PREFACE

E-Health Care Information Systems: An Introduction for Students and Professionals is the latest in a series of works that I have published over the years, including Health Management Information Systems ( first edition, 1995; second edition, 2001) and Health Decision Support Systems (1998). These works parallel the changes we have witnessed over the years in the evolution and development of health computing as a discipline. They also reflect the growth and maturation of my own reading and research in this intriguing and expanding field. Of course, this work represents the forefront of my research in the integration of information technology (IT), e-commerce, and health care.

Health Management Information Systems focused on the application of IT to replace manual clerical and information-processing tasks as well as to automate information flow models used to simulate well-structured (and not-so-well-structured) organizational and managerial activities in health care. The pieces of the health management information systems (HMIS) puzzle were put together to offer the reader a comprehensive view of how IT can be applied in health care organizations to facilitate efficient operational and tactical planning, administration, and evaluation. Health Decision Support Systems concentrated on the use of IT to extend the cognitive capacity and decisional expertise not only of health administrators and policymakers but also of clinicians, nurses, and other health professionals. Hence, health decision support systems (HDSS) moves one step forward from HMIS in applying the power of IT not just to achieve information-processing efficiencies but also to enhance decisional effectiveness on tasks that are mostly semi-structured and complex. Briefly, the purpose of HDSS is to effectively enhance human thinking and extend human knowledge, to intelligently capture the interactions between end users and their health providers, and to creatively support organizational and clinical decision tasks.

E-health is next in line because the application of IT in health care is not confined to individual caregivers or even patients and should not be limited only to health organizations and urban communities. Indeed, if IT in health care is to flourish, its applications must be further enhanced with the potential for reaching the masses, especially those who are underserved, those who are elderly, and those who have no easy access to urban health care facilities. Accordingly, this publication was commissioned to remedy the lack of a comprehensive text on e-technologies in health care for students in all areas of medicine and health care, including population health and clinical epidemiology, nursing, pharmacy, occupational and environmental health, health administration, health policy and management, health education and health services research, and public and community health care programs. Such a work is especially needed in this era of explosive medical knowledge diffusion and rapidly advancing e-technologies, particularly the Internet. As we begin to see the pervasiveness of e-technologies in every aspect of health care and medicine, we will begin to understand why a course in e-health is logical for the health information systems curricula in medical schools as well as allied health, engineering, and business disciplines.

In light of these developments, we must understand the vision of future health in the context of evolving e-health systems and environments (Chapters One and Two). This book therefore offers the reader wide-ranging perspectives of e-health systems and environments (Chapter Three) and provides critical foundational knowledge of e-health in areas such as e-health records (Chapter Four), e-public health information systems (Chapter Five), and e-networks (Chapter Six). It surveys general and specific domains and applications of e-health, including e-rehabilitation (Chapter Seven), e-medicine (Chapter Eight), e-home care (Chapter Nine), e-diagnosis support systems (Chapter Ten), and e-health intelligence (Chapter Eleven). This book also provides information to increase the reader's understanding in key areas of e-health strategies (Chapter Twelve), e-health care technology management (Chapter Thirteen), e-security issues (Chapter Fourteen) and impacts of e-technologies (Chapter Fifteen). Finally, this work portrays the use of new and emerging e-technologies such as mobile health, virtual reality, and nanotechnology as well as how to go about harnessing the power of e-technologies for real-world applications (Chapter Sixteen).

The wide-ranging perspectives and interdisciplinary nature of e-health makes it impossible to expect any one individual to understand such an expansive field. Hence, the reader will soon discover, my collaborators are from diverse disciplines, including medicine, health sciences, engineering, business information systems, general science, and computing technology. Nonetheless, a single message has been conveyed throughout the text: the e-health paradigm shift is seen as a major transformation of our existing health care system and environment.

Instead of having to move patients to their caregivers, we are now going to be able to transmit medical information, knowledge, and relevant expertise to reach those who are in need of care, regardless of cultural, political, and geographical barriers as well as socioeconomic status. Even so, the future of e-health relates to further expansion of perspectives and clarity of the e-health vision (Parts One and Two of this text), new domains and emerging e-technology applications (Part Three), and new e-business strategies, management issues, and impacts (Part Four). All of these developments will ultimately lead to the blurring of corporate communities on one hand and user communities on the other hand. The defined roles of e-suppliers, e-providers, e-payers, and e-consumers are becoming less distinct. Therefore, it is still critical to come back, as we have done in the final part of this book (Part Five), to ask the questions “What is it that we want? How do we go about designing precisely what we want to achieve: the most accessible, available, affordable, and accountable medicine? How will such a system promote human health and well-being for the masses?”

Today, we stand at the crossroads where our current technology has the potential to be applied for the greatest good of many people, even entire populations, or to be used as a destructive weapon. The ongoing suffering in this world, the fighting over resources, the torturing of human beings, and the killing not only of animals but also of large numbers of human beings tell a story that must now be reversed. Technology can be a force for good only if humans know how to use it appropriately to better the lives of others. We have that power in our hands; its ultimate impact depends on how we go about using it. This, in essence, is the future of e-health care. The ideal and most significant paradigm shift will be the shift in human thinking—that is, applying new and emerging technologies not to destroy the human race but to create a peaceful and healthy world where illness is a thing of the past.

Joseph Tan

February 2005

Detroit, Michigan