eHealth Development in Context

eHealth Development in context




College 1 - Course organization and introduction to eHealth (07/02)
Toets in het Engels, ook in het Engels antwoorden

Design, content & planning
 Boek eHealth Research, Theory and Development: a Multidisciplinary Approach (not all
chapters)
 Lectures


Learning objectives
After this lecture, you can..
 Provide a definition of eHealth
 Explain why eHealth is needed
 Name the goals, different types, advantages and disadvantages of eHealth
 Name and explain the importance of the five pillars of a holistic eHealth development
process
 Name and explain the different phases and the corresponding goals and methodologies of
the CeHRes Roadmap

Quiz slides on canvas
What is eHealth (and what is not)?
1. Yes
2. No, it is not meant to improve your behaviour
a. eHealth is meant to change your behaviour
3. No, if it is used to enhance the health, it is eHealth
a. Having a pleasure temperature, daylight, etc.
4. Yes
a. Contact through technology
5. Yes
a. Communicate, information about health
6. No
a. It is meant to increase well being, but not to change the behaviour
Introduction to eHealth
“eHealth refers to use of (information and communication) technologies to improve health, well-
being and healthcare”
Technologies focus on intervening on behaviour and/or cognition.


Why eHealth?

,Provide best possible care that meets the needs of patients and their (informal) caregivers
We don’t know what the needs of the best possible care is….
 Self-management: more chronic diseases, 50% of the population. It is impossible to give care
to them all
 Efficiency: less people doing the care work for more people with diseases
 Shared decision-making: less hierarchy, patients can say more in the pathway for care. We
need tools to support the patients to make their own decision.
Health = “A state of complete physical, mental and social well-being and not merely the absence of
disease or infirmity”
= “The ability to adapt and to self-manage, in the face of social physical and emotional
challenges”

Categorization of eHealth
 Self-care and prevention
o About the patient or citizen taking control, decision making
o “thuisarts.nl”; wearables that monitor your health;
 E.g.: online health support to quit smoking or lose weight
 Supportive care
o Always an healthcare provider involved; together with the patient; cooperation
o Patient files, medical files, (digital) folders for information
 E.g.: Online Personal Health Records for DiBaties Patients where patient can
share their personal data about their health-related matters
 Societal health
o Again working together; main aim is public health, not about helping an individual
 E.g.: monitor for early detection of flue outbreaks

There are different kind of eHealth
Benefits:
 Access to care
o Patient can use whenever and wherever they want to. Medical assistance is provided
24/7.
o Independent of time and place, residents can access technology at any time
o Lower threshold to access social support; more people have possibility to access
support, also residents with no/limited social network
o Remove threshold like stigmatization on loneliness and social isolation
o Not everyone is willing to seek help;
o Most eHealth technology are text based: not accessible for everyone. It increases the
inequality in healthcare.
 Empowerment
o eHealth empowers the opportunity to have a say in their own well-being
o Can empower both patients and health care professionals. It helps to provide
accurate diagnosis and start treatment in time
o More control of their own health (e.g. choose when and where residents want to
social support; access to own health data)
o Patient-centeredness, insight in social well-being can help residents to make
informed decisions about whether additional support is required
o In a similar way, care professionals can be empowered in decision making about
social well being
 Innovation
o Base the decision on reliable things
o Creates new possibilities for healthcare

, o Provide groundwork for sustainable change in healthcare, VR could be used for other
areas as well (e.g. physical therapy)
o Catalyst for innovation: critical evaluation of current processes in nursing home,
opportunity to learn from residents and care professionals can lead to other new
innovations
 Quality of care
o More insight, but now more personalized care
o Effectiveness (social support could be improved by using possibilities of tech, e.g. self
monitoring, to improve traditional interventions/treatments)
o Efficiency (fewer resources to achieve same quality of care; less care professionals or
informal caregivers required)
Barriers:
 Implementation
o Very hard to do, overwhelming majority of eHealth will not make it to the market, it
does not suit the users or there are no right financers
 Ethical barriers
o Inequality of care, inequitable accessibility; who is responsible for the decisions, the
programmers or the users?
 Evidence
o Really quickly innovated: you don’t know the long-term effects of eHealth.
o Evidence based medicine: you need evidence before use; this is questionable for
eHealth

Holistic development approach
Limit the barriers, full use of the benefits
Not only looking into the technology, also taking the users into account

eHealth is more than a tool
A way of thinking about how health(care) could be improved

Requires a focus on people
 Interrelation between people, technology and healthcare

Existing frameworks, insights from practice and empirical studies
 Roadmap, supported by 5 pillars of eHealth development

PILLAR 1
Participatory development process
To account for needs of users
End-users, but also those who’s cooperation is needed for implementation, or otherwise involved
Cooperation is the key:
 Multiple perspectives ensure a broader view on the context (the development team
therefore considered of different team of people which includes; researchers, stakeholders,
NGOs, Policy makers, designers
Stakeholders can contribute:
 To development by expressing their needs
 To improving a tech via their personal experiences
 To implementation by identifying critical issues
 For example: the patient itself, physician, funders, healthcare reimbursement, healthcare
insurance, ICT