This study extends work gleaned from technology acceptance studies in healthcare by investigating factors which influence perceived usefulness and perceived ease of use of e-health services. Based on these empirical findings, we derive implications for the design and introduction of e-health services including suggestions for introducing the topic to physicians in ambulatory care and incentive structures for using e-health.

Various studies have proven the positive impact of ehealth solutions on treatment success and health care spending. Utilization of e-health is therefore urgently recommended by German health authorities. However, the diffusion of such technologies is currently very low, despite the availability of the underlying technology. A market failure is a likely reason for the unsatisfying situation, as there are currently hardly regular business models for electronic health services. This paper conducts a case study on telemonitoring, which has significant positive impact on patients with chronic heart failure, to illustrate a market engineering approach for e-health applications. The introduced case study is located in a southern German region, where health insurances and a physician network want to establish a telemonitoring solution. We investigate the socioeconomic, technical and legal environment in order to derive a transaction object and build a transaction service. Patients will transfer vital parameters to physicians on a daily base. Caregivers observe patients' health status and compile quarterly reports for the e-health provider. The provider distributes the funds of the health insurances according to the compliance among the stakeholders and adjusts the model on an annual base according to the realized savings. The presented solution can be built upon the emerging German infrastructure for telemedicine and be extended to further regions later.

Patient data, particularly emergency data, must be available to medical personnel within a short time frame and independent of potential interruption of (mobile) network connections. Additionally, medical data is confidential information that must not openly be available to anyone with physical access to the storage media. The planned German electronic Health Card (eHC) is supposed to hold emergency data. However, the eHC smart card will not always be available to caregivers in emergency situations, e.g., unconscious patient, since it cannot be duplicated, customized or read without physical contact. We therefore propose the SemTag prototype which utilizes Near Field Communication (NFC) technology to provide secure and quick access to medical information. Caregivers have the opportunity to store encrypted medical data on tags for a particular group of addressees, e.g., for emergency cases in home care environments. The tags can be placed on highly visible locations, e.g., entrance areas of homes and carried by the user in form of a token. Neither ubiquitous network access nor the unique eHC is necessary, to view emergency medical data within home care environments. Hence NFC tags can be regarded as a tool for information and identification alternative to distributed information systems for the collaboration of caregivers. This manuscript shows the technical storage and encryption process of emergency data on NFC tags. The technical feasibility, benefits, limitations and future research prospects of the prototype system are discussed.

The electronic health card and the telematics infrastructure are widely discussed in the German public. However, the applications which aim at improving the healthcare system by utilizing the capabilities of the service oriented healthcare telematics have hardly been addressed so far. The article discusses the potential of such value-added applications that are not subject to the limitations of current information systems in medical institutions and open up new potentials. To this end, overall requirements of value-added applications based on the architecture are illustrated by implementing a collaborative application for referral and appointment management. The issues security, interoperability, patient orientation, and system integration are of major interest.

Smartphone applications (apps) have been used and evaluated in the context of workplace health promotion (WHP) programs. However, there is a lack of studies analyzing actual app usage data and measuring changes in medical markers to evaluate the effectiveness of WHP apps in terms of health improvements in practice. In this study, we evaluated data from 555 employees of an IT company who participated in a WHP program over the course of one year. Participants of the program received a medical check-up as well as a health app to understand their medical results and receive advice for a healthier lifestyle. In addition, 99 of these employees underwent a follow-up medical check-up. It was found that the smartphone app for healthy lifestyle promotion in combination with onsite medical check-ups was effective in improving various health indicators, for example, BMI, body fat, blood pressure and triglycerides. The study further identified influence factors for sustained app usage, and analyzed different usage behaviors among gender and age groups.