Introduction

Despite the futuristic sound of the scenario in the box below, all the technologies mentioned are available, and some, such as computer interviewing, have been used since the 1960s.

Such a scenario raises questions about the nature of clinical practice and healthcare systems—for example, how muchinformation and responsibility should be transferred to patients when technology allows it. This final article examines some of these issues, and ends the series where it started, with a reminder that health informatics is more about understanding people and new models of care than it is about technology.

Factors encouraging eHealth

Gustafson and Wyatt define eHealth as “patients and the public using the internet or other electronic media to disseminate or provide access to health and lifestyle information or services.” This differs from telemedicine, in which there is a health professional at one or both ends of the communication.

Pressures towards the use of eHealth include:

• Patient demand—Information and services can be delivered in a personalised way, where and when they are wanted. eHealth provides simple, easy access to health information, support services, and goods. It can lead to loss of the general practitioner's role as mediator (for example, a patient and specialist could email each other directly) and enhanced self expression (for example, in weblogs)

• New functions—eHealth can link previously distinct services and information. For example, all the information and forms from different government departments relevant to having a baby could be accessed from one portal

• Democracy—eHealth could allow citizens to form pressure groups, lobby for services, or even set up their own health organisations (see box at bottom of page 1392)

• Health workforce—eHealth may help deal with staff shortages or requests from staff for improved working lives (for example, working from home)

• Technology—Futuristic devices (like implanted sensors and drug delivery systems) are made possible as technology …