e-Health, e-Pharmacy,

e-Hospital
Group 2
Hurul Aini 1941012132
Eliska Noviyani 1941012134
Vivi Dwi Maryeti 1941012136
Darussalam 1941012138
Nadya Zahra Henni 1941012140
e-Health
Definition
• e-Health is an informative and interactive method that both patients an
d health care professionals can come together and share information
with others in the profession from around the world.
• Regardless of location, medical issue, health concern, etc. health care
physicians can discuss data as well as past experience to provide the
best possible solution for the patient.
(Canada Health Infoway Inc, 2002)
 WHO definition of e-Health

"e-Health is the cost-effective and secure use of information and

communications technologies in support of health and health-related
fields,
• including health-care services
• health surveillance
• health literature
• health education, knowledge and research"

(World Health Organization , 2005)

5 Steps of e-Health

Electronic diabetes diary

(Canada Health Infoway Inc. 2002)

Steps of e-Health
• Step 1 - Information
• Providing information for patients or doctors e.g. via the web (information
in one direction), Medical databases like PUB MED
• Step 2 - Communication (action)
• The exchange of information between two people involved (patient -
doctor, doctor - doctor...) without direct and current reaction of the
communication partner (e.g. on-line diabetes diary)
• Step 3 - Interaction (action + reaction)
• Exchange of information or dates between people involved with immediate
reaction of the communication partner (e.g. telemonitoring, telesurgery…)
(Canada Health Infoway Inc. 2002)
• Step 4 - Transaction
• Electronic handling of a complete (treatment)process (“All or
nothing”)
• Step 5 - Integration (e.g. Electronic health record - EHR)
• Electronic health biography – central documentation for all health
relevant data from birth to death
(Canada Health Infoway Inc. 2002)
The 10 e’s in e-Health
1. Efficiency
One of the promises of e-health is to increase efficiency in health care, th
ereby decreasing costs.
2. Enhancing quality of care
Increasing efficiency involves not only reducing costs, but at the same im
proving quality.
3. E-vidence based
E-health interventions should be evidence based in a sense that their effe
ctiveness and efficiency should not be assumed but proven by rigorous sc
ientific evaluation.
(Canada Health Infoway Inc. 2002)
4. Empowerment of consumers and patients
By making the knowledge bases of medicine and personal electronic reco
rds accessible to consumers over the internet
5. Encouragement
New relationship between the patient and health professional
6. Education of physicians through online sources and consumers
7. Enabling informations exchange and communication in a standardized
way between health care establishments
(Canada Health Infoway Inc. 2002)
8. Extending
E-health enables consumers to easily obtain health services online from
global providers
9. Ethics
E-health involves new forms of patient-physician interaction and poses new
challenges and threats to ethical issues such as online professional practice
, informed consent, privacy and equity issues
10. Equity
To make health care more equitable is one of the promises of e-health, but
at the same time there is a considerable threat that e-health may deepen
the gap between the “haves” and “have-nots”
(Canada Health Infoway Inc. 2002)
Manfaat
a. Peningkatan efisiensi atau penurunan biaya,
b. Peningkatan kualitas pelayanan kesehatan,
c. Pembuktian diagnosa melalui evaluasi ilmiah,
d. Pemberdayaan pasien dan tenaga ahli,
e. Mendorong terjadinya hubungan yang lebih baik antara pasien dan
tenaga kesehatan,
f. Pendidikan bagi tenaga kesehatan dan masyarakat,

(A. Syahputra,2016)
Fungsi resep elektronik :
a. Mencatat semua data pasien yang dapat dengan mudah dicari kembali
b. Menulis resep elektronik tanpa kertas dan dapat langsung dikirim ke apotek,
sehingga pasien dapat langsung pergi ke apotek untuk ambil obat.
c. Membantu dokter dalam menulis resep dengan memberikan informasi
mengenai obat yang akan diresepkan dan mendeteksi apabila ada interaksi
antara obat-obatan tersebut dalam resep dengan memberi peringatan sebelum
obat dikirimkan ke apotek.
d. Mencatat data penggunaan obat
e. Membuat laporan dengan lebih cepat dan mudah
(D. A. Hafizh,2016)
Contoh Penerapan e-Health Pada Dunia Kesehatan
1. Sistem Resep Elektronik
Dikenal juga dengan E-Prescription, dimana pada sistem ini dokter menulis
kan dan mengirimkan resep kepada bagian farmasi/apotek menggunakan
media elektronik menggantikan tulisan tangan dan penggunaan media
kertas.
Sistem ini dibuat untuk menghindari terjadinya ROM (Reaksi Obat
Merugikan) yang biasa disebabkan oleh adanya kesalahan pemakaian
obat selama dalam penanganan tenaga kesehatan, yang sebenarnya
hal ini dapat dicegah apabila dilakukan dengan lebih teliti dan hati-hati.

(D. A. Hafizh,2016)
Kesalahan tersebut dapat dibagi dalam 4 fase :
a. Fase penulisan resep
b. Fase pembacaan resep
c. Fase penyiapan hingga penyerahan resep oleh petugas apotek
d. Fase penggunaan obat oleh pasien

(D. A. Hafizh,2016)
e-Pharmacy
Introduction
Online pharmacies are companies that sell pharmaceutical preparations
that include prescription-only drugs, on
the Internet via online ordering and mail delivery.
Online pharmacies can be classified basically as:
1. Legitimate Internet pharmacy websites providing high-quality pharmacy
services according to verification standards, and
2. Illegitimate online pharmacies that are not verified and may not comply
with national or international professional standards and regulations

(Prashanti et.al, 2017)

How does an e-Pharmacy model works?

• Mobile-based application for consumers to upload the scanned copy

1 of their prescriptions and place requests for medicines

• Every order that is received to be verified and checked by a team of

2 registered pharmacists

• The registered pharmacists to forward the validated prescriptions to

3 the pharmacy store from where the medicines are dispensed

(Chordiya & Garge, 2018)

 e-pharmacy Vs Conventional Pharmacy
e-Pharmacy

Pros Cons
• Convenience • Lack of physical evaluation in place
• Future vision • Need of using the same Online
• Time saving Pharmacy all of the time
• Lower price • Some online pharmacies don't
• Private and confidential adequately safeguard your health
• Range of choices • Some do not adequately protect your
personal and financial information
• Drug approval
• Medical information

(Chordiya & Garge, 2018)

 Pros Cons
• Processing of prescriptions • Time
• Care of patients • Price
• Monitoring of drug utilization • Inconvenience
• Responding to symptoms of minor
ailments
• Informing health care professionals and
the public

(Chordiya & Garge, 2018)

Advantages & Disadvantages Of e-pharmacy
Advantages
• Access to drugs for the disabled
or housebound
• Access 24 hours a day
• A virtually unlimited number of
products available
• Relative privacy, which may
encourage patients to ask
questions about embarrassing
issues, and more affordable
prices
• Free access to information,
comparison shopping
Disadvantages
• Lack of meaningful interaction with physician and
pharmacists
• In many cases, customers are not aware that products
offered by online pharmacies may not have the same
quality that a retail pharmacy may offer
• It is difficult to determine whether a website is legitimate or
not, because it is difficult to determine whether drugs
purchased online are counterfeit, unapproved, or illegal
• Misdiagnosis and inappropriate use of medicines. These
disadvantages and dangers are further exacerbated in the
case of unlicensed and illegally operated online pharmacies
(Prashanti et.al, 2017)
Some Other Issues Associated With The Online Availability Of Medicines

• This encourages more self-medication

• The medicines do require appropriate storage for retaining potency. There
is no assurance of temperature control either at their storage points or
during transport.
• The patients loose the opportunity to have a face to face discussion with
the professional pharmacists.
• The brand names may often cause confusion. There may be the same
brand but with different drugs.
• Ultimately, the patient is at receiving and getting wrong medicines.
• The most worried thing is the sale of antibiotics; India is already fighting
against antibiotic resistance for irrational use of antibiotics.
(Prashanti et.al, 2017)
e-Hospital
Introduction
In the modern world, technology has proven to be the most beneficial in doing any
work more efficiently and quickly. IT has penetrated each and every aspect of human
life in this present world and on the other hand healthcare facilities is that sector which
has to be upgraded with the changing times to serve the mankind in an efficient way.
when we merge the IT sector with the medical field sector, the product obtained is
called an e-Hospital.

(Prabhu et al, 2016)

e-Hospital
The operational features of an E-Hospital can be stated as follows:
a) Taking Appointments online
b) Taking in the Diagnostic Reports
c) Determining the availability of stock
d) Readjustment of the nativity and destruction
e) Approval and payment of bills

(Prabhu et al, 2016)

Implementation Of e-hospital

(Prabhu et al, 2016)

 Hospital Information system
In this system all the data related to the hospital,
whether it is the financial records or the
therapeutic or management related data are
made accessible to the individuals through
software. The Hospital Information System can
be fixed as the comprehensive software which
can be employed to integrate the information of
the individuals and also aids in exchange of this
information between different medical centers.

(Prabhu et al, 2016)

 Service Oriented Architecture
Service Oriented Architecture for hospital
management is an efficient one as it underwrites
the full facilities of the hospital and also helps
with interoperability of the services provided at
different programs. Thus, it works like a bridge
which helps in connecting the various parts of a
system to its spine and therefore the Service
Oriented Architecture makes the functioning of
E-Hospital smoothes. The service oriented
architecture also uses web services which makes
it to work faster. Service Oriented Architecture
(SOA) is a business-centric IT architectural
approach that supports integrating your business
as linked, repeatable business tasks, or services.
It is important to note that SOA is not a product
but is an architectural style.
(Prabhu et al, 2016)
 Wireless Machine To Machine Based
Healthcare System
This system of healthcare management is by far
more modern as compared to other available
health care systems. In this kind of healthcare
system a sensor will be tied to the patient’s body
which will automatically transmit the data to the
application server. In case the condition of the
patient becomes acute, then this information will
be quickly transmitted via machine to machine
network so the concerned doctor can initiate a
quick and an appropriate action. This health
care system can be made more efficient by
utilizing an application in android smartphones,
which records the information and helps in its
wireless transmission to the application server.
This kind of organization packs in high efficiency
and low cost. But this constitution is a big failure
if there is no proper internet access (Prabhu et al, 2016)
 Framework Architecture using
Agent Technology
Framework Architecture for healthcare systems is another
efficient way to manage the functioning of the E-Hospital
effectively. The commercially available systems are
complicated technologies and are highly decentralized.
Framework architecture using agent Technology helps in the
interoperability among the substantive components of an
E-Hospital. This system uses two major ideas which allow in
the intelligent agent technology and case based reasoning
approach which helps in widely distributed operation of the
system. The brokers run in lieu of (instead) of human agents
which aid in increasing the efficiency and accuracy of the
scheme. Case Based Reasoning helps in providing advice to
solve the problem by citing the results of the previously
solved problems by analyzing the present situation the right
room

(Prabhu et al, 2016)

 Problems Associated
With e-hospital
The major problem associated with the E- Hospitals is
the proper management of patient’s data. Since the
E-Hospitals use a wide variety of components to
function smoothly, the data available with them are at
high risk of getting hacked or changed or used by any
outsider who can use that data in unethical ways. The
security of the patient’s data on the healthcare system
s and the protection of this information from being
hacked or altered are great challenges. Most of the
healthcare systems use the ideology of cloud
computing, which is a developing technology, but this
throws the greatest risk of the information being
stolen or changed. The leak of data from the
healthcare systems is another large issue which needs
to be solved to make the working of E-Hospital more
efficient.
(Prabhu et al, 2016)
Solutions To The Problems
The solutions to problems affiliated with E-Hospital include encryption of
data and/or using the Digi Locker. Encryption is converting the data into
a coded form and then uncoding the same data when the user wants to
view it. Encryption is a potent method to protect the online stored
databases and it is very effective in protecting the data of the
e-Hospitals . Another possibility for the security of data is using Digi
locker. Digi Locker is a new initiative of the Government of India to
retain all the documents safely in an electronic locker. Under this
concept 10mb of an electronic space is offered to all resident citizens to
store their personal documents. This Digital locker can be further
widened to the E - Hospital where it can be applied to preserve the
records of the patients more safely
(Prabhu et al, 2016)
Conclusion
E-Hospital basically aims to modernize conventional hospitals to provide
perfect healthcare facilities to its patients. It also makes the data management
in hospitals more efficient and precise. E-Hospitals are a comparatively novel
concept in this globe and hence it will require time to become assimilated in
present world. Once the concept of E-hospital gets incorporated in all the
traditional hospitals then it will significantly convert the scenario of medical
science and assist in achieving the best standards of living with better health
care facilities. If the E-Hospital becomes successful in managing and
protecting its data efficiently, it can be the best alternative for the existing
hospitals.
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