BACKGROUND
Globally, public healthcare is under increasing pressure, an economic burden currently amplified by the Covid-19 outbreak. With the recognition that Universal Health Coverage (UHC) improves the health of a population and reduces health inequalities, UHC has been acknowledged as a priority goal. To meet the global needs in a population with increased chronic illness and longer life expectancy, the healthcare system is in dire need of new, emerging technologies. New approaches to the delivery of e-health solutions have the potential to enhance quality of care and reduce health care costs. To guide us in the right direction to prioritize for sustainability, promising solutions are highlighted. If implemented sub-optimally the effectiveness of e-health can be compromised.
OBJECTIVE
This study aims to explore and thematically categorize early studies on e-health technologies that are under development or undergoing testing. Further, to assess enablers and barriers of e-health implementation.
METHODS
A structured search was performed in PubMed, Medline and Cochrane to identify and provide insight of current e-health technology and methodology under development. This review attempts to both highlight the future potential direction of e-health technologies and to present enablers and barriers of e-health implementation.
RESULTS
In total, 27 articles were included in this review and the clinical studies were categorized thematically by illness into the four technology types mobile apps/tablets & web-based technology, sensor technology, virtual reality and television. All e-health assessment and implementation studies were categorized by usability, scaling and data management. Assessment methods were divided into feasibility studies, qualitative studies and heuristic assessments. Studies focusing on usability (16/27) mainly addressed user involvement and learning curve issues, the majority of scaling studies (6/27) on strategical organization aspects of e-health. Studies focusing on data management (5/27) emphasized barriers to overcome in connection to unstructured data sets and data sensitivity. Data security and data processing, user involvement and feedback and transitioning from small- to largescale implementation were the most important factors considered critical for successful implementation of e-health.
CONCLUSIONS
E-health interventions have considerable potential to improve lifestyle changes and adherence to treatment recommendations. To be implemented and scaled, factors such as individualization, data management, user-friendliness and accessibility need to be addressed. E-health should be assessed during its development into health services. The wide variation in interventions and methodology makes comparison of the results challenging and calls for standardization of methods.