e health practices, benefits

1. BY:QASIMRIAZRANJHA
2016
EHEALTH
It containsa summaryon literature thatwhyE-Healthisimportant
.What E-HEALTH initiativesare currentlybeingused.Italsocontains
a summaryof beste-healthinitiatives anduse of NBN fore health
practices
Importance of e health
E health initiativesinQLD
Best practices in E-Health
How NBN can be utilizedfor e health

2. Introduction:
Technology has made the life so fast, accurate, and effective at lower cost. E health
includes electronic health records, information about health of consumer and health
care information system.
Digital health is the electronic management of health information to deliver safer, more
efficient, better quality healthcare. The Commonwealth’s digital health initiatives include
My Health Record, Tele health and the Healthcare Identifiers Service.
"E-health is the important revolution in healthcare since the advent of modern medicine,
vaccines, or even public health measures like sanitation and clean water". [Silber, 2003]
Importance of e-health (literature review)
The term e-Health (E-Health) has been in use since the year 2000. E-health
encompasses much of medical informatics but tends to prioritize the delivery of clinical
information, care and services rather than the functions of technologies. No single
consensus, all-encompassing definition of eHealth exists - the term tends to be defined
in terms of a series of characteristics specified at varying levels of detail and generality
(see next section). The term is not included in the MeSH taxonomy but most of the
topics typically classified as being part of e-health are encompassed within the medical
informatics MeSH tree.
Throughout many western national healthcare services, extensive e-Health
infrastructures and systems are now viewed as central to the future provision of safe,
efficient, high quality, citizen-centred health care. (Information on current national e-
Health implementation programmes, centred on the deployment of national information
infrastructures and electronic medical record systems is provided on OpenClinical.)
E-Health emerged early in the 21st century and is an all-encompassing term for the
combined use of electronic information and communication technology in the health
sector. This term refers to that technology used for clinical, educational, research, and
administrative purposes, both at the local site and across wide geographic regions. The
use of e-Health has enhanced networking, facilitated global thinking, and improved
health care on local, regional, and national levels (Cashen, Dykes, & Gerber, 2004).
While some definitions associate e-Health strictly with the Internet, the term broadly
refers to any electronic exchange of health-related data collected or analyzed through
an electronic connectivity for improving efficiency and effectiveness of health care
delivery. Therefore it is often used to describe virtually everything related to computers
and medicine (Cashen et al., 2004; Deluca & Enmark, 2000; Kind & Silber, 2004;
Kwankam, 2004).

3. The goals of e-Health can be summarized to include increased efficiency in health care,
im proved quality of care, increased commitment to evidence-based medicine,
empowerment of patients and consumers, and the development of new relationships
between patients and health professionals (Austin & Boxerman, 2003). From a global
perspective, e-Health can be used to disseminate health information as well as ensure
that the most current information is used to improve people's health (Kwankam, 2004).
Rural areas may be the greatest benefactors of e-Health by having easier access to
information and access to telemedicine services (Kwankam, 2004). According to
Richards and colleagues (2005), the use of e-Health in rural areas is important because
95% of respondents have used the Internet and many have access to scanners, digital
cameras, and videoconferencing. E-Health networks can remove time and distance
barriers to the flow of health information and can help to ensure that collective
knowledge is brought to bear effectively on health problems throughout the world
(Kwankam, 2004).
Austin and Boxerman (2003) describe four areas of e-Health: e-Business, consumer
marketing, organizational management, and clinical customer service. Some of these
are accessed via the public Internet, while others are restricted by passwords on
Intranets or local area networks.
According to Deluca and Enmark (2000), e-Business in cludes online procurement
processing between health care providers and suppliers, online electronic claims
processing, eligibility authorization from insurance companies, and consumer purchase
of prescription drugs and health insurance. As of 2000, electronic claims submission
and materials management were the most widely implemented e-Health technologies in
health care. As an example, one large practice association automated nearly half of
their claims volume with an Internet-based claims submission system and reduced their
per-claim processing cost by almost 40% (Deluca & Enmark, 2000).
Consumer marketing includes the use of Web sites to showcase organizational
information to attract new patients and provide wellness information and disease-
specific information to existing patients. Organizational management includes posting
employee information on a company Intranet Web site, delivering educational programs,
listing job announcements, and announcing employee health benefit programs. It also
includes administrative processes such as billing management and strategic planning.
Clinical customer service includes patient access to medical information via electronic
health records allowing them to conduct risk assessments of their own health and
include patient-physician interaction using e-mail. According to Kind and Silber (2004),
e-mail communication can provide an opportunity for patients with Internet access to e-
mail questions and receive responses from their physicians. This form of electronic
contact shows promise as a means of enhancing communication and facilitating
interactions between patients and the health care delivery system (Kind & Silber, 2004).
One survey found that 50% of patients expressed an interest in accessing their personal
physician's Web site or e-mailing their physician, and one-third considered themselves
likely to switch providers in order to e-mail their physician (Deluca & Enmark, 2000).
Additional clinical applications include real-time alerts, clinical screening, and access to
reference materials for physicians. Many clinicians now keep patient information in an
electronic format and access this information by downloading into handheld computers
or personal digital assistants (PDAs) whenever patient-specific decisions need to be

4. made (Pancoast, Patrick, & Mitchell, 2003). In 2004, 40% of practicing physicians
owned a PDA, up from 19% in 2001 (Chin, 2005). This represents more than four times
greater PDA usage among physicians than the usage rate of consumers (Chin, 2005).
However, PDA's have yet to be used to their fullest potential in medicine and new
developments may encourage greater usage. Smart phones will continue to evolve into
mobile computing devices that will have computer capabilities and still fit in your hand
(Chin, 2005)
As discussed by Austin and Boxerman (2003), the key stakeholders in the e-Health
industry include employers, patients, providers, and health plans. Employers want to
analyze health care costs and utilization by their employees. Patients want information
about their own health. Providers want to save time and money by streamlining
communications. Health plans want to strengthen relationships with members and
providers while reducing the cost of doing business (Austin & Boxerman, 2003).
For patients, who can also be viewed as consumers, e-Health represents an opportunity
to change their relationship with providers and insurance companies. Opportunities for
improved communication include provider messaging, access to electronic medical
records, and the ability to access information about alternative approaches to medical
treatment. Patients generally get only 10 minutes of face-to-face time with their
physician and through e-Health have access to thousands of health care Internet sites
where they can gain unlimited health information. Also, it can take a week to get a
return phone call from a physician and almost a month to get a regular office
appointment (Deluca & Enmark, 2000). According to Cashen et al. (2004), the potential
for e-Health technologies to educate patients and promote improved self-management
skills is well documented.
Employers face growing health care costs, which jeopardize their competitive position in
the international market. Since health care costs are a large share of product cost,
employers are seeking new and innovative approaches to improve efficiency and quality
in health care. As a result, employers are becoming engaged in activities such as the
Leapfrog Group, which review the cost and quality in health care because they see this
involvement as essential to economic viability. Some organizations consider the Internet
as a way to streamline health care administrative costs and improve communication
among the various health care organizations (Meyers, Van Brunt, Patrick, & Greene,
2002). Since employers negotiate benefits packages, review geographic coverage, and
maintain a benefits administration staff, it is estimated that administration costs add up
to $10 billion a year to U.S. health care costs (Meyers et al., 2002). In addition, many of
the company health promotion activities are offered through the organization's Intranet
site because they reduce health care costs and improve productivity (DeGroot & Kiker,
2003; Sofie, 2000).
Providers view e-Health as an opportunity to improve efficiency, reduce administrative
costs, facilitate communication, and en hance patient care (Kirshenbaum, 2002). While
providers are also interested in the use of PDAs at the point of care, the cost and lack of
connectivity with electronic medical records and clinical practice management software
are continuing problems (Kirshenbaum, 2002). According to Chin (2005), U.S. medical
schools are increasingly requiring the use of PDAs and related information as a
mechanism to promote efficiency and safety in health care.

5. As the public use of the Internet grows, health care organizations are using this
opportunity to reach a large part of the population cost effectively (Deluca & Enmark,
2000). This includes using the Internet for marketing, patient education, administrative
transactions, establishing new relationships with consumers, and increasing operational
efficiency (Appleby, 2000).
The greatest barrier to e-Health is the difficulty for consumers to find accurate and
reliable information (Maloney et al., 2005). According to Dutta-Bergman (2004), the two
critical indicators of e-Health information quality are source credibility and information
completeness. Medical experts suggest that health information provided by a source
that is not credible is detrimental to consumer outcomes. Also, unless health information
is complete, it is likely to mislead the consumer into making incorrect decisions. The
completeness of health information is considered the single most important criterion in
health care decision making (Dutta-Bergman, 2004).
Since the Internet as a communications system is relatively uncontrolled, initiatives
have been introduced in an attempt to improve the quality of Internet-based health
information. One such control is the Health on the Net (HON) code, which offers a
stamp of approval for Web sites adhering to agreed quality principles. Similarly, Health
Internet Ethics (Hi-Ethics) has developed the "e-Health Code of Ethics" in an effort to
respond to concerns regarding reliability of information, privacy, and confidentiality (Kind
& Silber, 2004; Maloney et al., 2005).
The Health Insurance Por tability and Accountability Act (HIPAA) Privacy Rule
expanded federal regulations about the confidentiality of patient information and some
organizations are reluctant to implement e-Health technology. However, a major
provision of HIPAA was to expand electronic data exchange between payer and
provider entities (Kind & Silber, 2004). Therefore, the adoption of electronic data
exchange has the potential to improve efficiency, facilitate electronic claims processing,
and enhance patient outcomes. How ever, it also imposes a requirement to safeguard
patient data in the face of increased risks (Pancoast et al., 2003).
From a societal perspective, there are technological, organizational, managerial, and
ethical implications associated with e-Health proliferation (Deluca & Enmark, 2000).
According to Cashen et al. (2004), the most vulnerable people in our society may be the
least able to benefit from e-Health due to cognitive, social, and cultural barriers. These
barriers include literacy, cultural differences, language differences, access to technology
and educational deficiencies (Cashen et al., 2004). Only through conscious efforts to
address these barriers can e-Health initiatives be expanded to meet a broad range of
society's needs.
There is a considerable demand for health-related information in the population, and the
Internet is gaining ground as a central source of such information . In the US, studies
have found that between 56 % and 79 % of Internet users seek health information .
Starting out as a grassroots phenomenon much used by individual patients operating on
their own and often offered by idealists as well as by commercial interests, Internet
health sites and other electronic communication tools targeting patients are now
important policy instruments for both public and private health providers. In recent
years, we have seen national health authorities beginning to focus on e-health services
such as electronic health cards, electronic patient records and health portals, including
the English NHS Direct Online, the German Telematic Platform, and the Danish

6. Sundhed.dk. In the medical community, expectations about the Internet are mixed. On
one hand, the Internet has been described as having the potential to empower patients
and stimulate patient participation. On the other hand, potential dangers such as the
dissemination of inaccurate information and inappropriate use have been stressed.
Earlier European studies have shown that the use of the Internet for health purposes
varied in different parts of the world. As the dissemination of e-health services is
growing along with general Internet use, there is a need to improve our knowledge on
how these services are used, by whom and with what consequences.
Ehealth current initiatives used in rural or remote areas by
QLd:
In collaboration with the 16 Hospital and Health Services, the Department of Health has
been delivering eHealth solutions for the Queensland public health system since
2007.The move towards electronic healthcare management for Queenslanders is a long
term journey, being undertaken in a considered, staged way to ensure a successful
transition for healthcare providers and patients.
The first stage of the eHealth program is already delivering benefits across the health
department with a number of projects currently live in numerous sites across
Queensland.Queensland Health’s eHealth journey is being undertaken in stages with a
number of specialty clinical solutions already in use across the state.
FOLLOWING ARE THE INITIATIVES OF EHEALTH:
Ana esthetic record keeping solution to 43 healthcare facilities
Cardiac information solution to 7 healthcare facilities
Digital diagnostic imaging to 130 healthcare facilities
Discharge summaries from 81 hospitals being sent to the national personally controlled
eHealth records (PCEHR) system
Electronic discharge summaries at 110 healthcare facilities
Electronic radiology reports available at 130 healthcare facilities
Endoscopy reports available electronically at 31 healthcare facilities
Electronic infection surveillance available at 22 healthcare facilities intensive care
clinical information system available in nine healthcare facilities

7. Patient referrals being sent electronically from general practitioners to 10 healthcare
facilities
Statewide oral health information solution (including schools)
Statewide digital breast screening solution
Statewide access for authorized clinicians to critical patient information through th
viewer
Statewide electronic availability of mental health records
Statewide public health licensing and compliance.
Integrated electronic Medical Record (ieMR)
Historically, patient medical records were paper based and could be duplicated,
damaged, lost or destroyed. Medical charts can often grow to a number of volumes,
limiting access to correct information due to misfiling and an inability to quickly locate
important information.
Paper based records are limited to a single health care facility with little or no integration
or knowledge of previous history of care provided within alternative Queensland Health
facilities.
Through the integrated electronic Medical Record (ieMR), clinicians and supporting staff
will be able to securely access a single view of a patient’s medical record, making it
easy to share information about the patient’s history. The system will increase the
quality of care and safety for patients and will provide a sustainable health system.
Patients visiting ieMR sites will have their information entered in the system, making it
available to any clinician across any of these sites.
To date, the ieMR solution has been rolled out in:
 Cairns Hospital
 Mackay Base Hospital
 Royal Brisbane and Women’s Hospital
 Lady Cilento Children’s Hospital
 Princess Alexandra Hospital
 The Townsville Hospital.
Digital hospitals
In November 2015, the Princess Alexandra Hospital (PAH) became Australia’s first
large-scale digital hospital.

8. In a digital hospital doctors, nurses and healthcare teams can document and access a
patient’s medical information on computers instead of using paper files.
New digital bedside patient monitoring devices automatically upload vital signs and
observations, such as blood pressure, temperature and heart rate, directly to a secure
electronic medical record.
Digital hospitals deliver a wide range of benefits including:
 increased patient safety
 healthcare quality
 early detection and monitoring of possible adverse clinical events
 reductions in admissions
 improved patient flow.
In 2016, Cairns Hospital, Townsville Hospital and Mackay Hospital will also become
digital hospitals.
BEST E-HEALTH PRACTICES IN QLD
The eHealth Strategy and roadmap has been developed through extensive consultation
over a 5 month period with a broad group of stakeholders including members of the
Director General’s Clinical Advisory Group, the eHealth Advisory Group (a new
reference group of practising clinicians) and a large number of representatives from
various business units within Queensland Health. All staff within Queensland Health
were given the opportunity to review and provide feedback on the broad direction of the
strategy that was published on the Queensland Health intranet (QHEPS) and to provide
feedback.
For the purposes of this strategy eHealth incorporates the following:
• Clinical order entry
• Results reporting (e.g. Pathology, Diagnostic Imaging, Clinical Measurements)
• Decision Support
• Medications management
• Pharmacy
• Clinical documentation
• Patient Management and Coordination (including Scheduling and Booking)
• Emergency Information Management
• Mental Health
• Community Health
• Chronic disease management.

9. In addition, the integration to specialty care systems and line of business applications
(eg. Intensive Care (ICU), Anaesthetics, Oncology and Cardiology) is considered a core
component of eHealth for the purposes of the eHealth Strategy. However, the
implementation of these speciality and line of business solutions is not considered part
of the scope of the eHealth Program and would be subject to current governance
arrangements for approval, funding and implementation (Update comment: May 2007 –
now within scope). Similarly, the implications of the eHealth Strategy on infrastructural
components such as network, data centre and access devices is not considered within
the scope of the eHealth Strategy (Update comment: May 2007 – now within scope),
but rather has been addressed within Queensland Health’s broader infrastructure plan.
Implications for patients and clinicians
From: To:
Patients
• Patients are the 'messenger‘ – carrying test results, referrals and
supporting information from one provider to the next
• Patients have to juggle multiple independent appointments
• Patients are passive 'passengers' in their treatment
• Chronic care patients are heavily dependent on health-care
providers to monitor their condition and update progress
Patients
• No need for patients to carry physical
records - confident that relevant
information can be accessed
electronically by their provider
• Number of trips minimised, with
treatment streamlined for complex,
multi-stage procedures
• Patients empowered to play an active
role in managing their health
• Chronic care patients (e.g. patients with
diabetes) can provide regular health-
related updates online
Queensland Health Care Providers
• Providers work with incomplete and unreliable information to
support treatment decision making
• Sharing of information with other providers, either internal to
Queensland Health or with external partners, is limited
Queensland Health Care Providers
• Providers can access more complete
and accurate patient information
• Sharing information with each other,
and with external partners, is easier and
supports greater collaboration within new
models of care
General Practitioners
• Accessing relevant information about the patients’ treatment
within Queensland Health is difficult
• Sharing the patient information captured during primary care
with the acute sector to assist treatment is limited
General Practitioners
• Comprehensive and reliable discharge
summaries enable GPs to better
understand the treatment history and care
plan for their patients
• GPs can communicate information to
providers within acute and community

10. environments to support patient care.
External Providers (Private Hospital, NGO)
• Transferring patients, and supporting information (e.g. care
plans), between Queensland Health and external providers is time
consuming
• Accessing information about their patient’s treatment within
Queensland Health is limited for external providers
External Providers (Private Hospital,
NGO)
• Enhanced capability to support transfers
of patients between facilities to enable
greater partnerships between private and
public providers.
• External providers are able to access
information about the treatment of their
patients within the acute sector (e.g.
details of Emergency department
treatment, medication information
relating to a patient stays in an Intensive
Care unit)
EHealth Capabilities to enable the vision
Queensland Health requires four key capabilities in order to achieve this vision of a
patient-centric networked model of care including:
• integrated and comprehensive patient information, including:
• consolidated information to support decision making in areas such as:
• optimising scheduling of resources around patient need with a focus on:
• supporting delivery of location independent health services in two ways.
Achieving the vision of the patient-centric model of care can deliver benefits in the
following areas:
• patient safety
• quality of care
• effectiveness
• patient outcomes
• efficiency.

11. Qld Health restructures with dedicated eHealth division
The Queensland government has set up a dedicated eHealth division called eHealth
Queensland, bringing together the responsibilities of the Health Services Information
Agency (HSIA) with the office of the chief
health information officer, currently held by Mater Health CIO Mal Thatcher.
Health Minister Cameron Dick told the Health Informatics Conference (HIC) in Brisbane
today that the government believed that having Queensland Health's strategic and
operational information technology leadership in one agency would better enable it to
achieve its eHealth goals.
“We are committed to a fully integrated health system with a mobile workforce that can
access information as quickly and as close to the patient as possible,” Mr Dick said.
“Our eHealth investment priorities include contemporary network and data centre
foundations, a contemporary desktop environment to support a consistent user
experience, a secure environment to share information and images, and to consult with
others through an information interoperability platform and a statewide electronic
medical record system that enables digital hospitals.”
Mr Dick said Queensland would continue the roll-out of the integrated electronic medical
record solution (ieMR) in staged releases at selected state hospitals. The solution, from
global EMR giant Cerner, supports order entry, pathology and radiology results,
reporting, clinical documentation, alerts and allergies, and discharge summaries.
Queensland is also implementing a statewide patient information viewing solution called
The Viewer that provides Queensland Health clinicians with faster access to

12. comprehensive current patient information in one place. The Viewer is also
Queensland's link to the PCEHR.
“Queensland is also recognised as a leader in the adoption of national eHealth
standards, solutions and infrastructure,” Mr Dick said. “Queensland Health recently
launched an eHealth architecture vision which will form the basis the development of
our technology roadmap. It will service our clinicians, consumers and administrators
across the healthcare system, delivering quality information and better health outcomes
for patients.
BEST PRACTICES AND LESSONS
LEARNED
European governments are working together to change healthcare and offer an
integrated system. There are two main reasons why the European Parliament and other
EU institutions are pushing for the creation of a European electronic health card:(93)
1. Easy access to health and insurance data, regardless of country. Without an EU-
wide EHR, patients are put into jeopardy because physicians do not have access to
pertinent information. This is particularly true for those with serious and chronic
diseases.
2. To create an integrated system to overcome all the differences between Member
States' healthcare policies to guarantee that every EU citizen receives the same
medical treatment. European citizens are increasingly mobile and are demanding a
healthcare system able to accommodate this lifestyle reality.
Several joint projects in Europe are underway, including Cardlink 2 (Ireland, Germany,
Holland, Spain, Greece, Portugal, France, Italy, Finland), which is developing a medical
emergency health card; Diabcard (Spain, Greece, Italy), in the advanced stages of a
diabetic health card; and G-8 Healthcare Data Card Project (France, Germany, Italy,
Canada, UK, USA, Japan, Russia), an initiative to develop an international medical
emergency card, with the capability of allowing secure access for healthcare
professionals and the creation of administrative data.(94)
The European Commission has studied the implementation of electronic health
records systems in the EU, and developed a number of best practice guidelines
from the information collected:(95)
In the late 1980s, the United Kingdom initiated a national health information strategy,
with an agenda to research, develop, and implement health informatics policies and
technologies. For the last six years, the National Health Service (NHS) information

13. strategy: Information for Health, has focused on EHRs as one way to transform the
healthcare system into a vehicle for patient empowerment. The NHS also encourages
GP practices to utilize information management systems and has implemented a GP
computer systems accreditation policy to encourage the use of EHRs.
The U.K. government also has a long term commitment to electronic health record
development and implementation through its Electronic Record Development and
Implementation Programme (ERDIP), which has a mandate to learn everything there is
to know through the creation of local EHR initiatives. In all, nineteen ERDIP sites were
announced and implemented, seven of which were nearing completion by mid 200
Other best practices outlined in From Strategy to Reality: The WAVE Project, include:
o Having a leader with vision, a leader who is clinically-trained and willing to be
involved in the day-to-day operations, and act as coordinator between providers.
Stakeholder buy-in is also essential and steps should be taken to ensure and
encourage that both healthcare professionals and patients provide
recommendations for the development of EHRs and to remain active and involved.
o Privacy compliance, and a national electronic health record standard to create
interoperability between different clinical systems is crucial to make the system
work. New Zealand introduced privacy legislation a number of years ago, which puts
it much further ahead of many countries.
o Use integrated computer systems to protect against fragmentation of infrastructure,
and provide legible manual documentation for easy-to-use common interfaces.
o If you decide to import EHR software from another country, beware that there could
be some problems with technological compatibility. Sometimes not all of the
modules are usable and must be replaced with locally developed ones.
o Overall, developing systems for integrated care requires a proactive approach that is
goal-oriented; requires an audit trail; and ongoing evaluations to increase ROI
(return on investment).
National Broadband Network(NBN) and Modern
Technology:
o In last 3 decades broadband use is increasing and the demand and penetration
has continued to grow and broadband has become necessary infrastructure for
most businesses and a growing number of households. All countries specially the
developed countries taking actions to increase the access and affordability of
broadband for citizens.
o On April 7 2009 the Australian Government announced its $43 billion NBN plan
and at the same time announced its decision to fast-track negotiations with the
Tasmanian Government to begin the rollout of a fibre to the premises (FTTP)

14. network and next generation wireless services in Tasmania as early as July 2009
(http://www.dbcde.gov.au/communications/national_broadband_network). The
NBN proposal commits the Australian Government to a plan to connect
Australian homes, businesses and education facilities with optical fibre directly to
the premises with speeds of 100 megabits per second. The NBN will extend to
include towns with a population of around 1,000 or more people. For those living
in remote areas of rural Australia the fibre network will be supplemented by “next
generation wireless and satellite technologies that will be able to deliver 12
megabits per second or more”
(http://www.minister.dbcde.gov.au/media/media_releases/2009/022). The NBN
will be operated as a publicly owned and open access infrastructure with access
available on a commercial basis to carriers and other users wishing to leverage
off the network. A key driver of the Government’s plan to rollout the NBN is a
belief that high speed broadband such as will be delivered by the NBN will
increase productivity and innovation for Australia over the long term.
o Modern health care, like modern banking and other elements of society, requires
a comprehensive, well structured information system. The final report of the
National Health and Hospitals Reform Commission (NHHRC) made several
strong recommendations for e-health, including the person-controlled electronic
health record (PCEHR),1 for which the federal government allocated $466.7
million over 2 years in its 2010 Budget. Despite widespread use of modern
technology in general practice and community pharmacy, Australia’s health care
system lags behind all other sectors of our economy in the use of computerised
systems. Currently, Australia sits in the middle in rankings of health systems
among industrialised nations, and our use of modern electronic technologies for
communication and clinical information transfer within health systems is low.2
The poster child for e-health is Denmark, which has a comprehensive end-to-end
system that has reduced some errors to almost zero and improved working
conditions and health outcomes.3,4 Positive information on ehealth is also
accumulating in Italy, the Czech Republic and Spain.5 Improving the safety,
quality, and efficiency of health care will require immediate and ubiquitous
access to complete patient information and decision support provided through a
National Health Information Infrastructure (NHII)14.
o National Broadband Network can be used as to facilitate the delivery of
innovative E-Health initiatives by using the current services available to the
consumers with the addition of small new technological instruments (all available
and new tools and instruments) to the crowed, by using those the consumer can
update all its health related information from anywhere to his backend data
storage / concerned department and necessary steps can be taken.

15. o NBN has be implemented and progressing continuously to provide the best
accurate required solution to the consumer. In real time internet connections
o The system can be placed at some desirable places so that people can access
that system and the information can be retrieved using NBN, these placed
systems will be having the information of all the citizens and can access the
consumer details to analyse reports confidentially.
o Public awareness is the basic key to collect the information from the required
business to implement the proposed system, and to make public awareness
seminars, advertisement, and public media can be used.
Issue in implementation of E – Health:
o The problems in hospital practice are different, mainly because of scale and the
level of disconnection between those who use electronic tools for their work
(patient care, research, planning, measuring and evaluating) and those who
provide funding (local, regional, state and federal managers and legislators). The
uncoordinated implementation of differing, incompatible systems within hospitals,
between hospitals in a region and across boundaries compounds a dire lack of
national coordination and so loses the benefits of drawing on expertise and
knowledge across the nation.
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