mHealth, eHealth, Telehealth, and Telemedicine

Digital healthcare in the world has seen a massive growth over the last few years. eHealth, mHealth, telehealth, and telemedicine are used to describe the use of mobile and computer technologies for healthcare service delivery and patient management. Although these terms are confusing and used interchangeably at times, each represent a different aspect of healthcare technology. 

It is worth learning about the differences between eHealth, mHealth, telehealth, and telemedicine and to know the difference between them, while knowing their importance in healthcare service delivery t this crucial juncture. 

Differences between mHealth and eHealth

Both mHealth and eHealth play a role in supporting healthcare with electronics. They perform similar functions, however the means by which the information is provided is the primary difference. 
mHealth is an abbreviation for mobile health that utilises mobile devices, such as a cellphone or a tablet, to support healthcare practices. With mHealth services, patients are able to log, store, and monitor their health records on their personal mobile devices. These applications are helpful in improving the efficiency of the delivery of healthcare information. mHealth applications can be helpful in research, and in patient care. 

Health tracking apps on mobile devices are becoming increasingly popular, especially with the advent of Covid-19 pandemic. There are over 318,000+ health apps on the market. Popular health app example of mHealth include, Fitbit, GoogleFit, Apple Heart Study etc. mHealth has the ability for healthcare professionals to track the recovery of patients 
As hospitals and healthcare become more technologically reliant, more and more hospitals and health facilities have apps where you can access your records, make appointments, and ask questions from your mobile device. 

On the other hand, eHealth consists of a much broader understanding of healthcare practices supported by electronic processes. The technology used to improve healthcare practices with eHealth include electronic health records, patient administration systems, lab systems, and other records that cannot be stored within mobile health applications. 

According to the Journal of Medical Internal Research, there are 10 “e’s” in eHealth 

  • Efficiency- avoid unnecessary duplication and streamline the health care service between patient and provider. 
  • Enhancing quality- providers have access to each other’s notes to avoid duplicating any previous exams or studies. 
  • Evidence based- there should still be scientific evidence on the basis of all information provided in eHealth. 
  • Empowerment- it should empower patients to be a part of the medical process. 
  • Encouragement- improving the relationship between healthcare provider and patient to work together in a partnership. 
  • Education- healthcare providers and patients have increased educational resources to learn and implement.
  • Enabling- allowing easy communication between healthcare providers and patients across the board. 
  • Extending- allowing healthcare services and assistance across the globe instead of relying on your set geographical location. 
  • Ethics- maintain the same values of professional practice, informed consent, privacy and equity. 
  • Equity- make healthcare more equitable for users. 

Furthermore, it should be easy-to-use, entertaining, and exciting. 

Differences between Telehealth and Telemedicine

These two terms are confused with one another and used interchangeably too. However, like eHealth and mHealth one term serves a broader purpose. The broader term in this comparison is telehealth. Telehealth refers to both clinical and remote non-clinical services, including providing training and continued medical education for practitioners. 

Telemedicine is solely referring to remote clinical service. The concept of telemedicine was started to treat patients who are located in remote or inaccessible areas. With the onset of Covid-19 pandemic, throughout last year with more and more services relying solely on virtual resources, it has served a greater purpose – providing people access to care without putting themselves at risk of contracting COVID-19. As more people gain access to these services, expectations around waiting room times, access to care, and convenience of care are changing. 

Understanding the ways the terms work together to create the big picture of virtual healthcare is crucial to understanding your access to care. The aim of all of these services is to provide greater quality, efficiency, and cost of care to both practitioners and patients. Each plays their unique role in crafting a well-rounded digital healthcare plan for patients. 

eHealth and how is it differ from telehealth

In the rapidly changing digital world, technology is making a difference. It’s transforming every industry. Making change possible. Opening up opportunities and, hopefully, providing people with the information they need. Nowhere is this truer than in healthcare. Technology is becoming an integral tool in how healthcare practitioners and educators work. They are using ehealth and telehealth to make a difference. But what exactly do these terms mean? And what is ehealth? And telehealth, for that matter?

eHealth

At its most basic, ehealth is the use of electronic systems to support healthcare delivery. In most parts of the world people who work in ehealth tend to be those with IT and computer science skills, who help healthcare practitioners use electronic means to enhance and augment the service they give to patients.

In Sri Lanka, the Ministry of Health has trained medical doctors from 2009 in masters (M.Sc.) in biomedical informatics and proceeded to train them in doctorate (MD) in health informatics from 2016. 

Telehealth

Telehealth is in many way a component part of ehealth, but it is more focused on patient delivery. Let’s get a definition from Jacki Mansfield, who coordinates telehealth services at Charles Sturt’s Three Rivers University Department of Rural Health.

“Telehealth is the use of technology to provide appropriate healthcare and advice to those who may not have access to services for reasons such as distance, lack of transportation, or assistance to attend appointments.”

So telehealth focuses on harnessing the power of technological innovation to help people. This could include innovations such as:

  • Video conferencing consultations
  • Wearable or implanted health data tools
  • Patients uploading images of conditions for review
  • Electronic pill dispensers.

Benefits of ehealth and telehealth

Here are three key ways that ehealth and telehealth can benefit patients and healthcare workers.

1. Access

Put simply, ehealth, and particularly telehealth enable more people to get the care they need. This is particularly important in rural and regional areas. These are the locations that tend to lack the most comprehensive health infrastructure, facilities and services. Technology can bridge that divide, particularly for those who can’t travel to access healthcare, meaning greater healthcare equity. Fortunately, the rise in the application of technology to healthcare is coinciding with a rise in digital literacy. So more people will have the skills to access ehealth and telehealth services. This means, as Jacki Mansfield points out, a continuing use of telehealth in the future. “The use of telehealth to deliver clinically appropriate healthcare and advice to those who may not have access to services is increasing every year.”

2. Efficiency

The use of technology can bring costs down in healthcare delivery, as electronic methods don’t have the same infrastructure and overhead costs associated with physical facilities. It can also help make many time savings, which can have a direct impact upon patients. For instance, the ability for practitioners in different types of healthcare services to share patient info quickly online means interventions and treatment plans can be devised and implemented more quickly. ehealth also allows laboratories, researchers and providers to share information, discoveries and innovations more quickly.

3. Empowerment

Technology also allows patients to have greater visibility of treatment options and avenues for patient care. They can also have access to the data about their own health. This means they become a more informed and active agent in their own care. They become empowered through information, and become partners with their medical practitioners in deciding treatments and care strategies. Knowledge is power, indeed.

Defining Telehealth

The overarching category that telemedicine and e-Health fall into is generally considered “Telehealth.” A March 2018 white paper called “The Promise of Telehealth: Strategies to Increase Access to Quality Healthcare in Rural America” defines telehealth as,

“communication and information technologies used to provide or support long-distance clinical healthcare, patient and professional health-related education, public health, and health administration.”

The Center for Connected Health Policy says, “Telehealth encompasses a broad variety of technologies and tactics to deliver virtual medical, health, and education services. Telehealth is not a specific service, but a collection of means to enhance care and education delivery.”

Part of the problem here is that federal and state agencies differ in how they define these applications. For example, California law says:
“The mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care while the patient is at the originating site and the health care provider is at a distant site. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.”

But the federal Health Resources & Services Administration says:
Telehealth is defined as the use of electronic information and telecommunication technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration.

Generally, telehealth encompasses the following technologies:

  • Live video, or synchronous (two-way) virtual visits between a person and their caregiver using telecommunications technology.
  • Store-and-forward, or asynchronous virtual visits that do not include the use of live feed, but instead use pre-recorded videos or digital images and the Internet to transmit this data.
  • Remote patient monitoring includes a patient sensor or another on-site machine that transmits information virtually through the web to a remote caregiver.
  • Mobile health, often called mHealth or eHealth, is a virtual visit conducted via a cell phone or other digital handheld devices like a PDA or tablet and not on a desktop.

While these generally are the four categories that are widely recognised in the industry, some technologists also list a fifth category called “eConsult,” which uses telehealth technology to transmit clinical data between two medical providers, such as a primary care doctor and a specialist. An eConsult can consist of just the transmission of data (store-and-forward) or real-time video consultations (synchronous telehealth). The distinction between synchronous visits and eConsult is that the communication is not between doctor and patient but two consulting clinicians.

No matter how the sub-categories are defined, telehealth is the framework for a technology that allows communication between two (or more) individuals within a healthcare setting. This may or may not include clinical visits, patient education, or some other type of remote monitoring process.

Defining Telemedicine

If telehealth is defined as the overarching services framework, where does telemedicine fit in?
The Center for Connected Health Policy suggests the concept of telemedicine is slowly being replaced by the more commonly used phrase “telehealth.” While we’re not certain that is necessarily true in many medical circles, there is consensus that telemedicine refers to the practiceof using telehealth technology for medical applications.

However, the American Telemedicine Association (ATA) defines telemedicine as:
In brief, telemedicine is the remote delivery of health care services and clinical information using telecommunications technology. This includes a wide array of clinical services using internet, wireless, satellite and telephone media.

The ATA uses telehealth and telemedicine as interchangeable terms, which supports the general usage of the two phrases as synonyms. Generally, across the industry, telemedicine and telehealth are considered to be remote or virtual healthcare technology to deliver care to patients.

How Does e-Health Differ from Telehealth and Telemedicine?E-Health was defined in a clinical study as far back as 2001 in the Journal of Medical Internet Research. In the research paper, the authors suggest that e-Health actually signifies a broadening of the telehealth category to integrate the technologies as a standard part of treatment. The authors suggested that when e-Health is broadly adopted as a descriptor for telemedicine applications, the technology will have reached widespread adoption in a similar way as e-commerce applications have become normalized in the retail sector. The article suggested the phrase was “an umbrella term…to describe the combined use of electronic communication and information technology in the health sector.”

Ironically, even health systems have their own definitions of these phrases. For example, The University of Kansas Medical Center says e-Health “refers to the use of computers and networks like the Internet to store and manage your medical records, instead of paper files.” They use this term interchangeably with the phrase “health information technology” (HIT).

Even educators are split on how to use these terms; Jacksonville University says, “eHealth is where medicine/healthcare and information technology converge.” They define forms of eHealth as:

  • Health informatics (HIT) for digital management of patient records.
  • Telemedicine to facilitate remote diagnoses and clinical care.
  • Electronic health records (EHR), a form of HIT.
  • Clinical decision support systems, which provide digital access to protocols to improve quality outcomes.
  • Consumer health informatics, which includes smart digital devices to monitor exercise, weight, eating habits, and more.
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Science Direct also includes the application of health interoperability between data exchanges, such as Health Information Exchanges (HIE) under the eHealth banner. HIE networks include the Department of Veterans Affairs, who has a long and successful history of applying telemedicine to improve access to care for our nation’s veterans.