Pagliari Claudia, Sloan David, Gregor Peter, Sullivan Frank, Detmer Don, Kahan James P, Oortwijn Wija, MacGillivray Steve
Division of Clinical and Community Health Sciences, University of Edinburgh, 20 West Richmond Street, Edinburgh EH8 9DZ, United Kingdom.
J Med Internet Res. 2005 Mar 31;7(1):e9. doi: 10.2196/jmir.7.1.e9.
Lack of consensus on the meaning of eHealth has led to uncertainty among academics, policymakers, providers and consumers. This project was commissioned in light of the rising profile of eHealth on the international policy agenda and the emerging UK National Programme for Information Technology (now called Connecting for Health) and related developments in the UK National Health Service.
To map the emergence and scope of eHealth as a topic and to identify its place within the wider health informatics field, as part of a larger review of research and expert analysis pertaining to current evidence, best practice and future trends.
Multiple databases of scientific abstracts were explored in a nonsystematic fashion to assess the presence of eHealth or conceptually related terms within their taxonomies, to identify journals in which articles explicitly referring to eHealth are contained and the topics covered, and to identify published definitions of the concept. The databases were Medline (PubMed), the Cumulative Index of Nursing and Allied Health Literature (CINAHL), the Science Citation Index (SCI), the Social Science Citation Index (SSCI), the Cochrane Database (including Dare, Central, NHS Economic Evaluation Database [NHS EED], Health Technology Assessment [HTA] database, NHS EED bibliographic) and ISTP (now known as ISI proceedings). We used the search query, "Ehealth OR e-health OR e*health". The timeframe searched was 1997-2003, although some analyses contain data emerging subsequent to this period. This was supplemented by iterative searches of Web-based sources, such as commercial and policy reports, research commissioning programmes and electronic news pages. Definitions extracted from both searches were thematically analyzed and compared in order to assess conceptual heterogeneity.
The term eHealth only came into use in the year 2000, but has since become widely prevalent. The scope of the topic was not immediately discernable from that of the wider health informatics field, for which over 320000 publications are listed in Medline alone, and it is not explicitly represented within the existing Medical Subject Headings (MeSH) taxonomy. Applying eHealth as narrative search term to multiple databases yielded 387 relevant articles, distributed across 154 different journals, most commonly related to information technology and telemedicine, but extending to such areas as law. Most eHealth articles are represented on Medline. Definitions of eHealth vary with respect to the functions, stakeholders, contexts and theoretical issues targeted. Most encompass a broad range of medical informatics applications either specified (eg, decision support, consumer health information) or presented in more general terms (eg, to manage, arrange or deliver health care). However the majority emphasize the communicative functions of eHealth and specify the use of networked digital technologies, primarily the Internet, thus differentiating eHealth from the field of medical informatics. While some definitions explicitly target health professionals or patients, most encompass applications for all stakeholder groups. The nature of the scientific and broader literature pertaining to eHealth closely reflects these conceptualizations.
We surmise that the field -- as it stands today -- may be characterized by the global definitions suggested by Eysenbach and Eng.
对电子健康含义缺乏共识导致学术界、政策制定者、提供者和消费者之间存在不确定性。鉴于电子健康在国际政策议程上的地位日益突出，以及英国新兴的国家信息技术计划（现称为“健康连接”）和英国国民医疗服务体系的相关发展，该项目得以启动。
描绘电子健康作为一个主题的出现和范围，并确定其在更广泛的健康信息学领域中的位置，作为对有关当前证据、最佳实践和未来趋势的研究及专家分析进行更全面综述的一部分。
以非系统的方式探索多个科学文摘数据库，以评估其分类法中电子健康或概念相关术语的存在情况，确定包含明确提及电子健康的文章的期刊及其涵盖的主题，并确定该概念已发表的定义。这些数据库包括医学索引数据库（PubMed）、护理及相关健康文献累积索引数据库（CINAHL）、科学引文索引数据库（SCI）、社会科学引文索引数据库（SSCI）、考克兰数据库（包括Dare、Central、国民医疗服务体系经济评估数据库 [NHS EED]、卫生技术评估 [HTA] 数据库、NHS EED书目）和科技会议录索引数据库（现称为ISI Proceedings）。我们使用搜索查询词“Ehealth OR e-health OR e*health”。搜索的时间范围是1997年至2003年，不过一些分析包含了这一时期之后出现的数据。此外，还通过对基于网络的资源进行迭代搜索加以补充，如商业和政策报告、研究委托项目和电子新闻页面。对从两种搜索中提取的定义进行主题分析和比较，以评估概念的异质性。
“电子健康”一词在2000年才开始使用，但此后已广泛流行。该主题的范围与更广泛的健康信息学领域的范围并无直接关联，仅在医学索引数据库中就列出了超过320000篇相关出版物，并且在现有的医学主题词（MeSH）分类法中没有明确体现。将“电子健康”作为叙述性搜索词应用于多个数据库，共得到387篇相关文章，分布在154种不同的期刊上，最常见的与信息技术和远程医疗相关，但也扩展到了法律等领域。大多数电子健康文章发表在医学索引数据库上。电子健康的定义在针对的功能、利益相关者、背景和理论问题方面各不相同。大多数定义涵盖了广泛的医学信息学应用，这些应用要么具体指明（如决策支持、消费者健康信息），要么以更笼统的方式呈现（如管理、安排或提供医疗保健）。然而，大多数定义强调电子健康的通信功能，并指明使用联网数字技术，主要是互联网，从而将电子健康与医学信息学领域区分开来。虽然一些定义明确针对健康专业人员或患者，但大多数涵盖了所有利益相关者群体的应用。与电子健康相关的科学文献和更广泛的文献的性质密切反映了这些概念。
我们推测，就目前的情况而言，该领域的特点可能如艾森巴赫和恩格所提出的全球定义那样。
