What Do the “Ten E’s” in E-Health Mean?

If we’re tackling the idea of e-health as it applies to medicine, we must first define the concept. There are a number of terms tied to telemedicine, including e-health and m-health, which are used interchangeably to mean the virtual patient visit. But the “e” in e-health usually is shorthand for the word “electronic,” which is healthcare delivered via digital processes. It’s a broad term that encompasses healthcare delivery via the Internet. This could include the use of Internet of Things devices to monitor and transmit the vital signs of remote patients or a telehealth visit on a smartphone screen. But it could also include the use of electronic health records.

As far back as 2001, an article in the Journal of Medical Internet Research suggested that the label “e-health” would naturally supplant the term “telehealth” with a more broadly defined term for electronic forms of healthcare delivery. While this hasn’t happened, e-health does need some context to help end users understand what the term encompasses.

This article will provide a framework for the concept of e-health and define the “ten e’s” behind the idea of e-health as an innovative way to deliver healthcare services that leverage today’s digital tools.

An article in the Journal of Medical Internet Research provides a clear framework for the concept of e-health:

E-health is an emerging field in the intersection of medical informatics, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies. In a broader sense, the term characterizes not only a technical development, but also a state-of-mind, a way of thinking, an attitude, and a commitment for networked, global thinking, to improve health care locally, regionally, and worldwide by using information and communication technology.

USF Health points out that e-health uses technology to improve outcomes, certainly, but also suggests that the idea has an additional goal:

E-Health empowers patients to take an active role in their treatment, allowing them to gain a deeper understanding of their conditions and how to effectively manage them.

When taken within the context of this definition, e-health could signal an interesting, and potentially seismic shift in the traditional doctor-patient relationship. Using technology to assist in healthcare delivery means that patients have new ways to manage their own treatment. Instead of relying on the physician to provide care, a virtual visit, remote monitoring device, or even a smartphone, can engage the patient in new and sometimes more proactive ways to improve their health. USF Health suggests:

When patients have e-health resources available at their fingertips, they’re better equipped to ask their physicians more pointed questions to understand their conditions and better manage their health. People are more likely to complete treatment plans recommended by physicians when they can research outcomes to learn the benefits of prescriptions, exercises and other health activities designed to improve their conditions. Sharing the burden of their own care increases patient satisfaction, as people are able to gain a deeper understanding of exactly what their physician is doing to help them.

The implications of this idea are profound and tied to the idea of digital technologies as disruptors to every industry they’ve impacted, including healthcare. An article in the Journal of Medical Internet Research recommended a framework for the idea of electronics in medicine, providing us with a set of 10 “e’s” within the idea of e-health. The author states that any e-health application should include:

• Efficiency in healthcare with the goal of decreasing costs. Telehealth applications meet this goal by reducing overhead costs in a practice, decreasing wait times for appointments, and also cutting encounter times.
• Enhancing care quality by empowering patients to participate in their own treatment while also increasing convenience but cutting travel time and costs to and from a provider.
• Evidence-based medicine tied to rigorous scientific frameworks with benchmarked quality controls.
• Empowerment of consumers by expanding their knowledge base and allowing access to electronic health records over the Internet, providing more patient-centered care and caring.
• Encouragement of patient participation in more proactive care. For example, e-health can help diabetics monitor their blood glucose levels and diet each day with the goal of patient awareness and empowerment.
• Education of patients and their physicians through the use of Internet research and online video or written health education information.
• Enabling easier exchange of information online between healthcare providers and their patients.
• Extending healthcare beyond traditional boundaries, both geographically by providing access to care in rural areas and conceptually.
• Ethically addressing new issues tied to patient-physician interaction, privacy, informed consent, and equity issues.
• Equitable, especially as it pertains to offering care in rural areas where specialty or primary care treatment may be lacking. Equity in care could also be related to the idea of e-health as intersection of business and healthcare. Or even, the ability of consumers to research physician performance scores online.

The U.S. Department of Health and Human Services published a brochure on the reach of consumer e-health tools. The title is apt; the whole point of our digital evolution is that it’s really a revolution. According to the brochure, e-health tools help consumers engage in their own care in new ways:

Consumers with diverse perspectives, circumstances, capacities, and experiences are included in the design of, and have meaningful access to, evidence-based e-health tools with strong privacy and security protections.

When taken within this framework, the idea of e-health facilitates an entire shift in traditional healthcare models.

The increasing costs healthcare and the struggle to improve patient outcomes remains driving factors behind the development of e-health tools. Telemedicine offers new ways to treat patients with models that use the “10 e’s.” These models can include:

• Remote home monitoring.
• Patient education.
• Advanced home health.
• Direct patient virtual visits.
• Specialist consultations.

The global market for e-health tools is rapidly expanding. Within this context, OrthoLive has introduced a tool designed for the specialty orthopedic provider to bring healthcare to the patient. Whether at home or at work, the OrthoLive app helps improve quality outcomes in healthcare. To find out more, contact us.