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Will e-health offer care providers a lifeline?

MALAGA, SPAIN – An aging population, more demanding and increasingly mobile citizens, shortages of health-care professionals and the threat of pandemics are changing the face of health care as we know it, said speakers at the fourth annual global eHealth conference, which wrapped up today.

Over the next five to 10 years, we’ll see increasing health-care and social services needs, as people get older and don’t reproduce as fast. Combined with large-scale threats ranging from pandemics to obesity, this will be like a tsunami hitting health-care systems, said Alejandro Jadad, director of Canada’s Centre for Global eHealth Innovation. “We’re already in trouble,” he said. “We’ll be in even deeper trouble if we continue.”

People use hospitals like they’re buying milk, he said, when hospitals should only be used as a last resort — for major emergencies, surgeries, complex procedures and intensive care. We could start to see a shift of services to the home, to pharmacies, even to kiosks in shopping malls. Asynchronous telehealth services, for example, would allow patients to use the Internet to send non-urgent information to doctors and receive messages back via e-mail or SMS.

But there’s still not enough collaboration among countries in the area of e-health, said Jadad.

And collaboration is increasingly important, as e-health plays a role in preparedness, warning and response to global threats, such as communicable disease and bio-terrorism, he said.

The EU is using medical intelligence, knowledge sharing networks and risk management tools at its health emergency operations facility in Luxembourg to help facilitate communications among subject matter experts, said Germain Thinus, directorate general of health and consumer protection with the Health Threats Unit of the European Commission. Coalition partners include Canada, the U.S., Japan and Mexico.

Tools include early warning and response systems, scanning tools (including Canada´s GPHIN, or Global Public Health Intelligence Network) and awareness tools, as well as audio and videoconferencing, satellite phones and a digital communications system. It is working on simulation tools, as well as geo-reports to predict the impact of outbreaks and geo-location reports to predict the movement of disease outbreaks. Other possible projects include outbreak management systems, contact tracing and syndromic (or pre-diagnostic) surveillance.

The World Health Organization (WHO) is trying to promote interoperability among nations by setting the rules of the game and “matchmaking” more developed countries with those that are less developed in the area of e-health.

But e-health must be needs-driven, said Niels Rossing, a health telematics consultant from Denmark. Governments should have a realistic budget and be open to change, he said. “Without change management, it’s just an add-on financial cost,” he said, adding that top-down approaches are not very fruitful.

”Unless a country can build a real business case, this is not going to be accepted by financial sources,” he said.

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