E-health in China: Challenges, Initial Directions, and Experience

Zhao, Jianhui; Zhang, Zhenjiang; Guo, Hongwei; Li, Yi; Xue, Wenping; Ren, Lianzhong; Chen, Yunqi; Chen, Shifu; Zhang, Xiaoyu

doi:10.1089/tmj.2009.0076

Cited by 43 publications

(29 citation statements)

References 7 publications

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“…C2: Technology and Interoperability -Challenges surrounding integration/interoperability [19], [20], [21], [22], [23], [24] and standardisation of technologies/lack of data standards [9], [25], [26] were two barriers that appeared often in the analysed set of literature. Interoperability should allow for the unified integration of varied technologies to enable secure and fast access to health data and to patient information situated in different locations.…”

Section: Challengesmentioning

confidence: 99%

“…Interoperability should allow for the unified integration of varied technologies to enable secure and fast access to health data and to patient information situated in different locations. However, the barriers identified also suggest a need for the standardisation of system components and services so that healthcare providers can avoid issues such as lack of data standards permitting the exchange of clinical data [26]. One such recent technology that can be used to overcome such hurdles is FHIR (Fast Healthcare Interoperability Resources).…”

Section: Challengesmentioning

confidence: 99%

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A systematic review of reviews to identify key research opportunities within the field of eHealth implementation

2018

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This paper is a systematic review of the relevant literature surrounding the implementation and utilisation of eHealth in order to identify key challenges and opportunities to future eHealth applications. NHS Evidence, PubMed, IEEE Explorer, Cochrane Library and JMIR Publications were all searched for reviews published between the dates 1 January 2010 and 30 June 2017. 47 papers met the final inclusion criterion. The published literature focused on a wide array of challenges, categorised into five areas, facing the implementation and utilisation of eHealth and from this, four areas of opportunity to advance eHealth were identified. The five challenge areas are (C1) Stakeholders and System Users, (C2) Technology and Interoperability, (C3) Cost-Effectiveness and Start-up Costs, (C4) Legal Clarity and Legal Framework and (C5) Local Context and Regional Differences. The four opportunity areas are (O1) Participation and Contribution, (O2) Foundation and Sustainability, (O3) Improvement and Productivity and (O4) Identification and Application. The literature analysed in this systematic review identifies design and implementation priorities that can guide the development and utilisation of future eHealth initiatives.

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Section: Challengesmentioning

confidence: 99%

Section: Challengesmentioning

confidence: 99%

A systematic review of reviews to identify key research opportunities within the field of eHealth implementation

2018

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“…Post SARS, People's Republic of China also has begun to employ e-health more systematically. 48,49 Scanning the literature reveals that many other developing countries in the region use telehealth to varying degrees, for various purposes, and with varying success, but mostly in the context of projects; there is little evidence of sustained application of programs and poor publication for any single country or the region as a whole.…”

Section: Telehealth In Asiamentioning

confidence: 99%

Telehealth in the developing world: current status and future prospects

Scott¹,

Mars²

2015

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161

131

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Abstract:In a setting of constant change and confusing terminology, telehealth continues to gain ground in both developed and developing countries within the overarching milieu of e-health. Evidence shows telehealth has been used in essentially all countries of the world, but is embedded in few. Uses and needs of telehealth vary between the developed and developing world; the latter struggles with both communicable diseases and noncommunicable diseases, and with very few resources. Common clinical applications include teleconsultation, telecardiology (transmission of ECGs), teleradiology, and teledermatology. Many telehealth projects exist throughout Latin America and the Caribbean, Asia, and Africa, but there is little published evidence and only isolated examples of sustained programs, although several sustained humanitarian networks exist. Application of mobile solutions (m-health) is on the rise in many developing countries. Telehealth is still not integrated into existing health care systems globally. Reasons vary: lack of proven large-scale operations, poor evidence base, inadequate implementation, lack of attention to the "soft side" of implementation (readiness, change management), and many others. For the developing world, reasons can be more pragmatic, including limited resources, unreliable power, poor connectivity, and high cost for the poverty stricken -those most in need. Telehealth is poised to improve health and health care in the developing world, driven by both altruistic and profit motives. But to have the desired effect, telehealth must address very specific and evidence-based health "needs" of each facility, region, or country; the shortage of health workers and specialist services; and the required skills upgrading and training, allowing the developing world to establish its own critical mass of experts. This will only be achieved by raising awareness, understanding, and ability regarding telehealth capability and limitations, and by the coordinated political and professional will of all those involved to guide public and private innovation and telehealth integration.

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“…In many other parts of the world, attention has also been devoted to the construction of e-health infrastructures using information and computer technology. China, for example, had supported some demonstration projects that enabled the setup of an economical, practical, reliable system so that medical records and laboratory results could be reviewed anywhere (Zhao et al, 2010). A multi-clinic randomized controlled trial in Malaysia reported that a text messaging reminder system was effective in improving attendance rate in primary care (Leong et al, 2006).…”

Section: Telehealthmentioning

confidence: 99%