) education /QA (quality assurance). eHealth has left its childhood. Its technical development is mature, and its use for primary and secondary diagnosis has been expanded to a great amount.

The probability of an incorrect handling of a relevant medical data, still dangerously high, mainly is due to: environmental factors, instinctive factors, emotional factors. As a consequence the probability of a serious error occurrence could be high and the probability off its recognition and correction very low. This frequently causes a repetition of exams in the same time or in different medical units and it slows down the diagnostic process (resources waste) and the proper treatment. Proper actions for improving the working procedures have to be taken.

The health care systems, and the education of health care personnel, have to be reorganized to systems that function in a cross-border fashion. Prerequisites for this development shall be a specific emphasis on equity of access, interoperability and standardization of systems and protocols, security and legal aspects. There are technical, legal, organizational, and financial problems to be solved. In spite of the potential which eHealth has as mechanism to support health systems, a number of barriers, at various levels, would need to be overcome for health systems to take full advantage of these opportunities. These barriers are not multidimensional constructed, encompassing technical knowledge, economic viability, organizational support and behavior modification.

The three most important barriers to eHealth adoption were identified as: the problem of interoperability (technical, cultural, systematic-financial reimbursement, inter- organizational workflow), acceptance of a “new” health system, and regulatory constraints. This emphasizes that telemedicine and eHealth implementation has to be accomplished by simultaneously horizontal and vertical multisectorial action. The most important and perspective application of telemedicine and eHealth is education of health care professionals at a distance, so called distance education (eLearning). It may be defined as the application of communication technologies to acquire new knowledge or skills across the whole range of areas which will affect health care professionals, and enrich their experience in rendering the best possible care to patients through out the process of medical care. Distance education has the abilities to apply new concepts, and ideas in which the learner becomes an owner of that knowledge, without any respect to distance. eHealth overall, and in particular eLearning, is significant part of health care revolution, since the event of modern medicine. The addition of technology should not substitute for failed pedagogical process, but technology should allow that educational process and the message to be disseminated, and tailored to individual groups and professionals, by retraining along some of the educational principles of traditional education.

Perspectives and strategies for eHealth are currently evolving, as emerging operative requirements would allow self-sustainable large scale exploitation while recent technological developments are available to support integrated and cost-effective solutions to such requirements. However, as far as we know few eHealth services have proceeded to large scale exploitation, even after successful technological demonstration phases. eHealth by comparison with the usual medical service introduces added value and a positive impact at social, economic and cultural levels. As a result eHealth is initiating to have an important influence on many aspects of medical service in countries with low and middle incomes. When implemented well eHealth may allow these countries to leapfrog over their developed neighbors in successful health care delivery.

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