E-Health: a novel way to redesigning healthcare
E-Health: a novel way to redesigning healthcare
E. E. van der Wall 0 1
0 Holland Heart House, Netherlands Society of Cardiology , Utrecht , The Netherlands
1 E. E. van der Wall
-
Electronic healthcare (e-health) will significantly alter the
way physicians practise medicine [
1, 2
]. Electronic medical
records with specialised software programs can increase the
quality of patient care, reduce unnecessary medical tests,
and directly connect with pharmacies to transmit
prescriptions. Electronic communication allows physicians to
respond to patients’ clinical concerns and questions, and
Internet access can provide physicians better access to
literature. One of those e-health aspects is remote patient care,
which has made considerable progress in remote
monitoring of ICD patients [
3–7
]. Nevertheless, there is significant
physician hesitance about implementing medical
computerisation: patient email can potentially overload physicians
with additional work, websites can direct patients to poor
medical information, the computerised interface can
degrade the patient-physician relationship, and health
regulations can create concern over electronic privacy issues. The
finances of e-health appear promising, yet conflicting
studies create uncertainty. However, if managed appropriately,
the potential disadvantages of e-health can be minimised,
and the benefits of e-health in clinical practices can be
obtained [1].
In the present issue of the Netherlands Heart Journal,
Treskes et al. [
8
] extensively discuss the current status of
health-monitoring devices and the implementation of
individualised healthcare services. The authors state that the
consumer market for personal healthcare devices is
developing rapidly and with the current healthcare-related
investments by technological companies it can be expected that
the way healthcare is provided will change dramatically. In
this way, healthcare will be redesigned with the final aim to
connect smart technology in order to improve patient
outcome. Although a variety of initiatives under the banner
of e-health are deployed, most are characterised by either
industry-driven developments without proven clinical
effectiveness or individual initiatives lacking the embedding
within the traditional organisations. However, the
introduction of numerous smart devices and internet-based
technologies facilitates the fundamental re-design of healthcare
based on the principle of achieving best possible care for
the individual patient at the lowest possible costs. Hospitals
are still willing to invest enormous amounts of money and
human resources in generic mainstream systems, whereas
it can be expected that in the near future information will
be stored in the cloud and networked distributed
applications will provide optimal support for treating individual
patients [
9
]. A simple calculation of costs returns an
astonishing 2.4 billion euros spent by approximately 80 Dutch
hospitals to introduce a basic hospital information system
[
8
].
According to the authors, several hurdles should be taken
to have this achieved [
8
]. First, instead of reimbursing
individual healthcare providers, it will be necessary to
reimburse healthcare systems. Second, it is important to
recognise possible hesitations by the involved
stakeholders. Third, it is important that data safety is ensured and
monitored by an independent inspectorate. Lastly, it is vital
that patients are able to refuse the exchange of their data
between healthcare providers and that access rights are well
described. Of course, the privacy of the patient has to be
guaranteed.
Along those lines, the European Society of
Cardiology (ESC) has recently published a Position Statement on
e-health in the January 2016 issue of the European Heart
Journal [
10
]. The ESC is very convinced about the great
value of e-health, but at the same time very much aware that
there are important societal and professional constraints that
reduce the impact of such innovation, including legal,
ethical, and data protection issues. Healthcare professionals
may be resistant to such innovation, particularly if the
technologies are considered to be solutions seeking a problem
and where the evidence for the impact on quality of care is
seen as less than robust. Regulatory bodies, reimbursement
authorities, and national and international political bodies
often find it difficult to react quickly, or consistently, to this
rapidly changing area.
The vision of the ESC is to play a pro-active role in all
aspects of the e-health agenda, helping to develop, assess,
and implement effective ICT innovations in the support of
cardiovascular health and health-related activity across
Europe. The action plan of the ESC includes the following
issues: 1) to facilitate wider implementation of e-health,
2) to educate and train ESC members in the appropriate
use of e-health, 3) to play an active role in discussions
regarding regulation and quality control of ICT techn (...truncated)