E-Healthcare Disparities Across Cultures: Infrastructure, Readiness and the Digital Divide

E-Healthcare Disparities Across Cultures: Infrastructure, Readiness and the Digital Divide

Seema Biswas (Ben Gurion University of the Negev, Medical School for International Health, Beer Sheva, Israel), Keren Mazuz (Ben Gurion University of the Negev, Medical School for International Health, Beer Sheva, Israel) and Rui Amaral Mendes (Case Western Reserve University, School of Dental Medicine, Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, Cleveland, OH, USA)
Copyright: © 2014 |Pages: 16
DOI: 10.4018/IJUDH.2014100101


As e-healthcare becomes a reality for healthcare service provision across the world, challenges in acceptance, implementation, usage and effectiveness have begun to emerge. The infrastructure, readiness and literacy levels required for the effective delivery of e-healthcare services may be prohibitive in providing access to those most in need. As research brings to light the real effectiveness of e-healthcare programmes across the globe, this paper explores how e-healthcare has been implemented worldwide and how populations have been served by an innovation in Information Technology and healthcare that has sought to bring health services to remote areas, improve access to healthcare and narrow the divide between healthcare providers and patients. While notable achievements have seen real time clinical data captured and medical records digitalised, the very determinants responsible for actual health and social disparities are equally responsible for disparities is access to e-healthcare.
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The World Health Organization, WHO, defines e-health as the transfer of health resources and health care by electronic means. They explain that e-health comprises three main areas:

  • The delivery of health information, for health professionals and health consumers, through the Internet and telecommunications.

  • Using the power of information technology and e-commerce to improve public health services, e.g. through the education and training of health workers.

  • The use of e-commerce and e-business practices in health systems management. (WHO, 2015)

They describe telehealth as including surveillance, health promotion and public health functions - a broader definition than telemedicine as it includes computer-assisted telecommunications to support management, surveillance, literature and access to medical knowledge. Telemedicine is the use of telecommunications to diagnose and treat disease and ill-health. Telematics for health is a WHO composite term for both telemedicine and telehealth, or any health-related activities carried out over distance by means of information communication technologies.

LeRouge asserts that telemedicine is so integral to the development of healthcare services that it “serves as the vital connective tissue for expanding health care organization networks” (LeRouge, 2012). As Kalema (2014) and Ackerman (2010) put it, the opportunity in e-healthcare is to break down barriers to healthcare, improve access for all - especially those underserved by healthcare services - and enable medical personnel to better connect with their patients – especially those remote from healthcare services - in other words, to improve equity in healthcare and access to health care: to improve Global Health. The intention is to do this at a lower cost, while improving efficiency and effectiveness. The importance to both developed and developing world health services is, therefore, clear. The vision, in particular in the developing world, is to harness information technology towards meeting crucial public health needs.

Three priorities emerge from these descriptions: The administrative, educational and clinical applications of e-healthcare are intended from the outset to:

  • improve healthcare both in terms of provision and access

  • connect distant sites, and, therefore, improve rural access to healthcare

  • improve health in both the developed and developing world

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