1. Ehealth Group A – Andrew McNaught, Konrad Borowiecki, James Wilson, Xi Chen

2. Introduction What is Ehealth? Healthcare practise supported by electronic processes and communication Examples EMR (Electronic Medical Records) Telemedicine Virtual healthcare teams

3. What will we talk about James NHS spine Andrew Impact of online pharmacy

4. What will we talk about Konrad Virtual health care Chen Telemedicine

5. James - EMR NHS Spine National Central Database to store over 50 million records accessible by up to 250000 NHS staff Part of £12 Billion IT programme for NHS

6. James - EMR NHS Spine benefits Records to be collected from GP practises Cradle to grave patient records Central database will be accessed anywhere in NHS Paper based records creating waiting times for access Statistical analysis can be run on the database

7. James - EMR NHS Spine privacy concerns Records reported to be uploaded without patient consent according to Guardian Unlimited Information could be accessed by Police and security services for details on Mental illnesses HIV status Drug taking

8. James - EMR NHS Spine privacy concerns Opt out rights given according to NHS option sealed electronic envelope GP representatives urge NHS spine boycott National program for IT won award for “Most Appalling Project” in Privacy Internationals UK big brother 2004 awards

9. Andrew - Online Pharmacy Since around 1999 many Internet pharmacies established worldwide Can be part of click-and-mortar operations, or stand alone online presences Health concerns 6 th most common reason people go online Many exist that require a doctor’s prescription, however many do not Dozens of online pharmacies in Canada, mainly to service US citizens who pay highest drug prices in the world Benefits? Problems?

10. Andrew - Online Pharmacy - Benefits Offers the consumer more privacy Is more convenient especially for homebound and disabled people Can be cheaper than at traditional pharmacies Ease of comparative shopping across many sites Easier and quicker access to product information and references to other sources of information

11. Andrew - Online Pharmacy - Problems Some online pharmacies selling prescription drugs without a prescription Fraudulent claims – “cure for cancer!”, “within 30 days you can experience growth of 3 inches!” Deception – e.g. was shown Herbal medications could not be sold profitably without deception Anonymity – no doctor-patient relationship. Leads to lack of ethical concern among online pharmacies Profit minded affiliate sites – only care about making a profit not about the quality of their information Privacy issues due to possibility of hacking Legal and cross-border issues Spam – 10 – 12% is health related

12. Konrad - Virtual healthcare – knowledge database e-health sites are being used as knowledge base by people –95% (88/93) of families characterized the information as very helpful in furthering the understanding of their child’s heart defect Doctors knowledge database –medical consultations over the internet –doctors cooperation so called virtual health care teams

13. Konrad - Virtual healthcare agents Implementation of e-healthcare into computer platforms, so called healthcare agents –some are desktop applications reminding to take a drug in time, –some are clients allowing to use internet knowledge database to personalize the information to help the user to examine himself –or applications designed especially to reduces the burden on doctors and help to better understand the patients condition

14. Konrad - Virtual healthcare – additional advantages In home-healthcare –to care patients sick on complex and chronic illnesses or contagious diseases Patient care in distant, isolated regions Surgery through the internet –Scientists in Australia have used internet to successfully perform microsurgery on cells located thousands of miles away in a southern California laboratory

15. Konrad - Virtual healthcare - pitfalls ”If I had to single out a single factor that is critical to the whole movement of healthcare to an online environment, it would have to be TRUST.” Dr Richard Darby

16. Konrad - Virtual healthcare - conclusions The increase of the computer influence in our lives is unstoppable and it is happening now and it is up to us to implement it in proper and thoughtful way.

17. Chen - Telemedicine What is Telemedicine: The application of telecommunications technology to health care, requires the integration of technology, tools and training with medical care practices and problems.

18. Chen - Telemedicine Telemedicine is practiced on the basis of two concepts: Real time (synchronous) store-and-forward (asynchronous).

19. Chen - Telemedicine Telemedicine in UK Start in 1991 NHS Direct Online http://www.nhsdirect.nhs.uk/ TEIS - UK Telemedicine and E-health Information Service http://www.tis.bl.uk/