Question

Analyze the scope, challenges, and impact of eHealth, mHealth, telemedicine, and social media use in health care and public health.

Answer 1

Greetings of the day!

Answer:

Introduction

Electronic health (E-Health) is often defined as healthcare practices supported by electronic processes and communication. It includes mHealth, defined as the practice of medicine and public health supported by mobile devices. Today emergent technologies like the Cloud, IOT, Human Computer Interaction, Cyber security can be added to it along with Anthropology, public policy and public health medicine to make this service robust. In a country like India, it is observed that there is a great deal of disparity in the quality and access to the health care among the urban and rural regions. In the rural areas there is an acute scarcity of the health care specialists, health services and health care providers.

mHealth is a component of eHealth. To date, no standardized definition of mHealth has been established. For the purposes of the survey, the Global Observatory for eHealth (GOe) defined mHealth or mobile health as medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices. mHealth involves the use and capitalization on a mobile phone’s core utility of voice and short messaging service (SMS) as well as more complex functionalities and applications including general packet radio service (GPRS), third and fourth generation mobile telecommunications (3G and 4G systems), global positioning system (GPS), and Bluetooth technology.

The World Health Organization (WHO) defines Telemedicine as, “The delivery of healthcare services, where distance is a critical factor, by all healthcare professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation and for the continuing education of healthcare providers, all in the interests of advancing the health of individuals and their communities.”

The context of social media is broad and constantly evolving with new ways of communication emerging rapidly. The term social media mostly refers to internet-based tools that allow individuals and communities to gather and communicate, to share information, ideas, personal messages, images, and other content, and in some cases, to collaborate with other users in real time.

scope, challenges, and impact of eHealth, mHealth, telemedicine, and social media use in health care and public health:

	E HEALTH	M HEALTH	TELEMEDICINE	SOCIAL MEDIA
SCOPE	Technologically equipped cellular interventions are widely accepted in healthcare to deliver quality services . For example, m-Health is providing different health interventions (preventive, promotive, and rehabilitative care) among all people . m-Health in the form of cellular communication is becoming popular among all group of people due to its handy, reliable and easy features. Text messaging or short message service (SMS) have ensured broad coverage in developing countries due to its low price which facilitates the process of accessibility. It can also receive instant feedback from the target group and give them prompt feedback in case of an emergency. Therefore, text messaging and phone calling offer a possible channel to render health behavior changing communications among the people. For example, during the pregnancy period, advanced communication over the telephone can motivate the mothers to seek proper health care . Phone call intervention can solve problems related to illiteracy or limited understanding of language barrier. In the case of inability of the patient’s to answer the call, a voice message (recorded) service can also play the alternate role. M-health can also be introduced in Maternal and Child health care, HIV/AIDS, Malaria, Tuberculosis and many other diseases . Health care professionals are using mobile devices and applications in the way of information management, time management, health record maintenance, consultation, clinical decision making, patient monitoring, medical education, and training to support the entire health system . For example, one study from rural Bangladesh found that child mortality can be decreased significantly by introducing the pulse oximeter in primary health care	• Communication between individuals and health services • Health call centres/Health care telephone help line • Emergency toll-free telephone services Communication between health services and individuals • Treatment compliance • Appointment reminders • Community mobilization • Awareness raising over health issues Consultation between health care professionals • Mobile telemedicine Intersectoral communication in emergencies • Emergencies Health monitoring and surveillance • Mobile surveys (surveys by mobile phone) • Surveillance • Patient monitoring Access to information for health care professionals at point of care • Information and decision support systems • Patient records	It can relay information to individuals as well as to the population as a whole. It can provide an easy access to those living in remote areas. It enables informed decision-making. It also simplifies the health decision-making process / or communication between healthcare providers and individuals regarding prevention, diagnosis or management of a health condition. As a result, the users are exposed to a broader choice base. It can go a long way to promote and maintain healthy behaviors in the community. It can also help in peer information exchange and emotional support. Examples include online Internet applications that enable individuals with specific health conditions, needs or issues to communicate with each other, share information and provide / receive emotional support. It promotes self-care and domiciliary care practices. Many living in the remote areas can be benefited by self-management of health problems which will supplement existing health care services. It can be a very important tool for the evaluation and monitoring of healthcare services.	These social media tools have also increased the ability of patients to find others with their conditions and to discuss treatment options, suggest lifestyle changes, and to offer support. Social media are not exclusively used by the patients and caregivers but also by health-care professionals. These tools can be used to improve or enhance professional networking and education, organizational promotion, patient care, patient education, and public health programs. The use of social media within the political arena context has become increasingly apparent in recent years. For example in the United States, members of the Congress have been encouraged to use Twitter (through the tweet congress initiative) as a means to encourage government transparency, communication, and engagement with the public.
CHALLENGES	The Challenges in deploying mHealth include changing the mindset of the people, convincing them with large success stories, providing education, training, providing solar units for power to charge their mobiles and making available appropriate, cost effective, need based, Value Added Services. E-Health should be ideally delivered in combination with other Services including ECare, EServices, ESurveillance and ELearning. The fruitful result from EHealth will depend on creating the right ‘fit’ between EHealth applications and healthcare needs; in other words EHealth should be needdriven not technologydriven	Approximately half of responding Member States (53%) reported competing health system priorities as their top barrier. Globally, infrastructure was cited as the least important barrier (26%). Similar trends were found in countries in the high, upper-middle, and lower-middle income groups; they all reported competing priorities, cost-effectiveness and lack of knowledge as their most important barriers.	Perspective of medical practitioners: Doctors are not fully convinced and familiar with e-medicine. Patients' fear and unfamiliarity: There is a lack of confidence in patients about the outcome of e-Medicine. Financial unavailability: The technology and communication costs being too high, sometimes make Telemedicine financially unfeasible. Lack of basic amenities: In India, nearly 40% of population lives below the poverty level. Basic amenities like transportation, electricity, telecommunication, safe drinking water, primary health services, etc. are missing. No technological advancement can change anything when a person has nothing to change. Literacy rate and diversity in languages: Only 65.38% of India's population is literate with only 2% being well-versed in English. Technical constraints: e-medicine supported by various types of software and hardware still needs to mature. For correct diagnosis and pacing of data, we require advanced biological sensors and more bandwidth support. Quality aspect: “Quality is the essence” and every one wants it but this can sometimes create problems. In case of healthcare, there is no proper governing body to form guidelines in this respect and motivate the organizations to follow-it is solely left to organizations on how they take it. Government Support: The government has limitations and so do private enterprises. Any technology in its primary stage needs care and support. Only the government has the resources and the power to help it survive and grow. There is no such initiative taken by the government to develop it.	The use of social media tools is not without risks in the health-care arena. As many cases in social media highlight, the information disseminated through social media platforms can involve high levels of self-disclosure (e.g., patient disclosing information on her experiences during the chemotherapy session). As with traditional online media, the main limitation of health information found on social media is a lack of quality and reliability. Health-care professionals as popular users of social media can also experience negative outcomes as a result of their presence in such media platforms. Perhaps one of the greatest risk associated with the use (or misuse) of social media is the posting of unprofessional content. The risk that health-care professional might unintentionally disseminate sensitive proprietary patient data existed before social media. However, with social media and the rise of international hacking, the potential for widespread of private information following a breach poses much greater risk to patients. The lack of a clear understanding of privacy in the context of social media and health-care organizations can threaten patient's autonomy and the therapeutic relationship of trust.
IMPACT	Electronic and internet-based data transmission, data storage, data safety and confidentiality issues will become the major concern in upcoming years. Moreover, applications of all technologies have limitations, and they are not designed to provide their benefits under every circumstance. For example, most of the health monitoring software runs on the user's smartphone and analyses the data received from the sensors. For the younger generation, using such software can be a natural choice. However, it can be complicated and a challenged phenomenon for the more elderly population. Universal health care is essential, and it needs to be implemented in developing countries . Implementation of e-Health has the potential to cover the health need of rural people. Although providing the real-time data can be a challenge for those who are in need of monitoring devices. Maintenance and expert handling to operate these devices can be somehow cumbersome as well. e-Health is an umbrella term that combines healthcare and technology to support people in a more efficient way, and it can also reduce health-related costs. Some developed countries who have been implementing health-related interventions, they always consider eHealth to be of top priority. However, the fruitful application of eHealth depends upon the multidisciplinary approaches . Teams must have the necessary expertise for the understanding of specific eHealth project . The team includes scientists, physicians, nurses, pharmacists, information technology expert, policy makers as well as the patients . However, there is a great promise that implementing eHealth can improve the total health care system in both developed and developing countries. eHealth is called to be an end-to-end process and is adapted to use under all circumference.	Mobile technologies have already changed, and will continue to change, the lives of millions around the world, though most particularly in high-income settings. Many are calling this change a revolution: almost 90% of the world’s population could benefit from the opportunities mobile technologies represent, and at relatively low cost. Many sectors in low-income countries are already incorporating the use of mobile technologies into their business processes in increasingly sophisticated ways. Diverse applications in use in developing countries include online education, election monitoring, citizen journalism during political unrest, agricultural assistance to farmers, and mobile banking services. Yet the health sector has been slow in adopting mobile technologies into routine operations, which would benefit patients and providers alike.	It does not require too much of a stretch of imagination to realize that telemedicine will soon be just another way to see a health professional. Remote monitoring has the potential to make every minute count by gathering clinical data from many patients simultaneously. However, information may be lost due to a software glitch or hardware meltdown. Therefore, relying too heavily on a computer system to prevent errors in healthcare data may be problematic. There has to be a smart balance between total dependence on computer solutions and the use of human intelligence. Striking that balance may make all the difference in saving someone's life. In 2008, the potential of telemedicine, tele-health and e-health is still left to our imaginations. Time alone will tell that Telemedicine is a “forward step in a backward direction” or to paraphrase Neil Armstrong “one small step for IT but one giant leap for Healthcare	With the inexorable growth of social networking in health care, and the rising influence of social media on individual health care, social media is attracting the attention of researchers, clinicians, health-care organizations and policymakers intrigued by its affordability, influence, and virtually universal reach. Policymakers in the health-care context view social media as a valuable tool to increase public's engagement to devise and implement policies to deliver public services that meet the needs of society. In the same light, the engagement of health-care professionals in the process of policy developing is equally important and needs to be pursued by the policymakers so that valuable input from frontline nursing staff, whose clinical, educational, and research expertise could add value to policy's scope and direction. Social media hold a great potential in disseminating health-related information as they provide the public, patients, and health professionals with a platform to exchange on different health matters potentially affecting population health outcomes. Furthermore, the use of media platforms as a real-time learning resource will potentially provide actionable insights into patients’ and caregivers’ needs and preferences across the continuum of care. Online storytelling by patients and caregivers active on social media can complement traditional methods of capturing a range of perspectives on the quality of care. Finally, social media can promote awareness, health promotion, provide peer support, and extend access to health interventions all of which bring a new dimension to health care. Despite its great potential, social media when used carelessly, the dangers these technologies pose to patients and health-care professionals are formidable.