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Digital Health, eHealth and Mobile Health, are said to be disruptive to health care. Yet, governments and payers trust it to be cost saving and quality building.

What is?
E-Health, Telemedicine and mobile health is about the development and improvement of health care by means of digital and internet technology.

An all-encompassing understanding
In essence,”ehealth” as a concept is globally accepted to be a term to all variations of healthcare by internet technology, such as: telecare or telemedicine, distant care, digital health, personal health records, teleconsult, telemonitoring, patient monitoring and support, health tracking, health data exchange, Big Data etc. Vice versa, when one speaks about telemedicine, ehealth is included. The words might be used interchangeably.

eHealth for the better
But, ehealth is also seen as the movement towards the continuous improvement of health care. This movement aims at a sustainable balance between outcomes, quality, and costs of care. And and hence, make a development and access to ehealth initiatives affordable.
Specifically by the latter, governments and health authorities have taken up ehealth development to try to prevent ever raising costs of care. This is due to increased demands for care, growth of the “grey generation” and more expensive treatments and therapies.
Examples in Europe are the national initiatives to create personal health record systems and initiatives to ehealth development. In the US, the initiative is around the project of “meaningful use” (also here) and HIMSS.
On European level, there’s HIMSS Europe, and all action and policy plans by the EU, like the ‘eHealth Action Plan 2012-2020‘.
The European Commission’s Directorate General for Communications Networks, Content and Technology (DG CONNECT) and the United States Department of Health and Human Services (DHHS), after consulting with stakeholders, have updated the road map for their Memorandum of Understanding on eHealth/Health information technologies.

Inspiration to many
The perspective of a right balance between quality and outcomes, inspires patients and health innovators to great enthusiasm for the development. However, applications of initiatives to ehealth, like EHR (Electronic Health Records), PHR (Personal Health Records), health apps and all sorts of mobile applications in wearables, do have an impact on the way health care is actually delivered.
For example:
When a physician agrees to look at a patient’s daily data to monitor his condition, arrangements must be made about how and when it will be done, how frequently feedback will be given, and the like. In current processes these are agreements and arrangements that have not been made before.
To arrange the activities and communication between patient and care providers successfully, one would like to know how to and what will work, and what will be effective to the therapy.
Also, it will be a question how the physician will be reimbursed for this ‘extra’ time spent to this patient.
On the part of the patient urgent questions might arise about whether the doctor will connect with him/her in case of some alerting incident, etc.

Effectiveness
Studies about effectiveness of ehealth initiatives demonstrate both positive outcomes in medical health perspective (Quality of Life), in patient and stakeholder satisfaction and in the potential to save costs of care. However, research point also at the need of a provident and structural development process: it is not about just applying a technology, as the example above may indicate.

Implications to be thought through
Things can go wrong, obviously. That is why it is said that digital or ehealth initiatives will have disruptive power to current health care processes. eHealth is not just about digital applications. One needs to think through what consequences ehealth initiatives will have before implementation. It might be necessary to rearrange the delivery process: not only to create the most effective and efficient ways of delivery, but also to accommodate for all necessary contributors to the process. That’s why “ehealth” is also associated with the term “connected health.”

Principles to the development of ehealth
That’s why ehealth developments appeal to principles of multidisciplinary, participative and integrated care. In one sentence:
How to create one pathway, or healthcare program, if you will, with the patient, professionals and all stakeholders actively involved, sharing common data and insights in a transparent consequence of activities, and communicating in respectful and understandable ways to arrive at true collaboration and coherent understanding of what is being done, and what needs to be performed and what actions each one needs to take and will be responsible for.
A relevant aspect of ehealth development therefore, concerns the collaboration between different parties concerned, patients, physicians of different medical disciplines, IT and administration.
Although this may seem complicated, studies of effectiveness demonstrate that already small, simple ehealth initiatives may have a positive impact on satisfaction and trust of stakeholders, professionals alike patients, and on better outcomes and reduction of costs, such as a diminished number of readmissions to care.

Need no complicated efforts
Although patients appear to have specific demands about ehealth, like for their health apps, it is also known by research that they don’t expect grand initiatives like full-blown health interactive platforms. They are pleased with each small step to improvements of the current practice of care. That puts every health care provider to the challenge of planning its proper initiatives.

Therefore, there is no one way of creating ehealth initiatives, all initiatives in the direction of using internet or digital technology are fine, and may make the difference in the effectiveness, outcomes and/or costs of care.

With our experience in developing care paths, in co-creation and in building integrated care, we can support you and your staff with orientation and information to ehealth, and can help you in building your proper road map to the development of your ehealth initiatives.

The eHealth Thought Lab
With the Fox Group of health care business consultants, we developed an eHealth Thought Lab, based on the several and different client needs that we experienced  in our work. The eHealth Thought Lab involves three meetings, focused sequentially on (1) concepts, (2) development, and (3) implementation of currently available eHealth solutions. Participants from the client organization will work side by side with several experts from The Fox Group, exploring concepts and opportunities for eHealth applications in your organization.

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