Abstract
This chapter introduces the reader to the diminishing health services in rural Australia and highlights eHealth as the potential ‘leveller’ for rural health settings. Initially, eHealth is defined in context and eHealth stakeholders and their current contribution to eHealth within the Australian health system are identified. Then it resumes by outlining the feasibility of a nursing eHealth agenda in rural Australia in light of examined barriers and enablers. A future trends section reviews the findings and suggests potential course of action and further opportunities for research. It concludes by suggesting that care must be taken in considering the myriad number of factors that can support or hinder the development of a successful eHealth agenda for Australian rural health context.
TopWhat Is Ehealth?
A comprehensive systematic review by Oh and Rizo (2005) analysed the definitions used to describe eHealth, and the context in which they occur. The review focussed on peer reviewed published papers and the Internet. Whilst the qualitative review concluded that there was no consensus on a definition for eHealth, it identified two universal themes: health and technology at the core with six other less general themes of: commerce, activities, stakeholders, outcomes, place, perspectives (Oh et al., 2005).
In addition, a second investigation on eHealth within the field of health (medical) informatics, ratified that the definitions varied in accordance with functions, stakeholders or context and most used a broad range of medical informatics applications with an emphasis on the networked communication capabilities, particularly via the internet (Pagliari et al., 2005).
These two studies provide a hint to two emerging visions of eHealth. One sees technology at the core leading a ‘health-care productivity revolution’ in the health care system through fast efficient flow of information that incorporates evidence-based practices into targeted patient care (Goldstein et al., 2004; Kirsch, 2002; Nagykaldi & Mold, 2007). The other, we would argue in this paper sees healthcare (Evidence Based Medicine) at the core supported by technology and more importantly, it is context specific.
This is a critical distinction that has deep ramifications for stakeholders and future change management strategies, particularly in the Australian rural context. At this point it is imperative to understand what evidence based medicine implies and who the stake holders are. Later in the chapter we will examine which vision best describes the current Australian situation.
Key Terms in this Chapter
Evidence Based Medicine (EMB): The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research and taking into account patient preferences.
Information Literacy (eHealth): To be information literate, a clinician must be able to recognize when information is needed and have the ability to locate, evaluate, and use effectively the needed information
Health Informatics: Also known as Medical Informatics is the intersection of information science, computer science, and health care. It deals with the resources, devices, and methods required to optimize the acquisition, storage, retrieval, and use of information in health and biomedicine. Health informatics tools include not only computers but also clinical guidelines, formal medical terminologies, and information and communication systems.
Nursing Informatics: The multidisciplinary scientific endeavour of analysing, formalizing and modelling how nurses collect and manage data, process data into information and knowledge, make knowledge-based decisions and inferences for patient care, and use this empirical and experiential knowledge in order to broaden the scope and enhance the quality of their professional practice. It includes computer, information and research literacy.
Computer Literacy (eHealth): The knowledge and ability to use computers and technology efficiently. It also refers to the comfort level a clinician has with using computer programs and other applications that are associated with computers and knowing how computers work and operate.
Research Literacy (eHealth): The ability to understand and use the IT-based tools relevant to the work of today’s researcher and scholar.
EHealth: For the purpose of this paper it is defined as the use of evidence based medicine supported by health technologies by clinicians in health setting.