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Who do you think should get all the attention in 2013 and beyond? Your contributions would help us (developing nations) focus more on best practices for eHealth & mHealth deployment.
Hi Joseph,I think you'll have to explain a bit more what you mean by this, give usmore context as to what you're thinking. And also, I think asking whoshould get ALL of the attention is not a valid question, since there willbe reasons to have both physician and patients involved, and the countrycontext and other factors will be a factor as to who drives the process.Joaquín___________________________________________________________________Gerente de Desarrollo, eHealth Systems <http://www.ehs.cl/>Research Fellow, Escuela de Medicina de Harvard <http://hms.harvard.edu/>Moderador, GHDOnline.org <http://www.ghdonline.org/>
The user drives the process, be it the physician or the patient user.best,rakeshInternational Journal of User Driven Health-care IJUDH, UShttp://www.igi-global.com/journal/international-journal-user-driven-healthcar...BMJ Case Reports, UKhttp://casereports.bmj.com/site/about/edboard.xhtmlJournal of Evaluation of Clinical Practice, UKhttp://www.wiley.com/bw/editors.asp?ref=1356-1294
Then I guess a more appropriate question would be: Who is the user (really)of mHealth/eHealth products?Regards,Usman Razalinkedin.com/in/uraza <http://www.linkedin.com/in/uraza>
I'd say who the user is (and consequently who drives the process) dependson the technology in question. I don't think "eHealth" or "mHealth" can be treated as single entities. eHealth and mHealth technologies have beenused by health workers, doctors, program staff, patients - in differentsettings for different things. They all have different needs and all thoseneeds drive the development and/or implementation of technology. In the endof course, the idea is to benefit patients (through prevention of disease,improved treatment outcomes, more efficient programmatic management, betterpalliative care, whatever the case is). But the users vary.Ali--Ali HabibDirector, InformaticsInteractive Research and DevelopmentPh: +92-21-34327697http://www.irdresearch.org
The user is any human being who uses the system through a user name. Giventhe right user driven learning environment (more here:http://www.igi-global.com/viewtitlesample.aspx?id=49256&ptid=41908&t=the+user...)both patient and health-professional 'users' can positively drive healthcare information to achieve better health care outcomes.(more here:http://www.igi-global.com/journal/international-journal-user-driven-healthcar...)best,rakesh
Hi all,Interesting discussion! I believe that the users of eHealth and mHeath are going to be both physicians and patients. There are already and there probably be a lot more applications that are dedicated to physicians and other that are dedicated to patients. I believe that eHealth and mHealth is going to be driven by patients and not very much by health community. I base this idea in the fact that although the information technology has advanced so much, health system is lacking behind in implementing all the capabilities that the new technology offers and this is mainly due to the very closed and conservative way of function in the health community. For example although the technology in our time is so advanced physicians are still using stethoscopes and other ancient equipments that could be replaced with much more powerful new equipments that offer much more qualitative and quantitative informations.Regrads,Blerim BerishaTelemedicine Centre of Kosova
This can vary in different contexts I believe. Here in Pakistan, I seethese the health care providers as the primary users of these technologiesat the moment, for a number of reasons (including other than simplyimproving their quality of care). However this may change with time.Regards,Usman Razalinkedin.com/in/uraza <http://www.linkedin.com/in/uraza>
Although I still trust too much on my sthetoscope, my hands, my eyes, myears..., I really believe in eHealth and mHealth as a complementary tool tobe more efficient on health care, offering the best affordable quality ofcare but optimazing resources. How? facilitating communication betweenphysician-patient and between physician-physitian physitian-nurses-healthcommunity workers... depending on enviroment...I think can be a great tool to integrate and facilitate a patient-centeredapproach, very important in Non Communicable Diseases management...But I am not expertise in anything! it is just a thought; In my opinionthey might be used to integrate relationships between all partners involveddirectly in health care: patients, physicians, nurses or communittyworkers.Nice to read all your comments,Best regards,nuria-- [image: Archivo adjunto]Nuria Gil-Fournier EsquerraEndocrinología. Diabetes. Nutrición.@nigsp <https://twitter.com/nigsp>
Thanks everyone for adding your comments. I may be wrong, but from my experience implementing eHealth projects, I have observed that Physicians are so used to their traditional approach of pen & paper, most of them have phobia for technology while others don't even bother about the quality of care they give to their patients (they just want to prescribe and go over to the next patient in queue).
Dear Joseph, this topic is so large it almost requires a PhD thesis to highlight the issues. Despite the limitations of space I would like to add more comments in the hope that they add positive value to what has been written before on this site,Physicians must change. They will be forced to change as shown by W. Stead in his 2008 document (Stead and Starmer 2008).The current outcomes of care as documented in several studies have shown we are not making significant progress in terms of costs, quality and outcomes. (Jha and Classen ; Wennberg 2004; Leape and Berwick 2005)SO what has been the patient population response to this with the availability of Web 3.0 and m-Health technologies? They have taken the initiatives for their own well-being.SO we now have the interesting findings from the “Wisdom of Crowds” where it appears that in some instances the overall health of members of the crowd based on the sharing of information is better than under the current widget/appointment-based model of care in many institutions.Of you look at the Californians Health Care Foundation site and the documents on Care without the Doctor and others there is much interesting information.[ http://www.chcf.org/] Two other recent publications worthwhile reading are;Medicine In Denial L. Weed, L. Weed and The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care Eric Topol M.D. Therefore patients are driving the change. Unless physicians adapt and realise the doctor-centred care is no longer a sensible option then change will be even harder to manage.Jha, A. K. and D. C. Classen "Getting moving on patient safety--harnessing electronic data for safer care." N Engl J Med 365(19): 1756-1758. Leape, L. L. and D. M. Berwick (2005). "Five years after To Err Is Human: what have we learned?" JAMA 293(19): 2384-2390. Stead, W. W. and J. M. Starmer (2008). "Beyond Expert-based Practice. Institute of Medicine (IOM) 2008. Evidence-Based Medicine and the Changing Nature of Health Care: ." 2007 Annual Meeting Summary, Washington, DC: The National Academies Press, pp. 94-105. Wennberg, J. (2004). "Wrestling with variation: an interview with Jack Wennberg [interviewed by Fitzhugh Mullan]." Health Aff (Millwood) Suppl Variation: VAR73-80.Terry
Prof. Terry, I totally agree with you. The discussion is becoming more interesting and new points coming out.
Agree with Prof. Terry and still want to say that the change we see asnecessary and inevitable, is hardly seen the same way by the averagephysician in some of the developing countries. One question is, what is theeasiest and most appropriate point in the health care system at which thischange could be initiated. It's important to realize though, that 'easiest'may not be the same as 'most appropriate'. To me it seems the easiest is toaim at undergraduate medical education. However, trainees eventually tendto absorb not what is taught but what they observe in the standardapprentice-ship model i.e. the practice model of physicians has to changeat the same time. This is where other larger contextual factors come intoplay and situation in a well developed health system and that of adeveloping country becomes incomparable. Countries with high out-of-pockethealth expenditures, low literacy rates and specifically low healthliteracy, lack of a collective awareness of the poor quality of care andother barriers to mass adoption of such technologies may face tremendouschallenges in developing meaningful, inter-operable e-health systems.Regards,Usman Razalinkedin.com/in/uraza <http://www.linkedin.com/in/uraza>