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EDITORIALS: David H Gustafson and Jeremy C Wyatt Evaluation of ehealth systems and services BMJ 2004; 328: 1150 [Full text]

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ehealth systems and services: evaluation studies!

Dr.Naseem Akhtar Qureshi, MD, IMAPA, LMIPS   (19 May 2004)

ehealth systems and services: evaluation studies! 19 May 2004
Dr.Naseem Akhtar Qureshi, MD, IMAPA, LMIPS, Medical Director(A), Director Of CME&R Buraidah mental Health Hospital,POB.2292, Saudi Arabia Send response to journal: Re: ehealth systems and services: evaluation studies!	Sir: The two editorialists raise a very important and relevant issue of evaluation of effectivity of ehealth systems and services. This is in principle with any new ehealth or otherwise initiatives, which comprise of three components, i.e., planning, implementation and evaluation. This BMJ issue with its main theme of electronic communications and health certainly inform us that millions of e-communities have already developed and are operating worldwide. Majority of these internet virtual communities are developed and managed by medical personnel but relatively less are using the bottom up approach. Initial studies, i.e., observational, anecdotal reports, hits and patients and care givers testimonials evidently are suggestive of good results of such e- communities on the quality of life of patients and their care givers. At the same time, managers and planners many of them are medical personnel of such communities are also satisfied. Moreover, no harmful effects of e- systems on patients and their carers were reported. Notably, future evaluation studies addressing multiple aspects like cost-effectiveness, users time, quality of life of users, and overall effectivity in terms of correct diagnosis, proper assessment, precise treatment and predictions of morbidity and mortality should be carried out but these studies will be associated with many unsurmountable methodological problems including recruitment criteria of ecommunities, e- patients, assessment tools and what to measure in terms of outcome. The evaluation research of e-patients is an uphill task and involve huge financial committments. Finally, these studies will project nothing new but most likely mixed results, many supporting the continuation of e-ccommunities while some showing negative impact of e-systems and services on users. Reference: David H Gustafson and Jeremy C Wyatt. Evaluation of ehealth systems and services. BMJ 2004; 328: 1150 Competing interests: None declared