In our last article we had a quick check of the new Strategic Plan Digital Health of the ministry of health. But let us roll back a little bit and try to understand what exactly digital health means!
First there are a bunch of terms out there which are used – sometimes interchangeably – to define or name the different approaches or concepts of using technology and the internet in a broad sense within the healthcare sector (Box 1).
Some of those terms are e-health, telehealth and telemedicine, and mobile health (mhealth) which has gained much attention with the rapid development of smartphones.
Digital health seems to be the new term used to label all endeavour to address health challenges with the help of technology. The expression has a more intuitive connotation as most people can grasp what both terms digital and health supposedly mean.
On the other side e-health or ehealth has been long associated with business because the term has emerged in the late 90’s when the internet started to play a disruptive role in most areas of socio-economic life. One of the first definitions then stated e-health as « an emerging field in the intersection of medical informatics, public health and
business … »²
But, more recent and pragmatic definitions of ehealth set it as a concept that ‘is used to describe the
application of ICTs across the whole range of functions which, one way or another, affect the health of citizens and patients’ and ‘the use of information, computers and telecommunications in support of meeting the needs of patients and the health of citizens’.2
Looking at their definitions, purposes, and concepts, digital health and ehealth are very alike and might certainly be used interchangeably (in this article we do not differentiate between both terms). One essential aspect they have in common are their potential and capabilities to thoroughly transform the practice of health care at all system levels.
A transformation that is meant to go beyond just introducing technology, but to also address the processes of organising and delivering health care, the relationships between the different actors, and the behaviours of individuals, to name but few.
Therefore, digital health is about designing new models of health delivery using technology…
It is about rethinking the way care is delivered – including some possible shifts in the interaction among individuals involved.
It is about empowering individuals to take ownership of their health and well-being.
It is meant to be a means of addressing the health challenges in the country and achieve national health goals.
And much more …
Nevertheless, beyond the terminology used and the available concepts, it is important to understand that the main
concern of digitization in the healthcare sector must remain to address the many pressing health challenges in the country and achieve national health goals through improvements in access, quality, outcome, and efficiency. This should be the central motivation of every person or organisation involved in digital health.
Digital health, eHealth, mHealth, Telemedicine and Telehealth are all concepts that encompass a new practice of healthcare underpinned by technology. If Telehealth incorporates a wide range of health services delivered over distances, Telemedicine’s focus is the provision of medical services (e.g., diagnosis, treatment) over distances. Hence, Telemedicine is often seen as a subclass of Telehealth.
For clarification, Information and Communication Technologies (ICTs) constitute the ground or foundation on which the implementation and deployment of all solutions and services needed for digitization depend. There is an overall strong correlation between ICT and digital health or ehealth. Whereas ICT serves as a precondition for deploying and implementing digital health solutions.
On the other hand, Telematics also is an enabling concept for ehealth!²
Telematics combines the theories of
telecommunication with informatics and plays an important role for healthcare as it used for the transmission of health
information across distance.²
The boundaries between the different concepts are sometimes blurred, and there are many overlaps between them, which have led to multiple definitions and meanings among implementers, researchers and practitioners.
1 Eysenbach G. What is e-health? J Med Internet Res 2001;3:e20 https://www.jmir.org/2001/2/e20/
2 Otto, L., Harst, L., Schlieter, H., Wollschlaeger, B., Richter, P. and Timpel, P.
Towards a Unified Understanding of eHealth and Related Terms – Proposal of a Consolidated Terminological Basis.